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Current state of stem cell-based therapies: an overview

Riham mohamed aly.

1 Department of Basic Dental Science, National Research Centre, Cairo, Egypt;

2 Stem Cell Laboratory, Center of Excellence for Advanced Sciences, National Research Centre, Cairo, Egypt

Recent research reporting successful translation of stem cell therapies to patients have enriched the hope that such regenerative strategies may one day become a treatment for a wide range of vexing diseases. In fact, the past few years witnessed, a rather exponential advancement in clinical trials revolving around stem cell-based therapies. Some of these trials resulted in remarkable impact on various diseases. In this review, the advances and challenges for the development of stem-cell-based therapies are described, with focus on the use of stem cells in dentistry in addition to the advances reached in regenerative treatment modalities in several diseases. The limitations of these treatments and ongoing challenges in the field are also discussed while shedding light on the ethical and regulatory challenges in translating autologous stem cell-based interventions, into safe and effective therapies.

Introduction

Cell-based therapy as a modality of regenerative medicine is considered one of the most promising disciplines in the fields of modern science & medicine. Such an advanced technology offers endless possibilities for transformative and potentially curative treatments for some of humanities most life threatening diseases. Regenerative medicine is rapidly becoming the next big thing in health care with the particular aim of repairing and possibly replacing diseased cells, tissues or organs and eventually retrieving normal function. Fortunately, the prospect of regenerative medicine as an alternative to conventional drug-based therapies is becoming a tangible reality by the day owing to the vigorous commitment of the research communities in studying the potential applications across a wide range of diseases like neurodegenerative diseases and diabetes, among many others ( 1 ).

Recent research reporting successful translation of stem cell therapies to patients have enriched the hope that such regenerative strategies may one day become a treatment for a wide range of vexing diseases ( 2 ). In fact, the past few years witnessed, a rather exponential advancement in clinical trials revolving around stem cell-based therapies. Some of these trials resulted in remarkable impact on various diseases ( 3 ). For example, a case of Epidermolysis Bullosa manifested signs of skin recovery after treatment with keratinocyte cultures of epidermal stem cells ( 4 ). Also, a major improvement in eyesight of patients suffering from macular degeneration was reported after transplantation of patient-derived induced pluripotent stem cells (iPSCs) that were induced to differentiate into pigment epithelial cells of the retina ( 5 ).

However, in spite of the increased amount of publications reporting successful cases of stem cell-based therapies, a major number of clinical trials have not yet acquired full regulatory approvals for validation as stem cell therapies. To date, the most established stem cell treatment is bone marrow transplants to treat blood and immune system disorders ( 1 , 6 , 7 ).

In this review, the advances and challenges for the development of stem-cell-based therapies are described, with focus on the use of stem cells in dentistry in addition to the advances reached in regenerative treatment modalities in several diseases. The limitations of these treatments and ongoing challenges in the field are also discussed while shedding light on the ethical and regulatory challenges in translating autologous stem cell-based interventions, into safe and effective therapies.

Stem cell-based therapies

Stem cell-based therapies are defined as any treatment for a disease or a medical condition that fundamentally involves the use of any type of viable human stem cells including embryonic stem cells (ESCs), iPSCs and adult stem cells for autologous and allogeneic therapies ( 8 ). Stem cells offer the perfect solution when there is a need for tissue and organ transplantation through their ability to differentiate into the specific cell types that are required for repair of diseased tissues.

However, the complexity of stem cell-based therapies often leads researchers to search for stable, safe and easily accessible stem cells source that has the potential to differentiate into several lineages. Thus, it is of utmost importance to carefully select the type of stem cells that is suitable for clinical application ( 7 , 9 ).

Stem cells hierarchy

There are mainly three types of stem cells. All three of them share the significant property of self-renewal in addition to a unique ability to differentiate. However, it should be noted that stem cells are not homogeneous, but rather exist in a developmental hierarchy ( 10 ). The most basic and undeveloped of stem cells are the totipotent stem cells. These cells are capable of developing into a complete embryo while forming the extra-embryonic tissue at the same time. This unique property is brief and starts with the fertilization of the ovum and ends when the embryo reaches the four to eight cells stage. Following that cells undergo subsequent divisions until reaching the blastocyst stage where they lose their totipotency property and assume a pluripotent identity where cells are only capable of differentiating into every embryonic germ layer (ectoderm, mesoderm and endoderm). Cells of this stage are termed “embryonic stem cells” and are obtained by isolation from the inner cell mass of the blastocyst in a process that involves the destruction of the forming embryo. After consecutive divisions, the property of pluripotency is lost and the differentiation capability becomes more lineage restricted where the cells become multipotent meaning that they can only differentiate into limited types of cells related to the tissue of origin. This is the property of “adult stem cells”, which helps create a state of homeostasis throughout the lifetime of the organism. Adult stem cells are present in a metabolically quiescent state in almost all specialized tissues of the body, which includes bone marrow and oral and dental tissues among many others ( 11 ).

Many authors consider adult stem cells the gold standard in stem cell-based therapies ( 12 , 13 ). Adult stem cells demonstrated signs of clinical success especially in hematopoietic transplants ( 14 , 15 ). In contrast to ESCs, adult stem cells are not subjected to controversial views regarding their origin. The fact that ESCs derivation involves destruction of human embryos renders them unacceptable for a significant proportion of the population for ethical and religious convictions ( 16 - 18 ).

Turning point in stem cell research

It was in 2006 when Shinya Yamanka achieved a scientific breakthrough in stem cell research by succeeding in generating cells that have the same properties and genetic profile of ESCs. This was achieved via the transient over-expression of a cocktail of four transcription factors; OCT4, SOX2, KLF4 and MYC in, fully differentiated somatic cells, namely fibroblasts ( 19 , 20 ). These cells were called iPSCs and has transformed the field of stem cell research ever since ( 21 ). The most important feature of these cells is their ability to differentiate into any of the germ layers just like ESCs precluding the ethical debate surrounding their use. The development of iPSCs technology has created an innovative way to both identify and treat diseases. Since they can be generated from the patient’s own cells, iPSCs thus present a promising potential for the production of pluripotent derived patient-matched cells that could be used for autologous transplantation. True these cells symbolize a paradigm shift since they enable researchers to directly observe and treat relevant patient cells; nevertheless, a number of challenges still need to be addressed before iPSCs-derived cells can be applied in cell therapies. Such challenges include; the detection and removal of incompletely differentiated cells, addressing the genomic and epigenetic alterations in the generated cells and overcoming the tumorigenicity of these cells that could arise on transplantation ( 22 ).

Therapeutic translation of stem cell research

With the rapid increase witnessed in stem cell basic research over the past years, the relatively new research discipline “Translational Research” has evolved significantly building up on the outcomes of basic research in order to develop new therapies. The clinical translation pathway starts after acquiring the suitable regulatory approvals. The importance of translational research lies in it’s a role as a filter to ensure that only safe and effective therapies reach the clinic ( 23 ). It bridges the gap from bench to bed. Currently, some stem cell-based therapies utilizing adult stem cells are clinically available and mainly include bone marrow transplants of hematopoietic stem cells and skin grafts for severe burns ( 23 ). To date, there are more than 3,000 trials involving the use of adult stem cells registered in WHO International Clinical Trials Registry. Additionally, initial trials involving the new and appealing iPSCs based therapies are also registered. In fact, the first clinical attempt employing iPSCs reported successful results in treating macular degeneration ( 24 ). Given the relative immaturity in the field of cellular therapy, the outcomes of such trials shall facilitate the understanding of the timeframes needed to achieve successful therapies and help in better understanding of the diseases. However, it is noteworthy that evaluation of stem cell-based therapies is not an easy task since transplantation of cells is ectopic and may result in tumor formation and other complications. This accounts for the variations in the results reported from previous reports. The following section discusses the published data of some of the most important clinical trials involving the use of different types of stem cells both in medicine and in dentistry.

Stem cell-based therapy for neurodegenerative diseases

The successful generation of neural cells from stem cells in vitro paved the way for the current stem cell-based clinical trials targeting neurodegenerative diseases ( 25 , 26 ). These therapies do not just target detaining the progression of irrecoverable neuro-degenerative diseases like Parkinson’s, Alzheimer’s, amyotrophic lateral sclerosis (ALS), and multiple sclerosis (MS), but are also focused on completely treating such disorders.

Parkinson’s disease (PD)

PD is characterized by a rapid loss of midbrain dopaminergic neurons. The first attempt for using human ESC cells to treat PD was via the generation of dopaminergic-like neurons, later human iPSCs was proposed as an alternative to overcome ESCs controversies ( 27 ). Both cells presented hope for obtaining an endless source of dopaminergic neurons instead of the previously used fetal brain tissues. Subsequently, protocols that mimicked the development of dopaminergic neurons succeeded in generating dopaminergic neurons similar to that of the midbrain which were able to survive, integrate and functionally mature in animal models of PD preclinically ( 28 ). Based on the research presented by different groups; the “Parkinson’s Global Force” was formed which aimed at guiding researchers to optimize their cell characterization and help promote the clinical progress toward successful therapy. Recently, In August 2018, Shinya Yamanka initiated the first approved clinical trial to treat PD using iPSCs. Seven patients suffering from moderate PD were recruited ( 29 ). Donor matched allogeneic cells were used to avoid any genetic influence of the disease. The strategy behind the trial involved the generation of dopaminergic progenitors followed by surgical transplantation into the brains of patients by a special device. In addition, immunosuppressant medications were given to avoid any adverse reaction. Preliminary results so far revealed the safety of the treatment.

MS is an inflammatory and neurodegenerative autoimmune disease of the central nervous system. Stem cell-based therapies are now exploring the possibility of halting the disease progression and reverse the neural damage. A registered phase 1 clinical trial was conducted by the company Celgene TM in 2014 using placental-derived mesenchymal stem cells (MSCs) infusion to treat patients suffering from MS ( 30 ). This trial was performed at 6 centers in the United States and 2 centers in Canada and included 16 patients. Results demonstrated that cellular infusions were safe with no signs of paradoxical aggravation. However, clinical responses from patients indicated that the cellular treatment did not improve the MS condition ( 31 ). For the last decade immunoablative therapy demonstrated accumulative evidence of inducing long-term remission and improvement of disability caused by MS. This approach involves the replacement of the diseased immune system through administration of high-dose immunosuppressive therapy followed by hematopoietic stem cells infusion ( 32 ). However, immunoablation strategies demonstrated several complications such as infertility and neurological disabilities. A number of randomized controlled trials are planned to address these concerns ( 32 ). Currently, new and innovative stem cell-based therapies for MS are only in the initial stages, and are based on different mechanisms exploring the possibility of replacing damaged neuronal tissue with neural cells derived from iPSCs however, the therapeutic potential of iPSCs is still under research ( 33 ).

ALS is a neurodegenerative disease that causes degeneration of the motor neurons which results in disturbance in muscle performance. The first attempt to treat ALS was through the transplantation of MSCs in a mouse model. The outcomes of this experiment were promising and resulted in a decrease of the disease manifestations and thus providing proof of principal ( 34 ). Based on these results, several planned/ongoing clinical trials are on the way. These trials mainly assess the safety of the proposed concept and have not proved clinical success to date. Notably, while pre-clinical studies have reported that cells derived from un-diseased individuals are superior to cells from ALS patients; most of the clinical trials attempted have employed autologous transplantation. This information may account for the absence of therapeutic improvement reported ( 35 ).

Spinal cord injury

Other neurologic indications for the use of stem cells are spinal cord injuries. Though the transplantation of different forms of neural stem cells and oligo-dendrocyte progenitors has led to growth in the axons in addition to neural connectivity which presents a possibility for repair ( 36 ), proof of recovered function has yet to be established in stringent clinical trials. Nevertheless, Japan has recently given approval to stem-cell treatment for spinal-cord injuries. This approval was based on clinical trials that are yet to be published and involves 13 patients, who are suffering from recent spinal-cord injury. The Japanese team discovered that injection of stem cells isolated from the patients’ bone marrow aided in regaining some lost sensation and mobility. This is the first stem cell-based therapy targeting spinal-cord injuries to gain governmental approval to offer to patients ( 37 ).

Stem cell-based therapies for ocular diseases

A huge number of the currently registered clinical trials for stem cell-based therapies target ocular diseases. This is mainly due to the fact that the eye is an immune privileged site. Most of these trials span various countries including Japan, China, Israel, Korea, UK, and USA and implement allogeneic ESC lines ( 35 , 36 ). Notably, the first clinical trial to implement the use autologous iPSCs-derived retinal cells was in Japan which followed the new regulatory laws issued in 2014 by Japan’s government to regulate regenerative medicine applications. Two patients were recruited in this trial, the first one received treatment for macular degeneration using iPSCs-generated retinal cell sheet ( 37 ). After 1 year of follow-up, there were no signs of serious complications including abnormal proliferation and systemic malignancy. Moreover, there were no signs of rejection of the transplanted retinal epithelial sheet in the second year follow-up. Most importantly, the signs of corrected visual acuity of the treated eye were reported. These results were enough to conclude that iPSCs-based autologous transplantation was safe and feasible ( 38 ). It is worthy to mention that the second patient was withdrawn from the study due to detectable genetic variations the patient’s iPSCs lines which was not originally present in the patient’s original fibroblasts. Such alterations may jeopardize the overall safety of the treatment. The fact that this decision was taken, even though the performed safety assays did not demonstrate tumorgenicity in the iPSCs-derived retinal pigment epithelium (RPE) cells, indicates that researchers in the field of iPSCs have full awareness of the importance of safety issues ( 39 ).

Stem cell-based therapies for treatment of diabetes

Pancreatic beta cells are destructed in type 1 diabetes mellitus, because of disorders in the immune system while in type 2 insulin insufficiency is caused by failure of the beta-cell to normally produce insulin. In both cases the affected cell is the beta cell, and since the pancreas does not efficiently regenerate islets from endogenous adult stem cells, other cell sources were tested ( 38 ). Pluripotent stem cells (PSCs) are considered the cells of choice for beta cell replacement strategies ( 39 ). Currently, there are a few industry-sponsored clinical trials that are registered targeting beta cell replacement using ESCs. These trials revolve around the engraftment of insulin-producing beta cells in an encapsulating device subcutaneously to protect the cells from autoimmunity in patients with type 1 diabetes ( 40 ). The company ViaCyte TM in California recently initiated a phase I/II trial ( {"type":"clinical-trial","attrs":{"text":"NCT02239354","term_id":"NCT02239354"}} NCT02239354 ) in 2014 in collaboration with Harvard University. This trial involves 40 patients and employs two subcutaneous capsules of insulin producing beta cells generated from ESCs. The results shall be interesting due to the ease of monitoring and recovery of the transplanted cells. The preclinical studies preceding this trial demonstrated successful glycemic correction and the devices were successfully retrieved after 174 days and contained viable insulin-producing cells ( 41 ).

Stem cells in dentistry

Stem cells have been successfully isolated from human teeth and were studied to test their ability to regenerate dental structures and periodontal tissues. MSCs were reported to be successfully isolated from dental tissues like dental pulp of permanent and deciduous teeth, periodontal ligament, apical papilla and dental follicle ( 42 - 44 ). These cells were described as an excellent cell source owing to their ease of accessibility, their ability to differentiate into osteoblasts and odontoblasts and lack of ethical controversies ( 45 ). Moreover, dental stem cells demonstrated superior abilities in immunomodulation properties either through cell to cell interaction or via a paracrine effect ( 46 ). Stem cells of non-dental origin were also suggested for dental tissue and bone regeneration. Different approaches were investigated for achieving dental and periodontal regeneration ( 47 ); however, assessments of stem cells after transplantation still require extensive studying. Clinical trials have only recently begun and their results are yet to be fully evaluated. However, by carefully applying the knowledge acquired from the extensive basic research in dental and periodontal regeneration, stem cell-based dental and periodontal regeneration may soon be a readily available treatment. To date, there are more than 6,000 clinical trials involving the use of with stem cells, however only a total of 44 registered clinical trials address oral diseases worldwide ( 48 ). Stem cell-based clinical trials with reported results targeting the treatment of oral disease are discussed below.

Dental pulp regeneration

The first human clinical study using autologous dental pulp stem cells (DPSCs) for complete pulp regeneration was reported by Nakashima et al. in 2017 ( 49 ). This pilot study was based on extensive preclinical studies conducted by the same group ( 50 ). Patients with irreversible pulpitis were recruited and followed up for 6 months following DPSCs’ transplantation. Granulocyte colony-stimulating factor was administered to induce stem cell mobilization to enrich the stem cell populations. The research team reported that the use of DPSCs seeded on collagen scaffold in molars and premolars undergoing pulpectomy was safe. No adverse events or toxicity were demonstrated in the clinical and laboratory evaluations. Positive electric pulp testing was obtained after cell transplantation in all patients. Moreover, magnetic resonance imaging of the de - novo tissues formed in the root canal demonstrated similar results to normal pulp, which indicated successful pulp regeneration. A different group conducted a clinical trial that recruited patients diagnosed with necrotic pulp. Autologous stem cells from deciduous teeth were employed to induce pulp regeneration ( 51 ). Follow-up of the cases after a year from the intervention reported evidence of pulp regeneration with vascular supply and innervation. In addition, no signs of adverse effects were observed in patients receiving DPSCs transplantation. Both trials are proceeding with the next phases, however the results obtained are promising.

Periodontal tissue regeneration

Aimetti et al. performed a study which included eleven patients suffering from chronic periodontitis and have one deep intra bony defect in addition to the presence of one vital tooth that needs extraction ( 52 ). Pulp tissue was passed through 50-µm filters in presence of collagen sponge scaffold and was followed by transplantation in the bony defects caused by periodontal disease. Both clinical and radiographic evaluations confirmed the efficacy of this therapeutic intervention. Periodontal examination, attachment level, and probe depth showed improved results in addition to significant stability of the gingival margin. Moreover, radiographic analysis demonstrated bone regeneration.

Regeneration of mandibular bony defects

The first clinical study using DPSCs for oro-maxillo-facial bone regeneration was conducted in 2009 ( 53 ). Patients in this study suffered from extreme bone loss following extraction of third molars. A bio-complex composed of DPSCs cultured on collagen sponge scaffolds was applied to the affected sites. Vertical repair of the damaged area with complete restoration of the periodontal tissue was demonstrated six months after the treatment. Three years later, the same group published a report evaluating the stability and quality of the regenerated bone after DPSCs transplantation ( 54 ). Histological and advanced holotomography demonstrated that newly formed bone was uniformly vascularized. However, it was of compact type, rather than a cancellous type which is usually the type of bone in this region.

Stem cells for treatment of Sjögren’s syndrome

Sjögren’s syndrome (SS) is a systemic autoimmune disease marked by dry mouth and eyes. A novel therapeutic approach for SS. utilizing the infusion of MSCs in 24 patients was reported by Xu et al. in 2012 ( 55 ). The strategy behind this treatment was based on the immunologic regulatory functions of MSCs. Infused MSCs migrated toward the inflammatory sites in a stromal cell-derived factor-1-dependent manner. Results reported from this clinical trial demonstrated suppressed autoimmunity with subsequent restoration of salivary gland secretion in SS patients.

Stem cells and tissue banks

The ability to bank autologous stem cells at their most potent state for later use is an essential adjuvant to stem cell-based therapies. In order to be considered valid, any novel stem cell-based therapy should be as effective as the routine treatment. Thus, when appraising a type of stem cells for application in cellular therapies, issues like immune rejection must be avoided and at the same time large numbers of stem cells must be readily available before clinical implementation. iPSCs theoretically possess the ability to proliferate unlimitedly which pose them as an attractive source for use in cell-based therapies. Unlike, adult stem cells iPSCs ability to propagate does not decrease with time ( 22 ). Recently, California Institute for Regenerative Medicine (CIRM) has inaugurated an iPSCs repository to provide researchers with versatile iPSCs cell lines in order to accelerate stem cell treatments through studying genetic variation and disease modeling. Another important source for stem cells banking is the umbilical cord. Umbilical cord is immediately cryopreserved after birth; which permits stem cells to be successfully stored and ready for use in cell-based therapies for incurable diseases of a given individuals. However, stem cells of human exfoliated deciduous teeth (SHEDs) are more attractive as a source for stem cell banking. These cells have the capacity to differentiate into further cell types than the rest of the adult stem cells ( 56 ). Moreover, procedures involving the isolation and cryopreservation of these cells are un-complicated and not aggressive. The most important advantage of banking SHEDs is the insured autologous transplant which avoids the possibility of immune rejection ( 57 ). Contrary to cord blood stem cells, SHEDs have the ability to differentiate into connective tissues, neural and dental tissues ( 58 ) Finally, the ultimate goal of stem cell banking, is to establish a repository of high-quality stem cell lines derived from many individuals for future use in therapy.

Current regulatory guidelines for stem cell-based therapies

With the increased number of clinical trials employing stem cells as therapeutic approaches, the need for developing regulatory guidelines and standards to ensure patients safety is becoming more and more essential. However, the fact that stem cell therapy is rather a new domain makes it subject to scientific, ethical and legal controversies that are yet to be regulated. Leading countries in the field have devised guidelines serving that purpose. Recently, the Food and Drug Administration (FDA) has released regulatory guidelines to ensure that these treatments are safe and effective ( 59 ). These guidelines state that; treatments involving stem cells that have been minimally manipulated and are intended for homogeneous use do not require premarket approval to come into action and shall only be subjected to regulatory guidelines against disease transmission. In 2014, a radical regulatory reform in Japan occurred with the passing of two new laws that permitted conditional approval of cell-based treatments following early phase clinical trials on the condition that clinical safety data are provided from at least ten patients. These laws allow skipping most of the traditional criteria of clinical trials in what was described as “fast track approvals” and treatments were classified according to risk ( 60 ). To date, the treatments that acquired conditional approval include those targeting; spinal-cord injury, cardiac disease and limb ischemia ( 61 ). Finally, regulatory authorities are now demanding application of standardization and safety regulations protocols for cellular products, which include the use of Xeno-free culture media, recombinant growth factors in addition to “Good Manufacturing Practice” (GMP) culture supplies.

Challenges & ethical issues facing stem cell-based therapies

Stem cell-based therapies face many obstacles that need to be urgently addressed. The most persistent concern is the ethical conflict regarding the use of ESCs. As previously mentioned, ESCs are far superior regarding their potency; however, their derivation requires destruction human embryos. True, the discovery of iPSCs overcame this concern; nevertheless, iPSCs themselves currently face another ethical controversy of their own which addresses their unlimited capacity of differentiation with concerns that these cells could one day be applied in human cloning. The use of iPSCs in therapy is still considered a high-risk treatment modality, since transplantation of these cells could induce tumor formation. Such challenge is currently addressed through developing optimized protocols to ensure their safety in addition to developing global clinical-grade iPSCs cell lines before these cells are available for clinical use ( 61 ). As for MSCs, these cells have been universally considered safe, however continuous monitoring and prolonged follow-up should be the focus of future research to avoid the possibility of tumor formation after treatments ( 62 ). Finally, it could be postulated that one of the most challenging ethical issues faced in the field of stem cell-based therapies at the moment, is the increasing number of clinics offering unproven stem cell-based treatments. Researchers are thus morally obligated to ensure that ethical considerations are not undermined in pursuit of progress in clinical translation.

Conclusions

Stem cell therapy is becoming a tangible reality by the day, thanks to the mounting research conducted over the past decade. With every research conducted the possibilities of stem cells applications increased in spite of the many challenges faced. Currently, progress in the field of stem cells is very promising with reports of clinical success in treating various diseases like; neurodegenerative diseases and macular degeneration progressing rapidly. iPSCs are conquering the field of stem cells research with endless possibilities of treating diseases using patients own cells. Regeneration of dental and periodontal tissues using MSCs has made its way to the clinic and soon enough will become a valid treatment. Although, challenges might seem daunting, stem cell research is advancing rapidly and cellular therapeutics is soon to be applicable. Fortunately, there are currently tremendous efforts exerted globally towards setting up regulatory guidelines and standards to ensure patients safety. In the near future, stem cell-based therapies shall significantly impact human health.

Acknowledgments

Funding: None.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/ .

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/sci-2020-001 ). The author has no conflicts of interest to declare.

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Most Americans think U.S. K-12 STEM education isn’t above average, but test results paint a mixed picture

Most Americans believe K-12 STEM education in the United States is either average or below average compared with other wealthy nations, according to a new Pew Research Center survey.

Recent global standardized test scores show that students in the U.S. are, in fact, lagging behind their peers in other wealthy nations when it comes to math. But America’s students are doing better than average in science compared with pupils in these other countries.

Pew Research Center conducted this study to understand Americans’ ratings of K-12 STEM education in the United States. For this analysis, we surveyed 10,133 U.S. adults from Feb. 7 to 11, 2024.

Everyone who took part in the survey is a member of the Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. This way, nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATP’s methodology .

Here are the questions used for this analysis , along with responses, and its methodology .

We also analyzed the latest data from the Program for International Student Assessment (PISA), which tests 15-year-old students in math, reading and science in member and partner countries of the Organization for Economic Cooperation and Development (OECD). This analysis only includes scores from students in the 37 OECD countries that took the 2022 PISA.

How do Americans think U.S. STEM education compares with other wealthy countries?

Just 28% of U.S. adults say America is the best in the world or above average in K-12 science, technology, engineering and math education compared with other wealthy nations. A third say the U.S. is average, while another 32% think the U.S. is below average or the worst in K-12 STEM education.

Some demographic groups are more pessimistic than others about the state of U.S. STEM education. White Americans (24%) are less likely than Black (31%), Hispanic (37%) or English-speaking Asian (43%) Americans to say U.S. K-12 STEM education is the best in the world or above average. And fewer women (25%) than men (32%) say K-12 STEM education is at least above average.

Republicans and Democrats give similar ratings to K-12 STEM education: 31% of Democrats and Democratic-leaning independents say it is at least above average, as do 27% of Republicans and GOP leaners.

Americans’ views today are similar to those in a 2019 telephone survey by the Center, which was conducted before the coronavirus pandemic caused major disruptions in the country’s schools. In that survey, 31% of Americans said U.S. K-12 STEM education is the best in the world or above average compared with other nations.

How does the U.S. compare with other countries in STEM test scores?

The latest figures from the Program for International Student Assessment (PISA) show a mixed picture in U.S. math and science scores.

As of 2022, the U.S. was below average in math but above average in science compared with other member countries in the Organization for Economic Cooperation and Development (OECD), a group of mostly highly developed, democratic nations:

• U.S. students ranked 28th out of 37 OECD member countries in math. Among OECD countries, Japanese students had the highest math scores and Colombian students scored lowest. The U.S. ranking was similar in 2018, the last time the test was administered. The U.S. average score for math fell by 13 percentage points between 2018 and 2022, but the U.S. was far from alone in experiencing a decline in scores. In fact, 25 of the 37 OECD countries saw at least a 10-point drop in average math scores from 2018 to 2022.
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PISA is taken by 15-year-old students about every three years. Students in 37 OECD countries took the 2022 PISA.

Note: Here are the questions used for this analysis , along with responses, and its methodology .

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Brian Kennedy is a senior researcher focusing on science and society research at Pew Research Center

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Edited by: Miray Tekkumru-Kisa and Mary Kay Stein Collection published: 25 November 2017

Research on STEM practices in education: International perspectives

This thematic series brings together the work of scholars from around the world to investigate the trends in STEM education research in terms of coverage of STEM practices and to illustrate how STEM practices can be made a component of STEM instruction. 

Edited by: Prof Sibel Erduran Collection published: 16 February 2015

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The  International Journal of STEM Education, covered by   Web of Science’s Social Sciences Citation Index (SSCI), has been identified as important to key opinion leaders, funders, and evaluators worldwide and has an  Impact Factor  of 6.7 . SSCI is a carefully selected and evaluated collection that delivers to users the most influential scientific research. All articles published in this journal are discoverable via the Web of Science with full citation counts, author information, and other enrichment.  Coverage  of the journal records started in 2018.

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Usage statistics of articles published over the last 9 months, retrieved on April 9th, 2024.

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The International Journal of STEM Education is a multidisciplinary journal in subject-content education that focuses on the study of teaching and learning in science, technology, engineering, and mathematics (STEM).

The journal provides a unique platform for sharing research regarding, among other topics, the design and implementation of technology-rich learning environments , innovative pedagogies , and curricula in STEM education that promote successful learning in Pre K-16 levels including teacher education. We are also interested in studies that address specific challenges in improving students’ achievement, approaches used to motivate and engage students, and lessons learned from changes in curriculum and instruction in STEM education. The journal encourages translational STEM education research that bridges research and educational policy and practice for STEM education improvement.  Read more  

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Articles in  International Journal of STEM Education  should be cited in the same way as articles in a traditional journal. Because articles are not printed, they do not have page numbers ; instead, they are given a unique article number  and a DOI (digital object identifier). 

Article citations in APA style should cite the DOI: English, L.D., & Watson J.M. (2015). Exploring variation in measurement as a foundation for statistical thinking in the elementary school. Int J STEM Educ.  doi: 10.1186/s40594-015-0016-x.

Article citations follow this format in Vancouver style : English LD, Watson JM. Exploring variation in measurement as a foundation for statistical thinking in the elementary school. Int J STEM Educ. 2015;2:3

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The book series: Advances in STEM Education

Advances in STEM Education is a new book series with a focus on cutting-edge research and knowledge development in science, technology, engineering and mathematics (STEM) education from pre-college through continuing education around the world. Read more Researchers who are interested in book publishing in STEM education are encouraged to contact the book series editor, Dr. Yeping Li, at [email protected]

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• ISSN: 2196-7822 (electronic)

Call for Proposals: Revitalizing STEM education to equip next generations with STEM Competency (Extended deadline: 12 May 2024)

The 15-month project aims to create innovative educational solutions, to increase institutional and professional capabilities, and share knowledge and best practices at both regional and global levels. The project will identify innovative proposals composed of STEM Research Activities and STEM Educational Activities presented by applicant teams. After 6 months of implementation, project teams will be invited to co-create and consolidate results to co-develop a STEM education knowledge hub and a regional inventory of STEM educational resources.

A supervisory board will select up to 5 promising proposals. Project proposals will need to consider national and local STEM educational landscapes and coordinate with relevant stakeholders. Selected teams will receive funding from the project of a total of up to 26,000 USD to implement their innovative STEM education projects within a 6-month period. 

The selected project teams will have the opportunity to share results, best practices, methodologies, and lessons learnt. The generated knowledge will then be scaled up within and across the region.

Each proposal will include both STEM Research Activities and STEM Educational Activities, whose implementation will be executed by project teams in close collaboration with UNESCO.

For STEM Research Activities , the research should focus on one of the following domains:

• Correlation between investments in STEM and educational outcomes
• Female participation in STEM education
• Flexible teaching and learning models and inclusive approaches
• Technologies development and application in STEM education in schools
• Effectiveness of the educational system to deliver STEM education
• National ecosystems and policies for STEM education

For STEM Educational Activities , the activities should relate to one of the following modalities:

• STEM teaching and learning activities for students
• Strengthening teacher development and inclusive STEM pedagogies

Educational agencies, universities, research agencies, independent experts, NGOs, and schools from UNESCO Member States in Europe  (with a priority focus on South-East Europe and the Mediterranean) are all eligible applicants. 

Interested applicants are requested to submit all documents to [email protected] by 12 May 2024 by 23:59 (CET). Applicants may direct questions related to the preparation of the application to the same email address.

For more details on the selection criteria and supporting documents, please download the attached “Call for Proposals” and “Application Form”.

Related items

• Natural sciences
• Basic sciences
• Science, technology, engineering and mathematics (STEM)
• Region: Europe and North America
• SDG: SDG 4 - Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all
• SDG: SDG 9 - Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation
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Research reveals tools to make STEM degrees more affordable

by University of Delaware

In a new study in Issues in Science and Technology , Dominique J. Baker, an associate professor in the College of Education and Human Development and the Joseph R. Biden, Jr. School of Public Policy & Administration at the University of Delaware, has explored the role of student loans on hopeful students striving for college degrees, particularly in STEM.

The cost of attending a public four-year college in the United States has more than doubled since the early 1990s, with inflation factored in.

Undergraduate student loan debt has become unmanageable for a wide swath of borrowers in the United States. Bachelor's degree recipients borrow on average $41,300, with a median of $30,000. The median borrower still owes 92% of their loan four years after earning a bachelor's degree, and nearly one-third of people who took out a student loan between 1998 and 2018 fell into default. As part of its emergency response to the pandemic, the US Department of Education suspended action on federal student loans that were in default as of March 13, 2020, until at least September 2024.

Student loan debt is uneven across racial groups.

Recent data has also shown variation in loan repayment patterns by major, challenging the popular assumption that all STEM graduates have similar prospects after college. Though the median amount owed on student loans for STEM majors four years after earning their degree is 80%, this varies—from 59% for engineering to 94% for biological and physical sciences and agricultural sciences. These figures do not include the amount of additional debt students may incur in pursuit of further graduate education. Due to interest accrual, delayed repayment of undergraduate student loans can also result in greater debt burdens.

The fact that differential tuition may make a STEM major more expensive than a non-STEM major at some universities deserves more attention when considering how to make STEM degrees more affordable. For example, advanced, in-state students at the University of Maryland pursuing engineering and computer science degrees pay $1,500 more per semester than their peers enrolled in other disciplines (nearly 27% higher).

The United States currently relies on a rough patchwork of policies and mechanisms to project the image of college affordability while actually depending on students to navigate huge variances in higher education costs. Inevitably, they're often left to shoulder a debt burden that might follow them around for decades. Lessons from other countries on how to assemble the policy patchwork more deliberately—to actually lower student costs and subsidize tuition in targeted disciplines—may help.

Experts on college affordability, tuition setting, and other related topics in higher education should convene to examine the value of tuition caps as a policy, particularly within the context of bringing the missing millions into STEM disciplines. Since most public university subsidies come from state coffers, federal efforts alone are unlikely to solve college affordability. And yet there are no clear policy tools available to ensure that states contribute their due for higher education.

The decentralized nature of US higher education conceals useful information from researchers, decisionmakers, and policymakers—like the national average tuition increase for STEM degrees under differential tuition. Higher education leaders, especially in STEM fields, should be invested in creating spaces for ongoing conversations about real changes in college affordability as another avenue for removing barriers to STEM education and careers.

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How Can Emerging Technologies Impact STEM Education?

• Published: 16 November 2023
• Volume 6 , pages 375–384, ( 2023 )

Cite this article

• Thomas K. F. Chiu 1 &
• Yeping Li 2  

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In this editorial, we discuss the affordances and challenges of emerging technologies in designing and implementing STEM education as a planned theme of this special issue. We view that emerging technologies, such as artificial intelligence (AI) and virtual reality, have a double-edged sword effect on STEM learning and teaching. Exploring the effect will help provide a balanced view that simultaneously recognizes the benefits and pitfalls of the technologies and avoids overstating either one. This themed issue highlights how immersive and AI-driven learning environments advance and transform STEM education in different contexts. It consists of this editorial, three research reviews, and two empirical research articles contributed by scholars from five different regions, including Australia, Hong Kong, mainland China, Singapore, and the USA. They discussed the educational, social, and technological effects of emerging technologies. Each article discusses to various extent about the current research status, what and how the technologies can afford, and what concerns the technologies may bring to STEM education.

Avoid common mistakes on your manuscript.

Introduction

Emerging technologies can drive changes throughout the educational landscape, leading to redefinition and reshaping of STEM (science, technology, engineering, and mathematics) education. Connecting with and developing skills in technologies is invaluable for being part of the rapidly evolving STEM learning and teaching environments. STEM education should utilize the capabilities and possibilities of technologies to create innovative learning experiences, which enhances students’ learning with new tools and environments such as artificial intelligence (AI), biotechnology, robots, virtual reality (VR), intelligent tutoring systems, STEM digital tools, and the next generation of learning management system. Students will need to develop new knowledge and skills to use appropriate emerging technologies to solve contemporary STEM real-world problems. These emerging technologies bring great opportunities for transforming the forms and ways of interactions and collaborations among individuals and with environments. At the same time, those changes can also be viewed as having the potentially disruptive power to interrupt our usual practices and policies and either to ameliorate or exacerbate social and historical inequities. Many questions remain in virtually every aspect of the learning and teaching process with the use of that technologies, such as students’ engagement, learning process, learning interest, outcomes, and instructional design. These questions call for extensive research needed to examine the untapped potential of these technologies in ways that can advance STEM education successfully. This collection of five articles addressed some of these questions from eastern and western perspectives through research reviews and empirical studies with a focus on AI and immersive technologies such as VR.

Overview of the Five Articles

These five articles cover a broad range of issues related to the educational, social, and technological effects of AI and immersive technologies on STEM education.

The first three articles used a systematics review approach to explore the educational, pedagogical, and technological effects of emerging technologies on STEM education. The first article, written by Chng et al. ( 2023 ), demonstrates how AI and immersive technologies advance STEM education by identifying and reviewing 82 journal papers. The authors analyzed the papers from two perspectives—doing things better and doing better things. Their findings discovered that VR and natural language processing were two popular technologies utilized in STEM education, that their use intended to nurture science epistemic skills, and that AI was used to forecast students’ future STEM careers. However, they argued that it is not evident how these technologies may contribute to the advancement of STEM education due to their pedagogical affordances and constraints.

The second article is an analysis of 17 empirical studies by Ouyang et al. ( 2023 ). The purpose of this review was to examine the use of AI in STEM educational assessment from three areas—academic performance assessment, learning status assessment, and instructional quality assessment. The findings showed that deep learning was employed in most of the AI application’s algorithm and that AI was mostly used for evaluating students’ academic performance. They suggested that AI can assist students acquire the capacity to think across disciplines and provide them the tools they need to solve real-world problems by integrating their STEM knowledge and skills. Due to the rising development of AI-based applications for educational assessment, their findings also showed that digital literacy is a requirement for students’ and teachers’ AI usage.

The third article is a descriptive review by Zhang et al. ( 2023 ) on computational thinking in Science, Technology, Engineering, Arts, and Mathematics (STEAM) early childhood education context. They identified and selected nine journal papers for an in-depth investigation. The results indicated that young children had positive learning experiences in a coding-as-playground environment (Bers et al., 2019 ), that they should acquire reasoning, creative, and algorithmic thinking (Angeli & Valanides, 2020 ; Bers et al., 2019 ), and that there were no gender differences in computational thinking utilizing educational robotics (Angeli & Valanides, 2020 ).

The last two articles in this issue addressed the design and implementation and evaluation of STEM learning and teaching with the emerging technologies across various educational levels—PreK-12 and higher education—as well as concerns over the use of the technologies. Specifically, the fourth article is an Australian qualitative study by Izadinia ( 2023 ). The author examined 23 Sydney high school students to determine how VR may be used to create an engaging learning environment that boosts girls’ confidence, engagement, and interest in STEAM. The results revealed that while studying STEAM using VR, girls felt more comfortable and secured utilizing the immersive digital technology. The apparent increase in self-efficacy and confidence motivated girls to pursue jobs in the field of technology by increasing their engagement and interest.

The last article, written by Majewska and Vereen ( 2023 ), investigated how undergraduate students and their instructors in the USA regard the use of VR for biology learning. Examining the impact of VR on the biology learning of undergraduates, they used a questionnaire and a test and instructors’ lecture notes to gain a deeper understanding of the advantages and difficulties that immersive technology brings to science learning. Their findings suggested that students perceived a positive attitude toward STEM and immersive technologies when learning with VR. Instructors developed a positive attitude toward VR because they were able to interact with their students in more authentic ways. They were concerned, however, that the technologies might exacerbate the digital divide between rural and urban areas.

In sum, the key themes that emerged from the aforementioned studies concern the affordances and challenges in the absence of adequately designed and robust pedagogies, along with the need of developing instructors’ and students’ skills and repertoires. These themes demonstrate that emerging technologies are two-edged swords. It is a great chance to advance STEM education, but we are not prepared for it. Students and teachers may find technology easy to use, but they will always expect more from technologies. Technologies are evolving faster than ever before; therefore, it is important to explore and understand the opportunities and challenges they present for transforming STEM education.

Building upon these five articles, we perceive three key opportunities and three key challenges that are relevant in an AI- and metaverse-driven STEM education and beyond. In the next two sections, we discuss how emerging technologies can advance STEM instruction (three key opportunities), followed by presenting three challenges of using the technologies in STEM education. In the last section, we make recommendations for future research direction in the hopes that they will stimulate further discussions among researchers and practitioners about the roles of emerging technologies and their impact on STEM education research and practices.

In What Ways, and to What Extent, May Emerging Technologies Advance STEM Instruction?

Providing a more inclusive, diverse, and equitable education to improve stem workforce development.

STEM educators prioritize inclusivity, diversity, and equity to ensure a comprehensive and impactful education that benefits all students (El-Hamamsy et al., 2023 ). The inequalities in STEM education have negative effects on the inclusivity and diversity of STEM careers, implying that students’ future employment prospects may be harmed by a lack of an appropriate STEM instructional design. Since there is a growing need for STEM professionals, not just the involved students but the workforce and economy as a whole may be negatively impacted by the inequity in STEM education. The inequity may be viewed in two ways—gender and digital (Sevilla et al., 2023 ). Due to gender bias and stereotypes, girls are underrepresented in STEM education and jobs. Gender stereotypes and a lack of female role models are two important factors that discourage young girls from pursuing STEM fields (Freedman et al., 2023 ; Herrmann, et al., 2016 ; Piatek-Jimenez et al., 2018 ). The second point of view is digital inequity or divide. This is due to accessibility and digital skills (Resta & Laferrière, 2015 ). Students who lack digital skills or reside in remote regions are less likely to obtain a more comprehensive STEM education because they lack access to the technologies and resources needed to participate in STEM activities.

The special issue takes a new perspective at how VR and coding may encourage more female and non-STEM students to participate in STEM activities. With the advancement of user-friendly interface, many emerging technologies do not necessitate the perceived need of acquiring specialized skills. They are designed for everyone. Students found VR beneficial and simple to use, establishing a more positive attitude toward technology and STEM learning (Izadinia, 2023 ; Majewska & Vereen, 2023 ; Zhang et al., 2023 ). This is explained by Davis’ ( 1989 ) technology acceptance model, which is a major paradigm for understanding the adoption of new technologies in a variety of contexts. According to the model, technology self-efficacy, perceived ease of use, usefulness to use, and attitude toward can predict behavioral intention to, intrinsic motivation to, and actual usage of a technology. This implies that students (boys and girls, computer enthusiasts and non-enthusiasts) are more motivated to use VR and coding in STEM learning (Yu et al., 2021 ). This intrinsic motivation is also strongly associated with STEM interest and identity development that can predict career choice (Chiu, 2023 ; Izadinia, 2023 ; Majewska & Vereen, 2023 ). Emerging technologies empower and engage girls and computer non-enthusiasts in STEM education, increasing their likelihood of developing a stronger interest and identity toward STEM (Izadinia, 2023 ; Majewska & Vereen, 2023 ; Zhang et al., 2023 ). Furthermore, Ouyang et al.’s ( 2023 ) study revealed that AI analytics can predict student STEM career involvement and that AI-based virtual mentors may help students grow their STEM careers. To summarize, incorporating emerging technologies into STEM education reduces the likelihood of students falling behind in a way that permanently eliminates them from STEM-related fields. It has the potential to open up the future STEM job opportunities and boost the workforce development by offering a more equitable education.

Encouraging Other Fields to Be Included for Greater Transdisciplinary STEM Learning

Interdisciplinary STEM education is an approach by which students learn the interconnectedness of the disciplines of STEM. Students analyze real-world problems by gathering ideas from STEM disciplines and then integrating these ideas for conducting a more comprehensive analysis. This education needs to be carried out through well-designed curriculum and innovative pedagogy. The interdisciplinary level is affected by teachers’ perceptions and pedagogical content knowledge and students’ discipline knowledge in STEM (Margot & Kettler, 2019 ; Thibaut et al., 2018 ). For example, teachers who have a positive attitude toward STEM and students who have greater abilities are more likely to integrate STEM disciplines in problem-solving. Teacher education is essential to the promotion of interdisciplinary STEM education (Thibaut et al., 2018 ).

Instead of taking a focus on teacher education, in this special issue, we advocate for the use of emerging technologies to create a learning environment conducive to interdisciplinary learning. For example, Izadinia ( 2023 ) claimed that VR can involve students in digital arts for STEM learning; Ouyang et al. ( 2023 ) revealed that students may readily utilize AI to solve problems in integrated ways. These findings could be explained by the theory of experiential learning (Fromm et al., 2021 ) and interdisciplinary nature of AI (Casal-Otero et al., 2023 ). VR can enable experiential learning, allowing students to learn via participant experience or by doing. Students will be able to explore problems and utilize multiple discipline knowledge to complete tasks in an authentic scenario in VR settings. AI is viewed as an interdisciplinary field that includes computer science, mathematics, physics, neurology, psychology, and languages. Understanding how AI works requires interdisciplinary approaches (Chiu et al., 2022 ). AI learning assistants also can help student to gain interdisciplinary STEM knowledge (Carlos et al., 2023 ). These also imply that emerging technologies—VR and AI—have advantages to include other disciplines in STEM education. For example, both Izadinia ( 2023 ) and Zhang et al. ( 2023 ) found that VR and coding can help students explore digital art and expand STEM to STEAM. AI goes beyond STEM and often includes knowledge from other disciplines such as history and geography. Integrating AI in STEM would make STEM more interdisciplinary and readily include other disciplines (Park et al., 2023 ). Therefore, using emerging technologies could create a learning environment that fosters more interdisciplinary STEM education.

Rethinking the Major Learning Outcomes

Emerging technologies, especially AI and the metaverse, have an impact on our society. Some of the jobs will be replaced by technologies, while others have not yet to be created. Skills for the future workforce have evolved. To better equip the next generation, we need to refocus our education efforts and nurture student skills, such as computational thinking, AI literacy, creativity, leaderships, and collaborative skills. These are evidenced in various global educational initiatives like STEM education and AI education for K-12 (Casal-Otero et al., 2023 ; Chiu et al., 2022 ), as well as design thinking and global leadership programs (Kijima et al., 2021 ; Li et al., 2019a ). Our education needs to adapt to the shifting nature of working environment in the future.

The major learning outcomes of interdisciplinary STEM education include STEM knowledge, twenty-first century competencies, interdisciplinary thinking, and STEM interest and identity (Anderson & Li, 2020 ; Li et al., 2019b ). This special issue suggests that, due to the impact of emerging technologies, we should rethink the learning outcomes of STEM education. The “T” and “E” in STEM education are directly influenced by emerging technologies, for instance, students would design and create their own solutions to solve a real-world problem. The “S” and “M” are the foundational knowledge of emerging technologies; for instance, computer vision algorithms are derived from sets of mathematical equations. The findings of the five articles in this issue show that algorithmic and computational thinking, as well as digital, AI, and media literacy, should be core learning outcomes of future STEM education. To strengthen the future workforce, STEM educators and researchers should thus incorporate the learning outcomes in their educational or research projects.

What Challenges and Issues May Emerging Technologies Pose to STEM Instruction, and What New Skills Will Students and Teachers Be Required?

Widening digital divide.

Emerging technologies are double-edged swords and have the potential to both lessen and exacerbate the digital divide. As previously noted, emerging technologies designed for educational purposes are accessible to a wide range of students and user-friendly (Izadinia, 2023 ; Majewska & Vereen, 2023 ; Ouyang et al., 2023 ; Zhang et al., 2023 ), hence reducing the digital gap in STEM education. To build more sophisticated solutions, students need to have a firm grasp of mathematics and hard sciences, in addition to strong technical skills in developing technologies (Majewska & Vereen, 2023 ). As emerging educational technologies become more accessible to young kids, the technologies to be utilized by young kids depend on the school’s resources and the digital competency of the teachers, including their technical knowledge and skills, as well as attitude and value. Most schools and teachers are resistant to change (Chng et al., 2023 ); nevertheless, incorporating new technologies into STEM education represents a significant change for both schools and teachers. Consequently, emerging technologies may worsen the digital divide if schools and teachers do not receive adequate resources and professional training and support, respectively.

Enhancing Prerequisite Skills Needed for Emerging Technology-Enhanced STEM Education

Emerging technologies come with the benefit of fostering new learning skills, but they also call for the development of new prerequisite skills in order to make more successful use of the technologies in STEM education. Despite the fact that the educational technologies are simple to use, a strong foundation of necessary prior knowledge is required for more effective and safe learning and teaching. Articles in this special issue suggest that the required skills include computational thinking, digital literacy, and AI literacy (Chng et al., 2023 ; Ouyang et al., 2023 ; Zhang et al., 2023 ). We believe that it shall be beneficial for students if these skills are taught to them in elementary or middle school. Consideration ought to be given by educational institutions to the development of basic curricula for learning and teaching these skills.

Encountering Technical and Health Concerns

Emerging technologies in STEM education may cause technical and health concerns in implementation. It is time-consuming for teachers to experiment with emerging technologies or design-related materials prior to STEM classes (Majewska & Vereen, 2023 ). Less-well-prepared teachers are more likely to experience technical issues in STEM lessons with emerging technologies. When technological issues arise, it is difficult or impossible to deliver an emerging technology-driven STEM lesson. In addition, some technologies, such as VR, may pose health risks (Izadinia, 2023 ; Majewska & Vereen, 2023 ). Teacher’s knowledge of the technologies will help lessen the incidence of these technical and health concerns. Providing relevant professional training and support is necessary for using emerging technologies in STEM education.

Concluding Thoughts and Future Research Directions

With the inclusion of a limited number of articles, this special issue indicates the initial stage of research in this topic area. There are still many research areas regarding the use of emerging technologies in STEM education that are exciting but remain to be explored. For example, a line of possible research work is the provision of safe learning environments when employing emerging technologies in STEM education. For the purpose of optimizing learning, emerging technologies such as AI and avatars in the metaverse may capture students’ personal information such as learning data, body movement, and face and voice data. How the technologies collected and used the data can associate with privacy and ethical concerns. Another issue is the psychological safety of students. Some students may become addicted to VR and AI and find it difficult to leave the virtual and chatbot environments. Their emotions, such as fear or anger, may be elicited by the environments, influencing their decision-making. Even in the digital environments, maintaining psychological safety is still very much relevant and important to promote STEM learning. Therefore, we suggest that future research should focus on how to create safe learning environments while incorporating emerging technologies in STEM education, taking into consideration of those ethical, privacy, and psychological concerns.

Teacher professional learning is another area that is underserved. Even though four of the five articles addressed teacher involvement in STEM education, none of them examined what and how to provide professional learning for the use of emerging technologies in STEM education. To successfully employ emerging technologies, teachers must have sufficient pedagogical knowledge and skills as well as digital literacy (Chng et al., 2023 ; Ouyang et al., 2023 ). Policy on ethical, privacy, and psychological considerations necessitates the engagement of educational leaders. We encourage future research should focus on how to design, develop, and deliver professional learning for both teachers and leaders.

Concerning theoretical perspectives, Ouyang et al. ( 2023 ) brought up the last line of work. Theoretical support is missing from most studies that use emerging technologies in STEM education. According to those studies, emerging technologies for STEM education were developed and used in new ways. They discussed how teachers and students can use technologies to teach and learn STEM subjects. Most of those studies did not utilize a theoretical framework to examine and interpret their findings. Therefore, future studies should look at their designs and findings from certain theoretical point of view of learning and development.

We hope that the publication of this special issue will inspire researchers to further explore and broaden the field’s knowledge of how emerging technologies transform STEM education, as well as how theories may be developed and used to explain and support the key role of the technologies in STEM learning and teaching. Finally, we encourage researchers and educators to consider possible benefits and difficulties that emerging technologies can offer to STEM education and to envision what a bright future STEM education can be.

Data Availability

The data and materials used and analyzed for the editorial were articles published in this journal. Journal article information is accessible at the journal’s website ( https://www.springer.com/journal/41979 ).

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Chiu, T.K.F., Li, Y. How Can Emerging Technologies Impact STEM Education?. Journal for STEM Educ Res 6 , 375–384 (2023). https://doi.org/10.1007/s41979-023-00113-w

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Chuck Chan, stem cell researcher who discovered how to regrow cartilage, dies at 48

The Stanford Medicine researcher was known for his groundbreaking work and his generous spirit as a mentor and colleague.

April 23, 2024 - By Jennifer Welsh

Chuck Chan on a road trip to Yellowstone National Park. Wan-Jun Lu

Charles “Chuck” Kwok Fai Chan, PhD, an assistant professor of surgery at Stanford Medicine, died March 12 at Stanford Hospital surrounded by his wife, parents, siblings, and some of his dearest friends and colleagues. He was 48. 

“Chuck accomplished a great deal in the short time he had,” said   Lloyd Minor , MD, dean of the Stanford School of Medicine and vice president for medical affairs at Stanford University. “He knew he was working against the clock, which drove him to persevere in his research. He leaves behind a wealth of foundational stem cell discoveries that will inform the future of rejuvenative medicine. Stanford Medicine mourns the loss of such a talented researcher at such an early age.”

A member of the Stanford  Institute for Stem Cell Biology and Regenerative Medicine , Chan discovered the mouse and human stem cells that give rise to bone, cartilage and some types of cells that nurture blood-forming stem and progenitor cells. These stem cells are integral to developing new healing technologies for joints affected by osteoarthritis or skeletal injuries. 

​“Chan was an outstanding scientist with a prodigious intellect and curiosity. He was a giant in the field who we lost way too early,” said  Michael Longaker , MD, a professor of plastic and reconstructive surgery and the Deane P. and Louise Mitchell Professor in the School of Medicine. “His work will have a long-lived impact. Decades from now, millions of people with arthritis may be benefiting from his discoveries, and I will say, ‘This work traces back to the Chan lab.’”

Chan trained many young scientists, including undergraduates,  CIRM scholars  and international students. His colleagues said he was generous with his time, ideas and the secret recipes used in his experiments. He believed there were always more discoveries to make and more  Nature  papers to write. 

“He was very confident that there was enough science to go around. He was so willing to share, to talk about science, to collaborate because he was confident that there was so much still to discover,” said his brother  Ed Chan , a researcher in the plastic and reconstructive surgery department at Stanford Medicine. “He was very open with his science, pushing his teams to present their research and share what they discovered and the new tools they developed.”

Chan identified and isolated essential components needed to encourage the development of skeletal stem cells, which can make bone, cartilage and helper cells for blood-cell precursors. To bring these findings to the clinic, he dabbled in gene editing and even a project using microneedle-based technologies for repairing cartilage with his brother.

“He was a brilliant young scientist, unafraid to explore new technology,” said  Irving Weissman , MD, founding director of the Stanford Institute of Stem Cell Biology and Regenerative Medicine, professor of pathology and developmental biology, and the Virginia and D.K. Ludwig Professor in Clinical Investigation in Cancer Research. “Though he didn’t treat patients, he was always thinking about how they’d benefit from his discoveries. We will miss his drive, his empathy, his deep intelligence. Sadly, generations of patients will miss his potential discoveries.”

Boundless curiosity, unrestrained imagination

When he applied to Stanford Medicine’s graduate program, Chan wrote in his personal statement, “If I cannot be a child, then let me be a scientist…scientists have boundless curiosity and an unrestrained imagination.” It was a definition Chan embodied his entire life, friends and family say. 

Though he didn’t treat patients, he was always thinking about how they’d benefit from his discoveries.

Born May 14, 1975, in Hong Kong, Chan moved to the U.S. in early 1982, landing in Anaheim, California, where he could see Disneyland’s famous fireworks displays from his living room window. He was the eldest of six siblings — he had four brothers and one sister. His mother is a homemaker, and his father was in the photographic equipment business during his youth.

“Chuck was the leader of our gang. He was No. 1,” Ed Chan said. “He was always into science — he had a big rock collection; he was into bugs and how the ecosystem works. As a family, we used to laugh at him a bit for his obsessions.”

He attended Alhambra High School, where he played clarinet in the marching band. He started his research career in high school, interning at university labs over the summer. 

He earned a bachelor’s degree in molecular biology from the University of California, Berkeley, in 1999, staying on for two years to complete a research project and publish his work. In 2002, he enrolled in the development biology program at Stanford Medicine, joiningWeissman’s lab, where he focused on finding and defining interactions between stem cells that lead to regenerative growth. He earned his PhD in 2011. 

“He explored many things and proved himself to be absolutely fearless in terms of technologies that might advance the field,” Weissman said. 

As a graduate student, Chan was diagnosed with non-Hodgkin’s lymphoma and underwent extensive treatments. “During that time, he did not stop doing science,” said his wife,  Wan-Jin Lu,  PhD, a research scientist at the Stanford  Institute for Stem Cell Biology and Regenerative Medicine . “He managed to publish a paper, defend his thesis, attend lab meetings and support his lab mates.”

Eventually, a bone marrow transplant from his sister gave him an eight-year remission. He was awarded with an independent Siebel Scholar position and built up his lab immediately after earning his PhD. His work focused on the stem cells that give rise to bones and cartilage. 

“Anyone else might have been demoralized by how hard these experiments were. But Chuck seemed like he couldn’t get enough of it,” Longaker said. “That’s what made him a unique and uber-successful scientist.”

Chan worked doggedly to identify the  mouse skeletal stem cell , which gives rise to the spongy bone that supports blood, hard bone and cartilage.

“Irv said these experiments would not work, but Chuck did not listen. He went ahead and tried it anyway,” Lu said. Eventually, he grew a piece of bone with a spongey inside and cartilage at the ends. “He was so proud of himself that he brought the bone straight into Irv’s office — it was his once-in-a-lifetime ‘Eureka’ moment that every scientist dreams about.”

Weissman added, “One of the unique aspects of helping great graduate students is that they discover what you doubted.”

That work was published in the top journal  Cell  and immediately put him on the map as a “researcher to follow,” Longaker said. Very quickly after that, he identified the human skeletal stem cell, again publishing the finding in  Cell .

“He became this iconic bone biology person early in his career — it was a testament to his vision for what’s possible,” Longaker said. “He went on to regenerate cartilage and reverse the slow healing of aging.”

When joint cartilage has worn away, bone painfully rubs against bone. Often, a patient’s only solution is pain medication or joint replacement surgery. Chan’s research may lead to ways to regrow cartilage.

“Because he had overcome so much with his health as a grad student, I think it gave him a sense of urgency in his work,” Longaker said. “He wasn’t on faculty long. But wow, his contributions will live forever.”

A lasting impression

Not only was Chan a dedicated scientist; he was an optimist inside and outside the lab — an upbeat person always happy to collaborate, colleagues said. He was also a well-known night owl, sending texts from the lab at all hours.

In the lab, Chuck was in his element. That was what he wanted to do with the people he wanted to do it with.

He took an unusual approach to picking his projects. He pursued the fundamental questions, pushing through ideas at an unusually fast rate. He conducted one experiment, focusing on one question, to decide if that project would work. If not, the next week, he would start a new project.

“He didn’t work on small projects. He wanted to make a difference,” Longaker said. “He was undaunted; no matter how complicated the experiment, he did whatever it took — that’s what made him unique.”

Chan was also a good mentor and group leader. “If someone was having a bad day, they would come to Chuck’s lab. They’d have a few beers, and he would help them through it. He would sit with you and inspire you,” Lu said.

Chan spent about 90% of his time talking about, thinking about or conducting lab work, Lu said.

“The idea of work-life balance wasn’t his focus. It’s work and life, they’re just together,” Ed Chan said. “In the lab, Chuck was in his element. That was what he wanted to do with the people he wanted to do it with.”

Outside the lab, Chuck found a profound connection with Hawaiian culture during a weeklong camping trip along the Maui coastline. This experience ignited a love for the Aloha spirit and the Hawaiian way of life. He was often seen in Hawaiian shirts, spending time at the beach and hiking the island trails. Chuck had a particular fondness for sea turtles, always seizing the chance to seek them out along the sandy shores.

When it came to his family, Chuck was the sterner older brother, Ed said. He pushed his younger siblings hard when they were younger, prepping them to take the SATs by having his siblings live with him for the summer and drilling them every day. “They hated it. But to this day, they all admit that they got into decent schools because Chuck was riding them so hard,”Ed Chan said.

Chan received a Siebel Scholarship Award from 2011 to 2013, a Prostate Cancer Foundation Young Investigator Award from 2013 to 2016, a National Institutes of Health Pathway to Independence Award from 2015 to 2020, and an American Federation for Aging Research and Arthritis National Foundation grant in 2018 and 2020. 

Chan is survived by his wife, Wan-Jin Lu, of Redwood City, California; parents Albert and Anna Chan; and his five siblings: Edward Chan, Andrew Chan, Marvin Chan, Brian Chan and Karen Haas. He has nine nephews and nieces.

• Jennifer Welsh Jennifer Welsh is a freelance writer

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu .

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ORIGINAL RESEARCH article

How did you perform investigating football players’ perception of self-regulated passing performances under auditory noise environments.

• 1 Section Cognition in Team Sports, Institute of Exercise Training and Sport Informatics, German Sport University Cologne, Cologne, Germany
• 2 TSG Research Lab gGmbH, Zuzenhausen, Germany
• 3 Faculty of Health, School of Health Sciences, University of Canterbury, Christchurch, New Zealand

Introduction: This paper deals with the question on how sport performances may be influenced by internal, emotional processes, which stem from outside feedback.

Methods: In terms of methods, players’ subjective performance ratings for four experimental auditory cue conditions were examined; these included both ‘positive’ and ‘negative’ stadium noise, ‘no (auditory) conditions,’ and a control/‘baseline’ condition. This resulted in a qualitative-analytic data set that was obtained succeeding each auditory cue condition using a unique football training machine (i.e., known as ‘Footbonaut’). Without having received any coaching/performance feedback, players were asked to rate and individually comment on their perceived performance ratings for each experimental auditory condition.

Results: Findings indicate stronger and more significant correlations between auditory conditions and subjective ratings compared to the non-auditory condition and its subjective rating. Furthermore, data provides initial insight into players’ emotional experiences during each of the practice conditions.

Discussion: These noteworthy findings on players’ abilities to accurately judge their performances based on selfmonitoring and intrinsic feedback are discussed from an Ecological Dynamics perspective, linked to a Nonlinear Pedagogy for coaching. Here, representative and affective learning designs for skill learning and performance preparation are presented. Finally, a hypothetical catalyst effect of auditory stadium noise on subjective performance rating is proposed.

• This study aims to better understand players’ emotional experiences of auditory noise environments and their subjective abilities to accurately perceive and judge their performances to them.

• Results show that skilled football players use self-monitoring and intrinsic feedback to judge their performances; and emotionally and positively respond to (game-representative) auditory noise environments.

• A link between auditory information, its effects as a catalyst on task performance and subjective emotional regulation is proposed.

• Findings underline the benefits of representative and affective learning designs and a hands-off coaching approach.

Introduction

During the COVID-19 pandemic, professional sports leagues worldwide experienced significant disruptions, often halting mid-season. Association football, with the first national league to resume being the German Bundesliga, tried to restart its schedule under stringent regulation. Notably, stadiums remained devoid of spectators—a measure intended to mitigate the spread of the virus. Consequently, professional players encountered a peculiar situation: the once vibrant and emotionally charged atmosphere of stadiums was replaced by silence. This prompts an intriguing inquiry: Did this change in auditory information affect the players temporarily in their playing ability, and if so, how?

Research into stadium noise and its impact on performance has surged during the COVID-19 pandemic. A meta-analysis by Leitner et al. (2023) comprehensively examines numerous studies conducted during the pandemic era, focusing on the home-field advantage. While the home-field advantage has been well documented across various sports and contexts by scientists over the last 30 years, no one clearly dominant factor for it has been established ( Legaz-Arrese et al., 2012 ). Rather, research highlights a multitude of causes, such as crowd and travel effects, territoriality, referee bias, and other psychological factors (see Pollard, 2008 , for an initial review). Here, Pollard (2008 , p. 13) stresses that “ultimately it is what goes on in the mind of players, coaches and referees that determine their actions and hence the result of a game and the role played by home advantage.” Connecting this research area on home-field advantages along with potential crowd noise effects back to the current study, it is of interest to what degree emotionally-laden (positively or negatively perceived) auditory stadium environments – in contrast to silent, no noise (COVID-19 pandemic-like) environments – may impact player performances, perceptions, enjoyment, and motivation ( Otte et al., 2021 ). While existing studies predominantly rely on in-field analytics, investigations into athletes’ behavior amidst altered auditory environments remain scarce. Previous studies examining the influence of stadium noise under controlled laboratory settings, such as Otte et al. (2021) , have primarily focused on objective metrics like passing accuracy and time. These experiments revealed that athletes exhibited quicker passing times when exposed to pertinent auditory cues compared to negative (e.g., booing) or silent conditions. However, these findings, though valuable, present an incomplete picture. The fundamental question that remains unanswered is the underlying mechanism driving divergent behavioral responses across varied noise conditions.

This paper aims to address this research gap by delving into the subjective experiences and perceptions of athletes amidst varying stadium noise levels. By analyzing a previously collected yet unexplored qualitative dataset concerning football players’ perceived performances under different auditory cue conditions, we aim to shed light on the nuanced interplay between auditory stimuli and athletes’ cognitive and emotional responses. This novel approach will not only enhance our understanding of athletes’ adaptability to stadium noise but also elucidate their ability to evaluate performance independently of coach-led feedback. Furthermore, we seek to correlate these perceptual abilities with players’ emotional engagement with distinct football-specific auditory cues.

Key concepts in Ecological Dynamics to highlight the importance of emotional processing in regards to self-regulation and self-monitoring

To understand why this research is a welcoming contribution to the expanding literature on behaviors of football players in different auditory contexts, we first must explain why it is important to view this study from the lens of the athlete’s emotional perspective. To do so, we will use an Ecological Dynamics perspective, highlighting the deeply intertwined relationships between perception, action, cognition, intentions, and emotions. From this perspective, understanding athletes as complex and adaptive systems, composed of numerous interacting parts, is critical ( Phillips et al., 2010 ). Particularly, it is the scale of analyzing athletes’ performances holistically on perceptual-cognitive, physical and emotional levels that further concerns their ability to self-regulate under varying contexts ( Davids, 2015 ). For practice and competition contexts, it is therefore the coach’s role to guide players’ self-regulation and self-monitoring toward goal-oriented and functional behavior ( Davids, 2015 ; Woods et al., 2020a ). Self-regulation is understood as the human capacity to manage ones urges according to previously defined goals or ideas ( Baumeister et al., 2007 ). These goals/ideas can be both from an external source but also stem from an internal one. An important subcomponent of self-regulation is self-monitoring, and as laid out by Zimmerman (2000 , 2001) , self-monitoring displays a way for the individual to implicitly sense and assess whether the current task is done effectively from the person’s own point of view. More importantly, papers from Diamond and Aspinwall (2003) or Bridgett et al. (2013) showcase that emotions can heavily affect the self-regulation process. These authors state that while negatively charged emotions often hinder the transfer of mental into task-related skills, positively charged emotions facilitate this transfer. If we keep the previous definition in the back of our mind, it becomes therefore essential to analyze the player’s own perceived emotional state, as without it, our ecological view would miss a key variable.

In addition, the bidirectionality of the player-environment relationship provides some clear principles for guiding the design of practice activities ( Woods et al., 2020a ). For example, the use of nonlinear pedagogical concepts, such as representative learning and affective learning designs , has been advocated by research for numerous years (see Otte et al., 2019 , 2020 , and Headrick et al., 2015 , for recent conceptual discussions for each learning design, respectively). Representative learning designs emphasize the notion for practice activities to replicate constraints and key information that is present in the competitive performance environment ( Woods et al., 2021 ), whereas affective learning designs highlight the embedment of emotions into these representative (practice) tasks, potentially evoking individualized behavioral tendencies in different athletes ( Headrick et al., 2015 ). These constraints are defined as part of the Constraints-Led Approach, which is in turn underpinned by principles of Ecological Dynamics and Nonlinear Pedagogy ( Renshaw et al., 2016 ; Button et al., 2020 ). Constraints are viewed as individual, task-related and environmental characteristics and features that guide a player’s search for and perception of relevant information. Examples can be objects, like specific passing targets or auditory conditions, such as stadium noise (e.g., Fajen et al., 2009 ). From an applied coaching perspective, it would therefore be ideal if one uses constraint manipulations (e.g., adding stadium noise conditions) to design these representative and affective practice environments, which focus on holistically integrating all performance-regulating sub-systems (i.e., perception, action, cognitions, intentions, and emotion; Woods et al., 2020a ). Put simply, the practice design and its constraints drive athlete self-regulation and exploration ( Woods et al., 2020b ). These processes are intentionally regulated in constant interaction between athletes and their surrounding environments ( Davids et al., 2015 ).

Without further coach-induced or similar types of augmented feedback, athletes learn to search for and perceptually attune to relevant environmental information and invitations for action (also termed affordances; see Fajen et al., 2009 ). It is important to note that search in this case stems from the perceptual-cognitive entanglement, highlighting how externally and internally perceived information are mutually dependent in driving athlete self-regulation. An example of this would be an internal appraisal of a whistling crowd, which would startle the athlete. This in an essence means that in absence of augmented feedback, people (and athletes) aim to enhance the use of intrinsic (sensory) feedback sources such as emotional feedback to self-monitor and adapt task-specific behavior ( Hodges and Franks, 2002 ; Otte et al., 2019 , 2020 ). For example, a football player would always feel and see the consequence of a pass without receiving further extrinsic and augmented coaching feedback ( Williams and Hodges, 2005 ). Particularly, the notions of task-intrinsic feedback and self-monitoring relate to this investigation, in that it aims to examine skilled football players’ abilities to accurately, and independently, judge their own performances. This idea may be further supported by previous research demonstrating athletes’ abilities to use acquired and specified knowledge to accurately assess movement performances ( Hadfield, 2005 ; Fajen et al., 2011 ; Millar et al., 2011 , 2017 ). For example, Millar et al. (2017) found Olympic rowers show accuracy in judging and successfully identifying quality rowing stroke performances by accessing knowledge of their performances. This finding may be extended by research demonstrating expert rowers to accurately perceive and monitor their own catch efficiency, which was objectively reflected by changes in boat speed ( Millar et al., 2017 ). While to the authors’ knowledge, there has been no investigation to date into football players’ abilities to accurately self-monitor performances (under varying noise conditions), previous research commonly emphasizes “high-level performers as expert systems adept at detecting and evaluating change focussed on performance” ( Millar et al., 2015 , p. 3). Yet a special importance of these ecological factors and emotions so far has neither taken place in research, nor in the common training regimen of athletes. In an essence, this leads the training tasks to become non-representative or at least less representative for a stadium-based (noise) atmosphere. This could lead to a missing transfer of training skills in a professional sporting environment, these being the stadium environment. Consequently, based on the proposed theoretical rationale with a focus on emerging player-environment relationships ( Davids et al., 2008 ) and the existing research gap, this article aims to investigate:

i. To what extent skilled football players accurately judge their performance in absence of augmented, coach-led performance feedback; and

ii. How football players perceive and self-regulate their emotional reactions to various auditory cue environments in practice.

Participants

An initial a priori analysis was conducted to determine the required sample size for this study using the computer program G*power 3.1.9.7. The estimated effect size for this study was unknown, as the few studies that analyzed stadium noise at a professional level all failed to include effect sizes. However, conceptually similar studies focusing on auditory stimuli affecting treadmill walking ( η 2  = 0.24; Karageorghis et al., 2009 ) and running performance ( η 2 =  0.20; Bood et al., 2013 ) demonstrated rather large effects. We, therefore, estimated the participants of a correlation analysis using a medium to strong effect of r  = 0.6 with a relative power of 0.80 and a critical alpha of 0.05. This resulted in 19 participants that we needed to recruit for this study. Unfortunately, this margin was missed by four participants due to the requirement of a highly specialized sample size of elite athletes. Therefore, the final participant number of the experiment is a sample of 15 male football players ( n  = 15, U23s age group) and results from this study should be taken with care due to possible type-1 error inflation. The ethical approval for the presented study protocols was granted by the lead author’s university ethics commission in 2019.

The highly skilled sub-elite players were tested on objective metrics such as their passing performances [i.e., passing accuracy score (in %) and average passing time (in s)], using the standardized and validated robotic football training tool, known as ‘Footbonaut’ (CGoal GmbH, Berlin, Germany; see Beavan et al., 2019 , and McGowan, 2012 ). In said training, after a warmup procedure consisting of 10 passing repetitions, the players were instructed to perform four identical football passing rounds consisting of 32 low passes over the course of 2–3 min. The Footbonaut is a high-tech robotic cage where footballers can improve their technical skills without any other players ( Beavan et al., 2019 ). The four sessions differed due to different randomized auditory noise conditions. These four different conditions are: (1) A ‘Baseline’ condition: the training environment allows for participants to perceive all relevant visual information (i.e., light signals) and auditory cues (i.e., ‘beep’ sound signals at a volume of approximately 75 dB) on passing source and passing target ‘window,’ as provided by the Footbonaut (i.e., participant’s hearing was not distracted). (2) A ‘No auditory’ cue condition: the training environment significantly limits the participant’s perception of auditory information (i.e., ‘beep’ sound signals) on passing source and target ‘window’ provided by the Footbonaut (i.e., participants were asked to wear ear defenders throughout the training session). (3) A positive auditory cue condition: the training environment displays loud stadium noises (i.e., a football crowd singing) played through speakers in the Footbonaut (i.e., with a volume of approximately 85 dB); thus, the participant’s perception of auditory information (i.e., ‘beep’ sound signals) on passing source and target ‘window’ provided by the Footbonaut are impaired. or (4) A negative auditory cue condition: the training environment displays loud stadium noises (i.e., a football crowd whistling and ‘booing’) played through speakers in the Footbonaut (i.e., with a volume of approximately 85 dB); thus, the participant’s perception of auditory information (i.e., ‘beep’ sound signals) on passing source and target ‘window’ provided by the Footbonaut are impaired. The crowd sounds of fans singing and chanting were pre-tested for their validity ( Otte et al., 2021 ).

The task was instructed to the players at the beginning, indicating that they should “receive and pass the ball as quickly as possible.” All conditions were completed by each participant in a randomized order. Notably, emotional valence of auditory stadium conditions was pre-tested by 30 participants ( n  = 30) and the Footbonaut training machine allowed the researchers to control for various variables (e.g., passing repetition numbers, ball release speeds and angles from the machine, light and ball conditions). Additionally, all available information remained the same for each passing repetition per session (e.g., visual information, auditory conditions, ball speed and trajectories; see Otte et al., 2021 ).

After all the information from the participants was recorded, feedback was provided for the athlete by the lead experimenter and the participant debriefed and dismissed.

Additionally, to the physical data already analyzed by Otte et al. (2021) with help of the Footbonaut, players were also asked to provide subjective statements regarding their own performance. These subjective statements will be the focus for the following analysis. Without disclosing players’ performance scores nor providing any augmented (verbal) coaching feedback, players were asked to provide both standardized and open statements following each of the four auditory conditions (i.e., under the ‘baseline,’ ‘no auditory cue,’ ‘positive auditory cue’ and ‘negative auditory cue’ conditions). Recordings were made by athletes answering a questionnaire after completing each practice condition. The lead experimenter was always present during the data collection of the Footbonaut and handed out the questionnaire, however the experimenter was not present during the time the athlete was filling out the answers. To further control for possible cognitive and emotional biases during the experiment, there was no feedback or consultations provided regarding the information on the questionnaires for the athletes during the four conditions. In detail, ratings and perceptions after each auditory cue conditions were measured in two ways. Both of these measurements were collected in a previous study ( Otte et al., 2021 ), but were not analyzed upon:

1. Players were asked to rate their performance for each session on a Likert-type scale from 0 (i.e., strongly unsatisfied) to 10 (strongly satisfied); and

2. Players were questioned on their performances and subjective perceptions of the auditory cue conditions. In particular, they were asked to ‘please comment on your perceptions of/ feelings about each auditory cue conditions’ after each of the four sessions.

Data analysis

For the data analysis, subjective ratings and statements were compared to objective performance data obtained from the Footbonaut system, as previously mentioned in Otte et al. (2021) , but briefly summarized here. The results of this experiment revealed that under negatively valenced sounds, such as negative auditory conditions or absolute silence, reaction times in the Footbonaut were slower. Conversely, positively valenced sounds, such as cheerful crowd noise, did not yield any significant improvements. Similarly, passing accuracy was not affected by any of the auditory conditions. To establish a connection with the present study, a Spearman-rho correlation analysis was employed to investigate whether subjective emotional scores are associated with average reaction time and passing accuracy. This correlation analysis was conducted for each of the eight conditions, and results are presented in Table 1 .

Table 1 . Overview of the different correlations between the different subjective emotional categories and the objective stats.

Additionally, a manipulation check was done to see whether participants correctly can assess their subjective performance this was done by comparing the perceived subjective rating to the accuracy achieved in the Footbonaut.

Qualitative-analytic exploration considered each player’s standardized ratings and subjective statements following each auditory cue conditions. Here, players’ perceived performance ratings (i.e., between 0 and 10) were used for correlation analysis with the two objective performance scores (i.e., passing accuracy and average passing time). Further, an inductive, data-driven theming process was used to code the qualitative, open statements that players provided after each auditory cue conditions ( Braun and Clarke, 2006 ). Specifically, in order to explore players’ subjective statements regarding each auditory cue condition, thematic analysis allowed to examine individual players’ perspectives and feelings ( King, 2004 ; Nowell et al., 2017 ).

A thematic analysis was conducted by the experimenters based on the open statements voluntarily filled out by each player. The result from these statements were filtered and subsequently divided into three coding themes, which include: (i) ability to perceive acoustic information; (ii) perceived positive influence on performance; and (iii) perceived positive influence on emotional engagement. All experimenters spoke the native language of the athletes, German.

Qualitative-quantitative exploration of players’ subjective statements following each Footbonaut auditory cue conditions provides insight into: (1) the correlation between players’ subjective performance ratings and two objective performance data measures of passing accuracy and average passing time; and (2) players’ subjective and internal emotional regulations to the auditory cue conditions.

Players’ subjective performance ratings

A spearman-rho correlation analysis was performed with all of the different emotional conditions (baseline, positive, negative, and headphones) in relation to average passing time and passing accuracy. Due to time-related issues, one participant out of 15 only managed to be tested in the objective conditions and could not be questioned regarding their subjective emotional analysis. This participant was excluded in the correlational analysis. In the baseline subjective rating condition, we saw a correlation of 0.657 ( p  = 0.011) for the baseline accuracy and a correlation of 0.413 ( p  = 0.142) for the average time taken. The positive subjective rating condition was correlated to the accuracy with 0.841 ( p  < 0.001) and not correlated to the average time with 0.102 ( p  = 0.729). The negative subjective rating condition was correlated to the accuracy with 0.790 ( p  = 0.001) and not correlated to the average time with −0.131 ( p  = 0.657). The headphone subjective rating condition was not correlated to the accuracy with 0.514 ( p  = 0.06) nor to the average time with 0.246 ( p  = 0.397) for the average time taken. Table 2 presents an overview of all correlations. Significant correlations are marked with an asterisk (*).

Table 2 . Spearman-rho correlational analysis between subjective performance ratings and their accuracy performance score, where a simple yes (√) or no (X) represents when each player was accurate about their highest (or lowest) subjective rating, matches their highest (or lowest) accuracy score or time taken.

Furthermore, as a validation check, Table 2 presents a qualitative analysis of a simple yes (√) or no (X) to represent when each player was accurate about their highest (or lowest) subjective rating, matches their highest (or lowest) accuracy score or time taken. For example, a tick (√) indicated a direct match between subjective rating and a performance score. Here, it can be observed in Table 1 (highest score), that 93% of players were accurate and knew when they had their most accurate round (of the four conditions) and subjectively rated it their highest. Likewise, players were mostly accurate to know when they had their lowest score. While players were less accurate about their performance time, all 14 players were accurate about at least one of the four measures and over 55% of players were accurate in 3 of the 4 measures. When all measures were taken together ( n  = 56), a significant correlation of 0.735 ( p  < 0.001) was given between own subjective rating and performance of the players. A non-significant correlation of 0.132 ( p  = 0.13) was shown between subjective rating and time taken of the scores.

Players’ subjective perceptions of the auditory cue conditions

Qualitative analysis of players’ subjective perceptions and statements after each practice round led to three coding themes; these include: (i) ability to perceive acoustic information; (ii) perceived positive influence on performance; and (iii) perceived positive influence on emotional engagement. Notably, due the analysis of participants’ perceptions of each practice condition concerned open and voluntary statements (i.e., statements about the ‘baseline,’ ‘no auditory cue,’ ‘positive auditory cue,’ and ‘negative auditory cue’ conditions). First, the ‘baseline’ practice condition was clearly perceived to be “easiest” in regard to multimodal cues providing support for passing performance. Its accessibility concerning perceiving acoustic information to support their passing performances was stated by 10 of 14 players ( n = 10). For instance, while one player stated that “ signals are clearly hearable ,” another player expressed that “ one can perceive both noises (ball machine and target) very well and one can often find the optimal position .” In regard to this condition’s impact on emotional engagement, remarkably no player made a statement leading to the notion that the baseline condition had a rather neutral effect on emotional engagement.

Second, eight players ( n  = 8) claimed that the ‘noise-canceling headphones condition’, as expected, had influence on their performances by, for example, making statements such as: headphones made it “ difficult to hear the signals ” and (more) “ difficult to perceive the noises .” Whereas these statements indicate perception of increased practice task complexity under a ‘no auditory cue condition,’ mixed feelings regarding its influence on performance were specified (i.e., eleven players mentioned for this condition to either have positive or negative impact on performance). For example, some players provide statements such as: “No noise helps because I was more concentrated through the silence” and “ I felt more concentrated and force[d] to find more [visual] orientation .” In contrast, other players mentioned this cue condition to be “ harder ,” because “ too much concentration on noises and because of that a bad focus on passing performance ,” and to lead to (internal) body-focused attention. Furthermore, the feeling of increased focus through impaired hearing was expressed. This, however, at the cost of feeling “ slower ,” “ rather annoyed ” and subjectively perceiving multimodal environmental cues with a delay.

Third, both stadium noise conditions (i.e., positive and negative stadium noise conditions) were stated to impede perception of acoustic Footbonaut sounds and thus, likely increase perceived task complexity, compared to the ‘baseline’ condition (i.e., nine and eight players mentioned this for the conditions, respectively). However, both auditory cue conditions were rated to increase players’ “ focus ” and “ concentration ” to perform in emotionally engaging football practice environments. This notion may be highlighted by one participant’s quote concerning the positive auditory cue condition: “ Because it is very loud, I had to focus more on orientating myse lf.” Finally, while both stadium noise conditions supposedly led to increased stimulation and motivation (e.g., a player stating: “ the whistling has motivated me ”), the lead researcher’s informal conversations with players after concluding the experiment found that the ‘positive auditory cue’ condition appeared to be slightly more favorable. This condition was explicitly stated to positively influence perceived performance, and perceived positive emotional engagement with the training space. This overall insight may be appreciated by one player’s written quote: “ The singing fans were positively perceived – I found the chanting wicked! ”

While the initial study by Otte et al. (2021) assessed the effect of auditory cue conditions with varying representativeness on football players’ objective passing performances, this article aims at approaching the study from an athlete-centered perspective on individuals’ performance perceptions and emotional engagement with practice under varying auditory noise conditions. Findings are discussed regarding (1) skilled players’ subjective perception of performance (i.e., as compared to objective performance data); and (2) skilled players’ emotional engagement during practice under auditory noise conditions .

Skilled players’ subjective perception of performances

The evaluation of players’ perceptions of their own performances compared to actual performance data reveals a strong correlation. The finding that the majority of skilled players correctly perceive and evaluate their own performances (in absence of any augmented feedback of results) aligns with the literature on expertise in sports. Table 1 also demonstrates that players were highly accurate in discerning whether they were successful or not in their performance, with all but one player being aware of which auditory condition they were most successful in. In contrast, players were less accurate in identifying which condition resulted in the fastest or lowest performance. This outcome might be expected in a sport like football, where players are constantly engaged in the dynamics of successful passes, thus arguably possessing expert knowledge of whether a pass was successful or not.

The correlations themselves show an interesting finding. The emotional engagement of the players was significantly correlated with their respective score in all conditions – except the one condition where players could not hear any outside information. In the baseline condition, outside noise from the Footbonaut informed them about their performance, similarly to the positive and negative emotional categories. That effect is not present in the category where the players do not hear any outside information (i.e., where they wear headphones). The correlations are also stronger in the emotionally charged conditions compared to the baseline condition. One reasoning for that might be that outside noise affects the players as a sort of “catalyst” which charges the player’s motivation or reasoning and with that, their performance. A player that was previously defined only by his technical ability (like in the headphone condition) is now rewarded or ridiculed by their outside noise. A good performance then might be enhanced and increased by the noise in the same way a bad performance may be diminished and decreased by crowd noise.

Overall, experiential knowledge of expert performers, here, supports self-monitoring and intrinsic feedback processes that naturally occur within all athletes ( Vereijken and Whiting, 1990 ; Hadfield, 2005 ; Greenwood et al., 2012 ). In other words, “it may be argued that over time, athlete knowledge will be superior to that of the coach in some aspects of performance” ( Millar et al., 2017 , p. 808). This advanced ability to accurately judge own performances may refer back to an ecological view on players’ attuning to their direct environments and thus, developing adequate knowledge of information that effectively supports monitoring of performance ( Gibson, 1966 , 1979 ; Fajen et al., 2009 ). Given this high level of player self-awareness, coaches may need to tailor both coaching approaches and informational constraints (e.g., in forms of augmented feedback and instructions) toward players’ needs ( Williams and Hodges, 2005 ; Chow et al., 2016 ). Put simply, coaches may rather act as (hands-off) facilitators of the practice environment, should consider players’ knowledge and wealth of experience and leave further exploration and problem solving to the players ( Millar et al., 2015 ; Renshaw et al., 2019 ).

Skilled athletes’ emotional engagement during practice under auditory noise conditions

Evidently, inducing auditory stadium noise into football practice had some impact on players’ performances and emotional engagement with the environment. This is supported not only by the statistically significant differences for passing times (see Otte et al., 2021 ), but also in terms of emotional disposition during various practice conditions. Based on an Ecological Dynamics rationale, a critical challenge for coaches concerns the design of holistic athlete practice experiences that support the search for adaptable movement solutions under emotional constraints present in competitive environments ( Davids et al., 2013 ). While continuous interaction between perception, action, and cognition is commonly considered, the presence and role of emotionally engaging training spaces remains underexplored. To theoretically discuss this matter in relation to the concept of affective learning design ( Headrick et al., 2015 ), two points appear to be critical: (1) representative and auditory stadium noise environments seemingly increase emotional engagement with the practice design; and (2) individual players rate various auditory noise environments as differently engaging on an emotional level.

First, it is suggested that emotional engagement supports search for relevant action invitations under game-representative informational constraints ( Seifert et al., 2013 ; Headrick et al., 2015 ). For example, a player unable to hear and communicate with his teammates due to crowd noise may effectively learn to rely on visual environmental information, while the player will also get perceptually attuned to these stadium noises. In other words: “emotions add context to actions” ( Headrick et al., 2015 , p. 87). Aligned with Constraints-Led Approach, we argue that the manipulation of task and environmental constraints can be critical for skill learning and increased player motivation; e.g., several players stated that both stadium noise conditions influenced emotional engagement in various ways. Thus, facilitating for players to experience training under stadium noise conditions may display one effective way of replicating environmental constraints experienced in football games ( Seifert et al., 2017 ; Otte et al., 2021 ). Notably, this notion connects back to the aforementioned home-field advantage and crowd noise as one potential reason for it ( Pollard, 2008 ) and hence, the impact of emotionally-laden auditory/crowd environments on players’ and teams’ perceptions and performances warrants further research in this context.

Second, the results indicate that various players had different perceptions of the auditory conditions. This finding is also supported by the original study, which demonstrated that the conditions impacted passing time scores across various situations ( Otte et al., 2021 ). Players in this study cited the four auditory conditions as influencing both performance and emotional engagement, highlighting a critical notion within a Nonlinear Pedagogy (NLP): the necessity for individualized learning designs tailored to players with different skill levels, personalities, and intrinsic dynamics ( Renshaw et al., 2009 ). In simple terms, there is not one ‘cookie-cutter practice drill’ or ideal practice environment (including its auditory noise environment) that is suitable for every athlete, and coaches must be aware of this.

Limitations and future research

Due to the articles’ highly specialized and unique sample size, findings in this paper should be carefully considered. The decreased representativeness of the practice task in the Footbonaut compared to an actual football task in a packed stadium is also something that should not be discounted easily. Additionally, we would suggest that in future studies with usage of the Footbonaut, the “no noise” earmuff condition could be replaced as a control condition with a condition using non-emotional/non-representative noise, such as white noise. That way, a user of the Footbonaut would still obtain physical information, and one could discern better the effects from stadium information. Furthermore, collected qualitative statements (complementing standardized performance ratings) were open-ended and thus, varied in depth and scope. However, this was deemed acceptable in order to receive an initial and honest insight into players’ emotional engagement and perceptions of the various practice conditions. Notably, since no player was obliged to make statements about particular feelings, any personal comments regarding emotional engagement and perceived performances may carry increased value and display players’ genuine emotional dispositions. Due to the unique sample in this paper, the data set in its depth is limited to an initial overview, demanding future profound investigation by additional studies.

Finally, and due to abovementioned limitations, this research extension may provide a direction for future research on (i) skilled athletes’ abilities to effectively use self-monitoring and intrinsic feedback sources for movement self-regulation; and (ii) athletes’ emotional engagement with different auditory noise environments in practice. Consequently, it is recommended for future studies to investigate these two areas with larger samples of (skilled) athletes.

Previous studies have aimed to assess football players’ passing performances under auditory cue conditions, such as stadium noise ( Otte et al., 2021 ). The findings of these studies include slower passing times in some auditory cue conditions, which are now supplemented by novel insight into players’ accurate judgments, self-awareness and self-monitoring of their own performances by the data presented in this paper. Thus, these advanced players may benefit from a hands-off coaching approach that focuses on the coach becoming a facilitator, manipulating (task and environmental) constraints within the practice environment. Additionally, use of emotion-laden and affective learning designs may warrant further attention by both researchers studying the effect of representative practice environments and coaches aiming to co-design practice sessions in accordance with principles from an NLP.

Data availability statement

The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding author.

Ethics statement

The studies involving humans were approved by German Sport University Cologne. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

Author contributions

SK: Conceptualization, Formal analysis, Methodology, Project administration, Supervision, Writing – original draft, Writing – review & editing. FO: Conceptualization, Investigation, Methodology, Writing – original draft, Writing – review & editing. AB: Methodology, Writing – review & editing. TS: Formal analysis, Writing – review & editing. SM: Conceptualization, Supervision, Writing – review & editing.

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: affective learning design, representative learning design, athlete self-regulation, Ecological Dynamics, Nonlinear Pedagogy, Footbonaut, skill learning, auditory cues

Citation: Klatt S, Otte FW, Beavan A, Schumacher T and Millar SK (2024) How did you perform? Investigating football players’ perception of self-regulated passing performances under auditory noise environments. Front. Psychol . 15:1390487. doi: 10.3389/fpsyg.2024.1390487

Received: 23 February 2024; Accepted: 09 April 2024; Published: 29 April 2024.

Reviewed by:

Copyright © 2024 Klatt, Otte, Beavan, Schumacher and Millar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Stefanie Klatt, [email protected]

† These authors have contributed equally to this work and share first authorship

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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2024 Creating Equitable Pathways to STEM Graduate Education

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The Higher Education Program at the Alfred P. Sloan Foundation is pleased to announce its third   Call for Letters of Inquiry  for the  Creating Equitable Pathways to STEM Graduate Education  initiative, continuing its investment in Minority Serving Institutions (MSIs) and in the establishment of partnerships between MSIs and graduate programs nationwide.

Grantees awarded via this initiative will engage the expertise of MSIs—and the unique experiences of their faculty and students—to model effective systems and practices that remove barriers and create opportunities for equitable learning environments in STEM graduate education so all students can thrive. Grant awards will support sharing MSIs’ institutional know-how on equitable undergraduate and graduate education, as well as modeling that know-how to create systemic changes that enhance pathways from MSIs to master’s and doctoral degree programs in  astronomy, biology, chemistry, computer science, data science, Earth sciences, economics, engineering, marine science, mathematics, physics, and statistics  at partner institutions.

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In addition to establishing seamless pathways, successful projects will address policies, processes, and practices that reinforce existing systems that are barriers to student access and success in graduate education. These projects could include efforts to examine or redesign graduate recruitment, admission policies and processes, mentoring practices, departmental climate, or other gatekeeping (or gateway) structures to and through STEM graduate education.

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