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This study applied Transmodal Analysis (TMA), a newly developed quantitative ethnographic approach, to examine whether and how virtual patient simulations can aid in educating undergraduate nursing students with competencies that exemplify practice-ready nurses. Multimodal transcripts capturing patient interactions, exam actions, and documentation were obtained from two students who used Elsevier’s Shadow Health® Digital Clinical Experiences (DCE) in Fall 2022 and Spring 2023. Patient scenarios were situated in three content areas (Gerontology, Mental Health, and Community Health) and two assignment types (focused exam and contact tracing). In each scenario, similar patterns of engagement were observed for both students as they completed learning activities such as collecting patient data and establishing a caring relationship. These activities—guided by the instructional design of DCE—indicated how students practiced recognizing and analyzing cues, subjective assessment, diagnosing and prioritizing hypotheses, generating solutions, evaluating outcomes, therapeutic communication, and care coordination and management in relation to each patient’s needs and conditions. A statistical difference was observed between competencies practiced while completing focused exam and contact tracing assignments. This study provides evidence for using simulations to facilitate competency-based education in nursing. Additionally, it provides motivation for using Transmodal Analysis combined with Ordered Network Analysis (T/ONA) to advance quantitative ethnography research in health care and health professions education. 

Wearable positioning sensors are enabling unprecedented opportunities to model students’ procedural and social behaviours during collaborative learning tasks in physical learning spaces. Emerging work in this area has mainly focused on modelling group-level interactions from low-level x-y positioning data. Yet, little work has utilised such data to automatically identify individual-level differences among students working in co-located groups in terms of procedural and social aspects such as task prioritisation and collaboration dynamics, respectively. To address this gap, this study characterised key differences among 124 students’ procedural and social behaviours according to their perceived stress, collaboration, and task satisfaction during a complex group task using wearable positioning sensors and ordered networked analysis. The results revealed that students who demonstrated more collaborative behaviours were associated with lower stress and higher collaboration satisfaction. Interestingly, students who worked individually on the primary and secondary learning tasks reported lower and higher task satisfaction, respectively. These findings can deepen our understanding of students’ individual-level behaviours and experiences while learning in groups. 

Self-regulated learning (SRL) is the ability to regulate cognitive, metacognitive, motivational, and emotional states while learning and is posited to be a strong predictor of academic success. It is therefore important to provide learners with effective instructions to promote more meaningful and effective SRL processes. One way to implement SRL instructions is through providing real-time SRL scaffolding while learners engage with a task. However, previous studies have tended to focus on fixed scaffolding rather than adaptive scaffolding that is tailored to student actions. Studies that have investigated adaptive scaffolding have not adequately distinguished between the effects of adaptive and fixed scaffolding compared to a control condition. Moreover, previous studies have tended to investigate the effects of scaffolding at the task level rather than shorter time segments—obscuring the impact of individual scaffolds on SRL processes. To address these gaps, we (a) collected trace data about student activities while working on a multi-source writing task and (b) analyzed these data using a cutting-edge learning analytic technique— ordered network analysis (ONA)—to model, visualize, and explain how learners' SRL processes changed in relation to the scaffolds. At the task level, our results suggest that learners who received adaptive scaffolding have significantly different patterns of SRL processes compared to the fixed scaffolding and control conditions. While not significantly different, our results at the task segment level suggest that adaptive scaffolding is associated with earlier engagement in SRL processes. At both the task level and task segment level, those who received adaptive scaffolding, compared to the other conditions, exhibited more task-guided learning processes such as referring to task instructions and rubrics in relation to their reading and writing. This study not only deepens our understanding of the effects of scaffolding at different levels of analysis but also demonstrates the use of a contemporary learning analytic technique for evaluating the effects of different kinds of scaffolding on learners' SRL processes.