Randomized Clinical Trial

Problem-based learning (PBL) is a learner-centered educational approach that helps nurses improve clinical skills through group discussion, case analysis, and collaborative problem-solving. However, the way participants are assigned to learning groups may influence how effectively they learn. Differences in learning styles among group members can affect participation, confidence, interaction quality, and knowledge retention. The Felder-Silverman Learning Style Model (FSLSM) is a widely used framework that categorizes learners based on how they perceive, process, and understand information (e.g., active vs. reflective, visual vs. verbal). Organizing PBL groups according to similarities or differences in these learning styles may lead to different educational outcomes. This study is a parallel, two-arm randomized controlled clinical trial designed to compare the effects of homogeneous grouping (participants with similar learning styles placed in the same group) versus heterogeneous grouping (participants with diverse learning styles placed in the same group) on PBL outcomes among hospital nurses. Registered nurses employed in teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences are randomly assigned to one of the two grouping strategies. All participants receive the same PBL curriculum focused on patient safety and medication safety. The only difference between groups is the method used to form discussion teams. The primary outcome is medication safety competence, measured using a validated questionnaire. Secondary outcomes include clinical reasoning competence and nursing care quality. Outcomes are assessed at baseline, immediately after the intervention, and eight weeks later to evaluate both immediate effects and short-term retention. The findings of this study are expected to clarify whether grouping nurses based on similar or diverse learning styles leads to better improvement and retention of critical clinical competencies. Results may help educators design more effective PBL programs in nursing education and clinical training settings.

Approximately 2-3% of children will have problems with one or both of their permanent or 'adult' canine teeth in the upper jaw. These canine teeth sometimes fail to erupt properly, because they are displaced into the roof of the mouth or palate. These are known as palatally displaced canines, PDC, (Brin et al., 1986, Ericson and Kurol, 1987). In addition to failing to erupt, displaced teeth can cause problems, such as damage to the roots or displacement of the neighbouring teeth (Ericson and Kurol, 1988a, Ericson and Kurol, 2000, Falahat et al., 2008). It has been suggested that if the primary ('baby' or 'milk') canine is extracted at an appropriate time in a child with a suspected palatally displaced canine, then the displaced tooth might spontaneously correct its position (Ericson and Kurol, 1988b) and the extraction of the baby canine when a clinician suspects that the adult canine is displaced has become accepted clinical practice (Short, 2009). This appears to be on the basis of one report of a series of 35 children who received the intervention and no control group (Ericson and Kurol, 1988b). Two recent systematic reviews have examined the evidence for the effectiveness of removal of the primary canine with the aim of correcting the eruption path of a palatally displaced canine. A recent systematic review published in The Cochrane Library in 2021 (Benson et al., 2021) noted that the evidence for any intervention to correct the eruption path of a displaced permanent canine is weak and further research is required. Numerous problems with the reported studies were identified by both reviews. Other authors have suggested that using a RME (Rapid Maxillary expansion) or headgrear (EOT) to create sufficient space within the dental arch for the permanent canine tooth will encourage the tooth to erupt (Baccetti et al., 2011). This approach might be less traumatic to a child who may have had no experience of dental treatment, other than routine check-ups. If either or both approaches are shown to be effective then their widespread use would be advantageous to both the child and the healthcare provider, because the need for an operation, under general anaesthetic, to uncover the tooth and extensive brace treatment to straighten the tooth will be avoided.

Higher mechanical properties are needed to restore structurally compromised posterior teeth, short fiber reinforced resin composite and injectable bioactive resin composites provide superior properties to flowable composites that were traditionally used to improve adaptation in deep cavities below the packable resin composite restorations. Thus, this study was designed to assess the clinical outcome of high strength dentine substitute materials.