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Other 4 learners reported to have had access to assistant support in all lectures.
The higher means compared to those in Table 2 show that these learners reported preparing more for all aspects of the test.
Learners reported that all testing methods were useful in measuring knowledge and clinical ability and should be used for accreditation and future training programs.
For instance, some learners reported that they were distracted by the eye and head animation of Laura, a virtual tutor that teaches Spanish [44].
Learners reported high intrinsic motivation levels with interest and enjoyment of tasks at 83.7%, perceived competence at 70.2%, effort/importance sub-scale at 80%, pressure/tension reported at 54%.
However, learners note challenges in the use of the LMS regarding its performance as having been problematic to them (57%) and only 8% of the learners reported navigation while 16% reported access as challenges.
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The effectiveness of the LMS was rated at 79% by learners reporting that they found it useful (89%) and using it makes their learning activities much easier (75.2%).
The technology quality during the blended learning intervention was rated at 69% with availability of 72%, quality of the resources was at 68% with learners reporting that discussion boards gave right content necessary for study (71%) and the email exchanges containing relevant and much needed information (63.4%) as well as chats comprising of essential information to aid the learning (69%).
Further, even when learners report having adequate cross-cultural communication skills and training, they feel that both systemic and patient factors inhibit their providing quality care [ 12].
We did not find a significant difference in outcomes between those that used the online interactive learning tool and those that did not, despite the learners reporting that the tool was easy to use and useful.
All levels of learner reported that this teaching model was very effective for the learner as there was ready access to a consultant GP teacher.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com