The study, led by Haiyan Xu, used an explanatory sequential mixed-methods design. In the first phase, 200 undergraduate questionnaires were distributed online; after screening out invalid responses, including reports of grade point averages exceeding the institution’s maximum, 120 valid questionnaires remained. The respondents were 86 men and 34 women aged 19 to 24, drawn from second-, third-, and fourth-year cohorts across multiple majors. Academic achievement was measured using cumulative GPA on the university’s five-point scale, which ranged from 1.89 to 4.05 with a mean of 3.13. Self-regulated learning was assessed with a Chinese adaptation of the Self-Regulation of Learning Self-Report Scale, covering six dimensions: planning, self-monitoring, effort, self-efficacy, evaluation, and reflection.

The quantitative results showed a consistent positive relationship between self-regulated learning and achievement. Overall SRL correlated with GPA at r = .52, and every individual dimension correlated significantly, with coefficients ranging from .29 for self-efficacy to .40 for effort. In a multiple linear regression, the six dimensions together explained 29.3 percent of the variance in GPA. But when the shared variance among the dimensions was accounted for, only two predictors remained statistically significant: effort (β = 0.282) and planning (β = 0.227). Monitoring, evaluation, reflection, and self-efficacy showed negligible unique effects once the other dimensions were controlled. Students classified as experiencing academic difficulty — those in the lowest 27 percent of the GPA distribution — reported significantly lower SRL than their peers across all six dimensions.

The second phase of the study dug into what those numbers actually mean in students’ daily lives. From the 32 students in the lowest GPA band, 21 of whom had documented course failures, the researcher purposively selected ten students who had failed courses in three consecutive semesters. All ten were male, comprising six second-year and four third-year students; none of the six female students in the lower-GPA group met the three-semester criterion. Each participated in a 30-to-40-minute semi-structured interview conducted in Chinese, organized around the six SRL dimensions and Zimmerman’s cyclical model of forethought, performance, and self-reflection. Interviews continued until thematic saturation was reached.

Four interrelated themes emerged. The first was reactive and examination-oriented regulation. Rather than planning deliberately across a semester, most participants described studying as something triggered by imminent exams. One student explained that he usually did not start reviewing until shortly before finals, and because so many subjects competed for attention, he often could not cover everything and failed courses as a result. Effort followed the same compressed rhythm: concentrated study occurred only in the days before exams, while problems encountered earlier were postponed. As unresolved questions accumulated, frustration and anxiety intensified, sometimes culminating in outright avoidance. One participant described reaching for his phone when he could not follow a lecture, watching undone questions pile up, feeling increasingly anxious, and eventually stopping studying altogether.

The second theme was superficial monitoring, evaluation, and reflection. Students showed some awareness of their emotional states and attention problems, but this awareness rarely translated into corrective action. Instead, they relied on external indicators such as teacher feedback and exam results, and several equated completing exercises with genuinely understanding the material — an illusion of understanding that collapsed at examination time. Evaluation focused on surface indicators like memorized problem-solving steps rather than conceptual grasp. Reflection, when it occurred, often took a maladaptive form: students attributed poor performance to stable, internal causes such as lack of ability rather than to controllable factors like ineffective strategies. One student said that even when he worked hard he still did worse than classmates, so it felt as though ability, not effort, made the difference — an interpretation that closed off the possibility of adjusting his approach.

The third theme was fragile, support-contingent self-efficacy. Only a few participants expressed confidence in their ability to complete academic tasks, and even that confidence depended on external conditions such as available teacher or peer support or sufficient preparation time. Most reported persistent self-doubt and fear of failure that led to disengagement rather than increased effort. Some described difficulties with self-control and concentration that further eroded their belief in independent learning. In the starkest example, one student admitted he skipped an exam because he was convinced he would fail it anyway. Success temporarily lifted confidence, but repeated failure quickly drained it, making self-efficacy fluctuate with short-term performance rather than function as a stable motivational resource.

The fourth theme concerned context. Teacher-related experiences shaped students’ willingness to engage in both directions: competent, engaging instructors fostered effort and sometimes produced acceptable grades despite ongoing difficulties, while negative experiences, some rooted in secondary school, triggered fear and avoidance that disrupted attention in class. One student said he had been afraid of mathematics since high school and could not really listen during university lectures. Family support was similarly inconsistent with students’ needs. Some participants found that family members did not understand their struggles, making them reluctant to communicate about them, while others described family expectations as unrealistic or mismatched with their actual academic situation.

Integrating both strands of evidence, the study argues that planning and effort play an ambivalent role. Statistically, they were the strongest predictors of GPA, consistent with prior meta-analytic findings. Qualitatively, however, struggling students did not lack planning or effort altogether — they enacted them in reactive, exam-driven ways characterized by last-minute cramming and a focus on short-term performance rather than deep understanding. Planning and effort appear to contribute to learning only when accompanied by continuous monitoring, adaptive reflection, and strategic adjustment; when those complementary processes are weak, they may sustain short-term examination performance while contributing little to long-term learning. The author links this pattern to resource-based accounts, in which immediate exam demands consume limited cognitive resources and crowd out proactive regulation, and to value-oriented perspectives, in which performance-focused goals direct regulatory effort toward passing tests rather than building competence.

The study’s limitations are substantial and worth keeping in view. The quantitative data were self-reported at a single institution with a modest sample, the cross-sectional design precludes causal inference, and demographic covariates were not controlled. The 27 percent cutoff for the academic-difficulty group was statistically derived and validated against course-failure records rather than a formal institutional criterion. The translated questionnaire lacked formal back-translation and factor-structure validation, and the self-monitoring subscale showed internal consistency below the conventional 0.70 threshold, so estimates involving it should be interpreted cautiously. The qualitative subsample was small, entirely male, and all coding was performed by a single researcher without independent co-coding or member checking. Within those constraints, the practical implication is clear: support for struggling students should move beyond urging greater effort or teaching isolated strategies, and instead help them build coherent regulatory processes — continuous monitoring, adaptive reflection, emotional regulation, and resilient self-efficacy — within learning environments that gradually cultivate genuine autonomy.

Subject of Research: Self-regulated learning and academic difficulty among undergraduates at a non-elite Chinese university

Article Title: Understanding academic difficulty through self-regulated learning at a non-elite Chinese university

Article References: Xu, H. (2026). Understanding academic difficulty through self-regulated learning at a non-elite Chinese university. Discover Education, 5(1), Article 1208. https://doi.org/10.1007/s44217-026-02346-4

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02346-4

Keywords: self-regulated learning, academic difficulty, higher education, Chinese universities, GPA, mixed methods, metacognition, self-efficacy, planning, effort regulation, regulatory distortion, examination-oriented learning

Methodologically, the study is a scholarly reflective analysis rather than an empirical evaluation. Terefe applied Schön’s theory of reflection-on-action, in which practitioners retrospectively examine their own decisions to surface the tacit assumptions embedded in professional practice, and organized the account around Kern’s Six-Step Approach to curriculum development, a framework that moves from problem identification and general needs assessment through targeted needs assessment, goals and objectives, educational strategies, and implementation, to evaluation and feedback. The reflection proceeded in three stages: a chronological reconstruction of the programs’ development, the identification of critical incidents in which decisions had to be made under evident tension, and the interpretation of those incidents through the combined theoretical lens. Because patterns that recurred across more than one program were judged more likely to reflect structural features of the institutional environment than idiosyncrasies of a single program, the cross-program comparison became the analytical core of the work.

The evidence base combined the author’s professional experience with an extensive documentary record. Curriculum and program proposal documents submitted to the Nursing Council of Kenya and the Commission for University Education, correspondence and feedback from the WASC Senior College and University Commission, internal program-costing and budget documentation, minutes of curriculum committee meetings and stakeholder consultations, and the author’s contemporaneous notes were all used to triangulate recollection against verifiable material. The author explicitly acknowledges the risk of a self-justifying narrative inherent in being both the developer of the curricula and the analyst of that development, and addressed it by checking specific claims against the documentary record and by deliberately foregrounding unresolved tensions and only partially successful strategies rather than presenting a uniformly positive account. No human participants or patient data were involved, so formal ethics review was not required.

The curricular innovations themselves form the most striking part of the account. The nursing degree embedded a global health orientation as a core component, exposing students to diverse healthcare systems, cross-cultural competencies, and international health challenges, complemented by global study tours offering experiential learning in healthcare environments beyond students’ immediate settings. The clinical pharmacology master’s program integrated computational pharmacology and toxicology, introducing in silico modeling and data-driven approaches to drug development and safety evaluation, alongside pharmacogenomics, which addresses genetic variability in drug response and is a cornerstone of precision medicine, and pharmacometrics, which equips students with quantitative tools for optimizing drug dosing. A structured clinical attachment bridged pharmacological theory and patient care in a discipline traditionally taught as laboratory science.

Perhaps the most transformative reorientation described is in the pharmacognosy and complementary medicine program, which shifted from a laboratory-based, product-focused discipline to a clinically integrated, patient-centered framework. Students gained competencies in health assessment and clinical services, undertook hospital attachments providing direct exposure to patient care, and studied evidence-based complementary and alternative medicine within therapeutic decision-making. The author notes that this reorientation can be read as anticipating the direction of the WHO Global Traditional Medicine Strategy 2025-2034, which encourages member states to develop evidence-based regulatory pathways for integrating traditional and complementary medicine into mainstream health systems rather than regulating them as an entirely separate domain.

Stakeholder engagement emerged as central to the programs’ legitimacy. The curriculum team convened dedicated consultative workshops with distinct groups for each program: practising clinicians and nurse leaders for nursing, hospital-based pharmacists and clinical pharmacologists for clinical pharmacology, and traditional and complementary medicine practitioners together with hospital pharmacognosy units for the pharmacognosy program. These sessions validated proposed competency domains against workforce expectations and surfaced gaps invisible from a purely academic vantage point. Regulatory engagement took the form of iterative, informal pre-submission consultation with the Nursing Council of Kenya and the Commission for University Education, allowing concerns to be resolved before they became formal conditions of accreditation. Feedback was incorporated iteratively: competency lists were revised after clinician workshops, clinical attachment structures adjusted to hospital partner capacity, and course sequencing corrected where academic reviewers identified prerequisite gaps.

Yet the analysis identifies four persistent structural challenges. Regulatory rigidity, particularly prescribed curricular structures from the Nursing Council of Kenya, constrained how far global health content could be embedded without extensive justification. Program costing models penalized specialized postgraduate programs with small initial cohorts, since conventional financial evaluations prioritized short-term enrollment and revenue over scientific or workforce merit, placing the viability of the pharmacology and pharmacognosy master’s programs repeatedly in question. Academic incentive systems undervalued curriculum development relative to research output, contributing to faculty fatigue across three programs developed in close succession. And reconciling divergent stakeholder expectations, notably industry partners favoring earlier clinical exposure against academic reviewers favoring stronger foundational grounding, required repeated renegotiation rather than a single resolution.

The strategies adopted in response met with mixed success. Iterative pre-submission consultation with regulators reduced, though did not eliminate, downstream delay. Resource-intensive components, particularly for the pharmacognosy program, were phased into implementation in stages to manage financial risk, an approach that drew directly on financial risk encountered earlier in developing the clinical pharmacology program. Stakeholder consultation was deliberately sequenced, with academic and clinical reviewers consulted iteratively rather than simultaneously. The misalignment between academic incentives and curriculum development effort was raised internally but not resolved, and the author identifies it as an unresolved structural issue: because curriculum work is collaborative, long-term, and poorly captured by conventional academic metrics, faculty who invest heavily in it often face increased workload without commensurate recognition, which in turn limits institutional capacity for sustained innovation.

The study’s limitations are stated plainly. It draws on a single institution and a single author, so its lessons are analytically generalizable and transferable rather than statistically generalizable. The retrospective, memory-based reconstruction was mitigated but not eliminated by triangulation against documents, and the author’s dual positionality introduces a residual risk that challenges are recalled as more fully resolved than they were. Crucially, no independent outcome data such as student performance, graduate employment, or employer satisfaction are presented to substantiate claims about program impact; the author flags such empirical evaluation as an important direction for future research.

The transferable lessons, the paper argues, lie in process rather than content. Curriculum innovation in this setting is best pursued as a negotiated, iterative process rather than a single design-and-approve event; early, structured regulator engagement reduces delay more reliably than post-submission negotiation; and financial evaluation frameworks require deliberate modification for specialized postgraduate programs, which will otherwise be structurally disadvantaged regardless of their academic or workforce case. The author recommends that comparable institutions embed pre-submission regulatory consultation as standard practice, that national regulators and international bodies consider explicit guidance on flexible regulatory pathways for interdisciplinary and emerging competency areas, and that universities formally recognize curriculum development as scholarly work in their incentive frameworks. Without such recognition, the paper concludes, reflective scholarship on curriculum development is likely to remain rare, precisely because the faculty best placed to produce it are not incentivized to do so, leaving the practical knowledge that determines whether well-designed curricula are actually implementable largely undocumented.

Subject of Research: Reflective analysis of health sciences curriculum development and innovation at a Kenyan university

Article Title: Reflective analysis of health sciences curriculum innovation at a Kenyan University

Article References: Terefe, E. M. (2026). Reflective analysis of health sciences curriculum innovation at a Kenyan University. Discover Education, 5(1), Article 1213. https://doi.org/10.1007/s44217-026-02287-y

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02287-y

Keywords: curriculum development, health sciences education, Kenya, nursing education, clinical pharmacology, pharmacognosy, accreditation, stakeholder engagement, low- and middle-income countries, reflective practice, Kern's Six-Step Approach, regulatory frameworks

Deaf people experience well-documented healthcare inequities, and the study's authors note that limited deaf insights and specialist communication skills training in medical education contributes to these disparities. Evidence suggests that training in deaf insights and exposure to deaf culture and communication styles can improve students' communication skills and understanding of deaf culture, yet such content remains uncommon in undergraduate medical curricula. The Imperial team set out to design and evaluate a course that could be embedded within an existing programme as a student-selected component, with deaf expertise built into both its planning and its delivery.

To evaluate the course, the researchers used an interpretivist qualitative approach combining a dyadic interview with an online survey, analysing the data thematically with transformative learning theory as a sensitising lens. Students reported gaining a new understanding of deaf culture alongside a recognition of the healthcare barriers and inequities faced by deaf people. They also described a perceived increase in their confidence in communicating with deaf people.

In the researchers' analysis, this learning appeared to have been facilitated by the co-design of the course, its co-delivery, and the opportunity for students to interact directly with deaf trainers and advocates rather than learning about deaf experiences second-hand. A notable pattern in the findings was what students intended to do with their new understanding. Participants reflected on their learning during group discussions and described intentions to act on these insights by changing their own practice and by educating others, with many hoping to act as advocates for deaf people in their future careers.

The significance of the delivery model runs through the findings. Because the component was co-created with a deaf trainer and advocate, students encountered deaf expertise and lived experience directly rather than through second-hand accounts, and the researchers link this direct interaction to the learning students described. The course was also deliberately structured as a student-selected component, meaning it could sit within an existing undergraduate programme without requiring wholesale curriculum redesign, an arrangement the authors suggest may be practical for other institutions considering similar training.

Because this was a qualitative study of self-reported experiences and perceptions across a single institution's cohorts, the findings describe what students said they learned and how they said they changed, rather than measuring objective changes in clinical behaviour or patient outcomes. The study captured the perspectives of the forty students who completed the component across the three cohorts, and the authors frame their conclusions in terms of the features observed in students' accounts rather than as demonstrated effects on practice. The study's conclusion is deliberately scoped to what the data can support: co-creation and co-delivery of a deaf insights and British Sign Language component with deaf trainers and advocates shows features consistent with the initial stages of transformative learning occurring in undergraduate medical students.

The authors suggest that their approach and findings may be of interest to other institutions developing similar training, and that wider adoption of this model could help improve students' confidence and their understanding of how to meet the needs of deaf people. They add that such improvements may, in turn, contribute to improving health equity for deaf individuals, positioning deaf-led curriculum design as a practical route for embedding deaf awareness into mainstream medical education rather than leaving it to the initiative of individual students. For medical schools weighing how to address communication skills training, the Imperial evaluation offers a worked example of what a small, co-delivered component can look like in practice, and of the kinds of learning students reported when deaf trainers and advocates led the teaching themselves.

Subject of Research: Evaluation of undergraduate medical students’ experiences, perceptions and learning from a deaf insights and British Sign Language course: a qualitative study

Article Title: Evaluation of undergraduate medical students’ experiences, perceptions and learning from a deaf insights and British Sign Language course: a qualitative study

Article References: Scott, K., Neve, G., Wilcock, N., & Powell, S. (2026). Evaluation of undergraduate medical students’ experiences, perceptions and learning from a deaf insights and British Sign Language course: a qualitative study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10639-3

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10639-3

Keywords: Evaluation, undergraduate, medical, students, experiences, perceptions, learning, deaf, insights, British, Sign, Language

The study was conducted by Mayez Almayez and drew on written responses from 62 English language instructors working in Saudi higher education institutions. Participants were purposively selected to capture a wide range of teaching experience, academic qualifications, ranks, and institutional affiliations. They came from 26 national backgrounds, spanning Arabic-speaking countries as well as South and East Asia, Europe, North America, Australia, and South Africa. Nearly 97 percent worked at public universities, a balance the author acknowledges as a limitation because private institutions were barely represented. The sample was almost evenly split by gender, with 51.6 percent holding master’s degrees and 48.4 percent holding doctorates. Teaching experience ranged from fewer than ten years to more than twenty, and academic ranks included lecturers, language instructors, assistant professors, and associate professors.

Data were collected through an open-ended questionnaire during the second academic term of the 2024–2025 academic year, following ethics approval from the University of Ha’il. The methodological design was deliberately exploratory. After expert review by five academics in applied linguistics and qualitative research trimmed an initial pool of eleven questions down to six, the instrument was pilot-tested with 13 English language teachers at Saudi universities who were excluded from the main study. The final prompts asked teachers why they adapted the mandated curriculum, how they enacted those adaptations, and what effects they perceived on student learning, classroom interaction, and their own professional identity. Responses were analyzed using an inductive codebook thematic analysis supported by MAXQDA software, with coding performed manually rather than automatically.

Two coders working independently achieved 83 percent overall agreement, with a Cohen’s kappa of 0.74, indicating substantial reliability in how the qualitative data were categorized. The analysis was theoretically informed by scholarship on teacher agency, which the author defines through Tao and Gao’s conceptualization as teachers’ capacity to make intentional, context-sensitive instructional decisions informed by professional experience, values, and institutional conditions. Within this framework, agency is understood relationally rather than as unrestricted individual autonomy: teachers’ capacity to act is shaped by the institutional structures, curricular requirements, and classroom conditions within which their decisions are made. The study also draws on Kayi-Aydar’s argument that language teacher agency is constructed through teachers’ ongoing negotiation of institutional expectations, professional identities, and classroom realities, rather than being a fixed individual characteristic.

The Saudi context gives this negotiation particular weight. Unlike many other countries, the Ministry of Education oversees every aspect of language education, from textbook selection and pacing guides to assessment standards, leaving little formal room for teacher involvement in curriculum decision-making. The author notes that broader English language teaching reform in Saudi Arabia, tied to the national Vision 2030 agenda, has been driven primarily by top-down socio-political priorities with limited emphasis on grassroots pedagogical reform or teacher empowerment. Prior research cited in the study has documented that the national curriculum privileges a fixed model of English, prioritizes grammatical accuracy and vocabulary acquisition over spoken fluency and communication strategies, and offers limited intercultural engagement, while teachers are rarely consulted in curriculum development or revision processes.

The thematic analysis converged on a central finding: teachers adapt the curriculum frequently, and they do so for reasons rooted in pedagogy rather than preference. Participants described textbook materials as linguistically complex, culturally misaligned, or pragmatically inauthentic, and as frequently out of step with students’ actual proficiency. One Saudi language instructor characterized the curriculum as “inappropriate and inapplicable,” noting that “the general level of foreign language acquisition and comprehension among students is poor” and that some topics were “repetitive and clichéd.” A Nepali lecturer with more than two decades of experience observed that there were materials his students did not find relevant, that were far removed from their context, and that sat beyond their levels. Participants also cited structural constraints, including large class sizes, mixed-ability classrooms, inflexible pacing schedules, and inconsistent access to digital tools and instructional resources.

The concrete strategies teachers described reveal the technical craft behind these adaptations. An American lecturer explained that the reading texts in her textbook were too complex, with long sentences and advanced vocabulary, so she spent considerable time rewriting paragraphs, breaking down sentences, and replacing difficult words with simpler synonyms. “It’s time-consuming, but my students can actually understand the core meaning,” she said. An Indonesian teacher described reversing the textbook’s assumed writing sequence, which expected students to produce paragraphs before learning sentence structure. “I reverse it: start with subject-verb agreement, then expand to compound sentences, and finally paragraphs,” he explained, comparing the process to building a house where bricks are needed before the roof. A Tunisian lecturer reported creating several scaffolded activities from a single prescribed work task, and an Australian instructor described replacing textbook gap-fills with short conversation-based tasks using grammar structures in contexts students care about.

Notably, teachers did not frame these decisions as opposition. A South African lecturer insisted, “I wouldn’t say I deviate, but I do add in additional exercises, worksheets and tests to ensure the students are able to fully understand the material.” Others described adapting content for students with learning disabilities or introducing photos to help visual learners understand while challenging them into critical thinking. This variation in how teachers understood their own practices suggests that curriculum adaptation operated along a continuum, ranging from substantial restructuring to cautious supplementation within existing curricular boundaries. For some participants, agency was exercised through selective additions rather than departure from the prescribed content, indicating that adaptation was not enacted uniformly but varied in degree according to how teachers balanced learner needs with adherence to institutional expectations.

The justifications teachers offered were grounded in professional reasoning about learners rather than institutional politics. An Indian language instructor explained that she provided reading articles from outside sources to support a unit theme, doing it “for the needs of my learners.” A Moroccan language instructor put his internal logic plainly: “if students are disengaged or confused, I know I have to shift the method.” A Sudanese assistant professor noted that administrators understood changes that were purposeful and student-focused. Many teachers also cited their instructional beliefs, with an Indian associate professor describing how her conviction that language is primarily a tool for communication pushed her toward communicative, task-based, and authentic approaches even when the curriculum leaned toward grammar-translation methods. A Latvian lecturer said the curriculum was very prescriptive, telling teachers and students exactly what to say and do, and that she adapted by providing students with choices and autonomy. The author interprets these patterns through Prenger and colleagues’ prior concept of strategic compliance, in which instructors preserve instructional autonomy without directly confronting institutional norms.

Teachers reported that these adaptations produced benefits for their students, though the study is careful to flag that these outcomes are teacher perceptions rather than independently measured changes in learning. Participants described improved comprehension, greater task completion, and increased classroom participation when content was aligned with learners’ actual levels. A Jordanian language instructor affirmed that curricular adaptations made students more motivated, improved their learning by meeting their needs, and created a more engaging and interactive classroom environment. Others reported affective gains, including reduced anxiety about English and greater willingness to take communicative risks. A Canadian lecturer observed that when content is relevant and paced properly, students stop fearing failure and begin taking risks. A Saudi associate professor noted that adaptations build students’ trust in the learning process and show them that teachers are listening, giving them confidence in themselves as well.

Participants also described how adaptation shaped their professional identity. A Sudanese assistant professor wrote that these experiences made her more confident, more autonomous, and more reflective in her teaching. A South African language instructor said it made her feel more like a teacher and not just a machine, while a Tunisian lecturer reflected that it made her feel like she was actually teaching rather than just delivering what someone else wrote. A Pakistani lecturer said adapting the curriculum validated her professional judgment. No contrasting accounts of diminished professional confidence were evident in the responses, though the author cautions this absence should not be interpreted as evidence that such experiences do not occur beyond the dataset. No classroom observations, student accounts, or assessment data were collected to corroborate the reported effects, and the questionnaire format did not allow the researcher to probe answers or investigate contradictions as they arose.

Within the study’s scope, the author draws practical implications for the Saudi context. The findings suggest curriculum reform processes should incorporate teachers’ experiential knowledge, with structured channels for instructors to provide feedback, particularly for those teaching preparatory or mixed-proficiency classes. Institutions are encouraged to offer greater flexibility in pacing expectations, provide differentiated guidelines for diverse teaching contexts, and design in-service training that equips teachers to navigate constraints through pedagogically sound adaptation. The author also argues that institutional discourse should shift toward valuing context-sensitive decision-making as a professional competency, with reflection on adaptive practices incorporated into performance reviews and professional learning communities. Prior research in other centralised systems, including Vietnam and Iran, has documented similar patterns of teachers negotiating tensions between policy mandates and classroom realities through localised instructional adjustments, and the Saudi findings add empirical detail on the professional reasoning underlying such practices in higher education.

Subject of Research: Teacher agency and curriculum adaptation in policy negotiation among English language teachers in Saudi higher education

Article Title: Teacher agency and curriculum adaptation in policy negotiation among English language teachers in Saudi higher education

Article References: Almayez, M. (2026). Teacher agency and curriculum adaptation in policy negotiation among English language teachers in Saudi higher education. Discover Education, 5(1), Article 1209. https://doi.org/10.1007/s44217-026-02336-6

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02336-6

Keywords: Teacher, agency, curriculum, adaptation, policy, negotiation, English, language, teachers, Saudi, higher, education

Sixty-six students completed six OSCE stations. Their performances were assessed using both analytical and global rubrics by faculty graders from various departments, who evaluated the students either in person or remotely. The researchers then conducted statistical analysis using linear mixed-effects models to evaluate the effects of grader background, grading method, and exam timing on student scores.

Two of the three factors mattered. Grader background had a significant impact on scores: faculty from Pharmacy Practice departments tended to award lower scores than graders from other departments. Grading method also had a significant effect, with remote graders tending to give lower scores than those who evaluated students in person. Exam timing, by contrast, showed no significant effect on student scores in this dataset.

The authors interpret the modality finding cautiously but meaningfully: asynchronous remote grading was associated with lower OSCE scores than live grading, suggesting that grading modality may meaningfully influence scoring patterns rather than merely reflecting differences in student ability. Combined with the observed differences tied to evaluator background, the results point to a practical implication for assessment design. The study concludes that these findings support the need for targeted rater calibration and standardized scoring practices to promote fair and reliable OSCE assessment in pharmacy education.

Subject of Research: Effects of grader type, grading modality, and exam timing on OSCE scores in pharmacy education

Article Title: Evaluating OSCE workflow designs: impacts of grader type, modality, and exam timing

Article References: Bach, A., & Beuttler, R. (2026). Evaluating OSCE workflow designs: impacts of grader type, modality, and exam timing. BMC Medical Education. https://doi.org/10.1186/s12909-026-10660-6

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10660-6

Keywords: OSCE, pharmacy education, assessment, grading modality, rater calibration, BMC Medical Education, clinical examination, grader background, remote grading, exam timing, Evaluating, workflow

The review, conducted using PRISMA procedures and synthesising literature published between 2023 and 2026, examined how pre-service teachers and related participant groups use generative AI tools such as ChatGPT in lesson design. The authors searched Scopus and ScienceDirect with an open-access criterion, screened records against empirical eligibility, and extracted data on the AI tool used, the instructional design focus, participant experiences, and key findings. Only two studies met the strict criterion that computational thinking be explicitly named and embedded in the design task, intervention, or reported analysis.

This uneven evidence base shapes the review’s central conclusion. The authors treat the fifteen implicitly aligned studies as contextual evidence rather than direct proof of computational thinking instructional design, and the nine studies without identifiable integration as broader background on generative AI in lesson planning. Stronger claims can be made about how generative AI supports general lesson planning; claims about computational thinking-specific design remain anchored in the small explicit subset.

Within that subset, generative AI appears useful as a scaffold between abstract concepts and classroom practice. Pre-service teachers used it to generate initial ideas for computational thinking integration, refine those ideas for real classroom conditions, and clarify conceptual links that might otherwise be equated narrowly with programming. Structured prompting frameworks such as CRAFT and the 6E Learning by Design model further operationalised this support by staging prompt construction, reflection, and design activity.

Across the broader literature, generative AI was most often positioned as a conditional pedagogical scaffold grounded in TPACK and Intelligent-TPACK perspectives. These frameworks emphasise that effective technology use depends on integration with pedagogy and content rather than on the tool alone. Applied to generative AI, the scaffold is conditional: the system may supply ideas, structure, examples, or feedback, while the teacher supplies goals, subject knowledge, contextual judgment, ethical evaluation, and final pedagogical decisions.

Several studies reported gains or positive experiences related to efficiency, confidence, engagement, creativity, or instructional design competence. The review cautions that these constructs were measured in heterogeneous ways across primary studies and should not be generalised as improvements in computational thinking teaching ability. Increased interaction, more prompts, or greater confidence are not treated as direct evidence of improved cognitive ability unless a study used an outcome measure designed to assess that construct.

Time savings emerged as one of the most frequently reported affordances, but the evidence reveals an efficiency paradox. Time saved during initial generation can be offset by the time required to verify information, correct errors, contextualise generic output, or refine prompts repeatedly. Efficiency therefore depends on both the quality of the AI output and the user’s capacity to diagnose what needs revision, reinforcing the need to evaluate it as part of a complete design process rather than by the speed of initial content generation.

Accuracy and ethics concerns recur throughout the included studies. Participants reported inaccurate, generic, inconsistent, or contextually inappropriate outputs, and in the computational thinking-explicit evidence, AI-generated responses sometimes blurred or misrepresented concepts, reinforcing the need for conceptual verification before instructional use. Ethical issues included academic integrity, plagiarism, professional responsibility, bias, and insufficient responsiveness to classroom context. Studies also documented risks of uncritical acceptance, overreliance, and what researchers describe as metacognitive laziness, a pattern especially consequential in teacher education because instructional design is itself a professional learning task.

More productive use of generative AI was consistently linked to human foundations: AI literacy, pedagogical and subject-matter knowledge, structured frameworks, iterative prompting, and critical evaluation. Users with stronger knowledge engaged more critically with outputs, while those with weaker foundations were more likely to accept content at face value. These associations do not establish that iterative prompting causes higher cognitive ability; rather, they show that existing competence shapes how effectively a learner uses the technology and detects limitations in generated content.

The review acknowledges important limitations. The search was restricted to Scopus and ScienceDirect with an open-access criterion, potentially omitting studies indexed in ERIC, Web of Science, ACM Digital Library, IEEE Xplore, and other sources, and creating accessibility bias. Reproducibility was constrained by gaps in the retained review record, including exact search dates, per-query counts, and study-level appraisal scores. The authors conclude that generative AI is better positioned as a provisional pedagogical scaffold than as a reliable autonomous partner, and they call for classroom- and practicum-based studies that explicitly define computational thinking integration, use validated assessment tools, and examine whether observed benefits persist beyond immediate AI-assisted tasks.

Subject of Research: Systematic review of generative AI in instructional design finds only preliminary direct evidence for computational thinking teaching support

Article Title: A systematic literature review of generative AI support for pre-service teachers in designing computational thinking instruction

Article References: Farah, H. L., & Budiyanto, C. W. (2026). A systematic literature review of generative AI support for pre-service teachers in designing computational thinking instruction. Discover Education, 5(1), Article 1210. https://doi.org/10.1007/s44217-026-02322-y

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02322-y

Keywords: generative AI, computational thinking, instructional design, pre-service teachers, systematic review, teacher education, systematic, literature, review, generative, support, pre-service

Awareness of mouthguard use as a preventive measure was the study’s brightest spot. Students rated their understanding of this primary prevention strategy highly, with a mean score of 4.31 out of 5, and this awareness increased significantly with the year of study (p = 0.0002). In other words, the longer students progressed through medical school, the better they recognized that mouthguards can help prevent dental injuries in the first place. The authors note that sport-related injuries remain a significant challenge in sports medicine, making this preventive awareness a relevant competency for future physicians who may encounter athletes at every level of competition.

Practical performance, however, told a very different story. When students were tested on the emergency management of an avulsed permanent tooth, only 17.9 percent of fourth-year students answered the practical questions correctly. The figures for fifth- and sixth-year students were barely better, at 25.3 percent and 25.0 percent respectively. Even as students approached graduation, roughly three-quarters of them failed the practical assessment items. The authors conclude that medical students demonstrated limited preparedness for the emergency management of permanent tooth avulsion, particularly regarding secondary prevention and the practical application of their knowledge.

Perhaps the most technically intriguing finding concerns the relationship between theoretical knowledge and practical skills. The association between the two was negligible and not statistically significant, meaning that knowing the theory did not predict performing the procedure. This dissociation matters because permanent tooth avulsion is an injury where emergency management decisions unfold in minutes, and the study’s findings suggest that medical students require enhanced education on the emergency management of permanent tooth avulsion, particularly in the practical application of their knowledge. A student who can recite the principles may still falter when asked to apply them.

The authors propose that simulation-based and scenario-driven methods may serve as effective educational strategies for closing this gap, although they are careful to state that the efficacy of such approaches requires assessment in future interventional studies. The current research was a cross-sectional survey using a validated questionnaire, so it captures a snapshot of student preparedness rather than testing whether any particular training intervention works. The study population consisted of medical students, and the questionnaire assessed primary prevention, theoretical knowledge, and practical skills, but the findings do not establish how practicing physicians would perform on the same measures.

As an early-view, peer-reviewed and accepted article carrying a permanent DOI, the study is citable now, though the version is subject to further edits before the final Version of Record replaces it. Within those constraints, the message is clear: mouthguard awareness among future physicians is high and rising, but the hands-on emergency skills for managing avulsed permanent teeth in sport-related settings remain limited, and the field now needs interventional research to determine whether simulation and scenario-based education can convert theoretical knowledge into reliable practical performance.

Subject of Research: Medical students' knowledge and preparedness for sport-related permanent tooth avulsion

Article Title: Sport-related permanent tooth avulsion as an underrecognized injury: knowledge and preparedness of medical students

Article References: Jastrzębski, B., Kamieńska, P., Kamieńska, W., Marushko, O., Marushko, O., & Pawlaczyk-Kamieńska, T. (2026). Sport-related permanent tooth avulsion as an underrecognized injury: knowledge and preparedness of medical students. BMC Medical Education. https://doi.org/10.1186/s12909-026-10628-6

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10628-6

Keywords: dental trauma, tooth avulsion, sports medicine, medical education, mouthguards, cross-sectional survey, practical skills, simulation-based learning, BMC Medical Education, emergency management, Sport-related, permanent

The analysis identified three themes describing age- and gender-based inequalities in access to care. The first, described as moving from surveillance to neglect, concerns age-stratified gatekeeping and delayed diagnosis. The second, termed sacrificial femininity and internalized ageism, captures how women absorb and reproduce devaluing beliefs about their own worth. The third frames mastectomy as an age-stratified embodied threat, with the surgery’s meaning and consequences differing sharply across life stages.

A central finding concerns the role of men as financial and moral gatekeepers. Participants described how male family members controlled decisions about seeking care, limiting women’s access to health services. This control was reported to be especially pronounced for young married women, who were regarded within their families as reproductive assets, a framing that shaped whether and when their symptoms were taken seriously.

Older women in the study experienced a different pattern of disadvantage. Rather than facing overt restriction, they reported internalized ageism, viewing their own bodies as less worthy of care. This self-directed devaluation represents a distinct mechanism through which age and gender combine to postpone or prevent treatment-seeking among women in later life.

Notably, participants reported no age-based discrimination from healthcare providers themselves. Instead, their accounts pointed to pre-clinical family and community contexts as the decisive arenas where gendered ageism operates, determining who is permitted to seek care and at what point in the illness course. The study concludes that the most critical barriers to timely breast cancer treatment are not biomedical but social, cultural, and age-gendered, produced within households and social structures before patients ever reach the health system.

Subject of Research: Gendered ageism and access to mastectomy care in Pakistan

Article Title: Gendered ageism among women undergoing mastectomy across two life stages: early adulthood and later life in Pakistan

Article References: Zahra, T. (2026). Gendered ageism among women undergoing mastectomy across two life stages: early adulthood and later life in Pakistan. International Journal for Equity in Health, 25(1), Article 254. https://doi.org/10.1186/s12939-026-03082-9

Image Credits: AI Generated

DOI: 10.1186/s12939-026-03082-9

Keywords: gendered ageism, mastectomy, breast cancer, Pakistan, qualitative research, critical phenomenology, healthcare access, gatekeeping, internalized ageism, health equity, Gendered, ageism

The study, led by Neda Naqdi Babaee, adopted a nonrandomized pretest-posttest design. Twenty-five learners received ChatGPT-generated feedback while 21 received teacher-written comments from the same instructor, who taught both groups within an identical instructional sequence. Across two complete feedback-revision cycles, students in each condition wrote argumentative and expository paragraphs of roughly 200 words and revised them after receiving comments. Writing was scored by two trained raters, blind to condition and testing phase, using adapted IELTS-based analytic descriptors covering task achievement, coherence and cohesion, lexical resource, and grammatical accuracy, with the four domain scores averaged into an overall composite.

The headline result was clear-cut. After adjusting posttest scores for corresponding pretest performance, the ChatGPT condition showed a robust advantage in overall writing, F(1, 43) = 16.86, p < .001, with a partial eta squared of 0.282. None of the baseline differences between groups was statistically significant, and tests confirmed that the relationship between pretest and posttest scores was comparable across conditions, supporting the validity of the adjustment approach.

The domain-level results demanded more caution. Unadjusted tests favored the ChatGPT condition for task achievement, coherence and cohesion, and lexical resource, but not for grammatical accuracy. Because five related outcomes were examined, the researchers applied a Holm adjustment across the four domain tests as a familywise sensitivity analysis. Only task achievement survived this correction, with an adjusted p value of .031. Lexical resource, at an adjusted p of .057, and coherence and cohesion, at .081, fell just above the threshold and were interpreted as suggestive rather than confirmatory. Robustness checks told a similar story: raw posttest comparisons, nonparametric tests, and Hedges g values ranging from 0.69 to 1.27 supported the ChatGPT advantage for several outcomes, but gain-score analyses reached the conventional significance boundary only for overall writing.

Perhaps the most practically important null finding concerned grammar. Both conditions directed attention to grammatical accuracy, and both groups improved descriptively over the four weeks, yet neither the adjusted models nor any of the sensitivity analyses detected a reliable difference between them. The authors suggest that short interventions may be insufficient to distinguish grammatical development, which typically requires repeated practice and sustained attention to recurring error patterns. The result, they stress, does not establish complementary roles for the two feedback sources; it indicates only that the implemented ChatGPT condition offered no clear grammatical advantage over teacher comments.

The qualitative strand of the study, based on open-ended post-intervention responses analyzed through reflexive thematic analysis, revealed two broad themes: actionable revision support, and trust, control, and feedback authority. Students in the ChatGPT condition repeatedly described the AI comments as immediate and elaborated. One learner explained that the feedback did not simply flag a weak paragraph but showed that an example was insufficient and suggested how to explain it more clearly, helping revise content rather than only grammar. Another said the most useful part was organization, because the system identified where connections between sentences were unclear, allowing new linking words or reordering of ideas — a shift, the student noted, from a previous habit of only checking grammar.

Vocabulary emerged as a particularly revealing area of learner experience. Students reported that ChatGPT offered alternatives for repeated or imprecise wording, expanding their options for academic expression, but they also emphasized the responsibility to judge appropriateness. One participant noted that some suggested words were too formal for their level and had to be checked against the intended sentence. This combination of availability and selection — a wider menu of choices paired with the learner’s own evaluative filtering — recurred throughout the accounts and is consistent with the favorable but statistically inconclusive lexical pattern in the quantitative results.

Trust worked differently across the two conditions. ChatGPT users valued speed and detail but did not treat the output as uniformly authoritative; several reported that suggestions sometimes altered their intended meaning or produced grammatical advice that made sense only in context, so they read carefully and rejected comments that distorted their ideas. Some linked immediacy to momentum, saying that instant access let them revise while their intended meaning was still fresh, and one student reported feeling more independent and confident. Teacher feedback recipients, by contrast, trusted comments because the instructor knew the course, the task, and the assessment expectations — but that authority could narrow revision. Several said they corrected only the parts the teacher marked and did not explore alternative versions, appreciating the prioritization while sometimes wanting more explanation or examples for content expansion and lexical refinement.

The authors are explicit that these findings concern implemented feedback conditions, not feedback source in isolation. The ChatGPT condition bundled AI generation with rapid access, extensive comments, and revision alternatives, while the teacher-written condition was more selective and contextually situated, so the estimated difference may reflect differences in amount, timing, specificity, and elaboration rather than the mere presence of AI. The study also cannot claim complementarity, because it included no combined ChatGPT-plus-teacher condition; a sequenced approach remains a pedagogical proposition for future testing rather than an empirical conclusion. Additional limitations include the nonrandomized allocation, the modest single-university sample, the four-week duration without a delayed posttest, and the fact that the qualitative strand captured perceptions rather than observed draft-to-draft uptake.

For educators navigating the rapid arrival of generative AI in language classrooms, the study offers a measured message. AI-generated feedback appears most useful when learners need elaborated options for task fulfillment, organization, or lexical revision, provided instruction requires them to evaluate suggestions against meaning and task criteria. The null grammatical result warns against assuming such tools can replace explicit grammar instruction or sustained corrective-feedback practice, and teacher feedback retains a distinct role in prioritizing problems and aligning revision with course goals. What the research most clearly demonstrates is not that ChatGPT is a superior teacher, but that the way feedback is delivered — how much, how fast, and how elaborated — may matter as much as who or what produces it.

Subject of Research: Comparing ChatGPT-generated and teacher-written feedback effects on EFL university students' writing development

Article Title: Comparing ChatGPT and teacher feedback for EFL writing development

Article References: Babaee, N. N. (2026). Comparing ChatGPT and teacher feedback for EFL writing development. Discover Education, 5(1), Article 1211. https://doi.org/10.1007/s44217-026-02329-5

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02329-5

Keywords: ChatGPT, generative AI, EFL writing, written corrective feedback, second language writing, teacher feedback, quasi-experimental study, ANCOVA, learner perceptions, task achievement, lexical resource, grammatical accuracy

The findings suggest that the choice between digital and physical simulation may depend on factors beyond immediate technical score, such as accessibility and specific learning objectives. The research involved novice medical students with no prior experience in arthroscopic procedures, who were randomly allocated into four distinct groups to ensure a rigorous comparison. The first group, designated IVR3, underwent three separate sessions of immersive virtual reality training.

The second group, IVR1, received a single session of IVR training. A third group utilized a non-anatomic physical arthroscopy simulator for one session, while the final group served as a control with no specific training. This design allowed the researchers to isolate the effects of training frequency and the type of simulator on skill acquisition, providing a structured framework for evaluating the impact of repeated exposure versus single-session practice.

During the training phase, specific metrics were recorded for the virtual reality participants to track their progress. The system monitored precision, scope manipulation, and object-tracking capabilities across their respective sessions. The data revealed that the IVR3 group, which received repeated exposure, demonstrated significant within-group improvement in these technical metrics.

The statistical analysis indicated that these improvements were highly significant, with p-values less than 0.001. Following the training period, all participants performed a standardized diagnostic knee arthroscopy on an anatomical model, which served as the primary endpoint for the study. A blinded evaluator, who did not know which training group each participant belonged to, assessed the performance using a Global Rating Scale (GRS).

The researchers also measured task completion time and collected participant-reported data on confidence and experience. This multi-faceted approach aimed to capture both objective technical performance and subjective learner perceptions, providing a comprehensive view of the training outcomes across different dimensions of surgical skill. The primary finding of the trial was that no statistically significant differences were detected between the IVR groups and the physical simulator groups across all domains of the Global Rating Scale.

This indicates that, for the specific task of diagnostic knee arthroscopy, training on an immersive virtual reality system did not result in better or worse technical scores compared to training on a physical simulator. However, a notable difference emerged when comparing the physical simulator group to the untrained controls. Task completion time provided another layer of insight into the efficacy of the training methods.

The IVR3 cohort, which underwent three sessions of virtual reality training, completed the assessment faster than both the IVR1 group and the untrained participants. This difference was statistically significant, suggesting that repeated exposure to the virtual environment enhances efficiency and speed in performing the procedure. In contrast, self-reported confidence levels did not differ significantly between the groups.

This implies that while trainees may become faster and more precise in their movements with repeated IVR practice, they do not necessarily feel more confident in their abilities compared to peers who used physical simulators or received no training. Qualitative feedback from the participants highlighted the perceived strengths of each training modality. Trainees noted that physical simulators offered a higher degree of realism.

Conversely, the immersive virtual reality system was praised for its accessibility and repeatability. The ability to practice the same procedure multiple times in the virtual environment was identified as a key advantage. This feedback underscores the complementary nature of the two technologies, suggesting that they may serve different educational purposes within a surgical curriculum, with physical simulators potentially better suited for realism and IVR for frequent, accessible practice.

The study authors emphasized the limitations of the trial, noting that it was small in scale and not designed as an equivalence study. Therefore, the absence of a statistically significant difference between the IVR and physical simulator groups should be interpreted as the lack of a detectable difference rather than proof that the two methods are equivalent. The researchers also pointed out challenges related to task comparability and anatomic fidelity.

The physical simulator used was non-anatomic, which may limit the direct transferability of skills to real human anatomy. Furthermore, the absence of validated arthroscopy-specific assessment tools for virtual reality training complicates the interpretation of comparative effectiveness. These factors must be considered when evaluating the potential role of IVR in surgical education.

Despite these limitations, the findings support the potential role of immersive virtual reality as a scalable adjunct for early arthroscopic skill development.

Subject of Research: Comparison of immersive virtual reality and physical simulators in arthroscopic surgical training

Article Title: Comparing the efficacy of immersive virtual reality and traditional physical arthroscopy simulators in arthroscopic training: a randomized controlled trial

Article References: Koucheki, R., Raleigh, M. J., Hauer, T. M., Wolfstadt, J. I., Larouche, J., Backstein, D. J., Chahal, J., Ravi, B., Ferguson, P. C., & Lex, J. R. (2026). Comparing the efficacy of immersive virtual reality and traditional physical arthroscopy simulators in arthroscopic training: a randomized controlled trial. BMC Medical Education. https://doi.org/10.1186/s12909-026-10595-y

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10595-y

Keywords: virtual reality, surgical education, arthroscopy, medical simulation, randomized controlled trial, skill acquisition, knee arthroscopy, training efficacy, Comparing, efficacy, immersive, virtual