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The use of combined collaborative and self-directed learning strategies gave the same percentages of women with a moderate (47.4%) and advanced degree (47.4%) of digital competence (Fig. 7).
Furthermore, elaborately designed problems can stimulate self-directed learning strategies, team participation skills, information retention, and reasoning and problem-solving skills that will be available to the student after graduation [ 13– 15].
In this respect, tutors should be trained to help students to develop critical thinking skills, metacognitive thinking and self-directed learning strategies [ 26] because students need support and guidance to foster the development of self-directed learning [ 27].
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Serious games create opportunities to develop this competency, which can be used as a self-directed learning strategy to complement existing didactic learning and simulation-based strategies.
The purpose of this study was to determine whether a self-directed learning strategy as a part of student-centred education improved knowledge of and attitudes towards depression among Chinese medical students.
This study suggests that the combined didactic teaching and self-directed learning strategy employed in an anti-stigma education for depression among Chinese medical students resulted in an improvement in knowledge of public health and treatment aspects of depression and a sustained reduction in stigmatising attitudes towards depression.
Though students were required to prepare for imminent sessions with assessments (videos representing Teaching Presence), students also worked independently (when and where it was convenient), showing volition, displaying self-directed learning and learning strategies, culminating in Emotional Presence.
Tutors can promote self-directed learning directly by teaching learning strategies or indirectly by arranging a learning environment that enables students to practice self-directed learning [ 28].
Making students aware that learning English through multimedia technology demands new learning strategies and self-directed learning is a crucial first step.
Self-directed learning is an effective education strategy in improving medical students' knowledge of and attitudes towards depression.
It included the different forms of learning ICT preferred by the women, incorporating different modalities of training, from the most conventional based on performing courses to strategies involving self-directed learning.
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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