Rld context could be dangerous, expensive, or even impossible [46]. Computer-generated content, such as sound, graphics, 3D, video, or text, shows learners an indirect view of surroundings and enhances learners’ different senses to achieve the learning objectives. In these environments, learning activities are added, which will help medical learners to recognize and build their personal paradigm as they develop skills, gain insights, and determine the dispositions that are essential for translating what they learn into action. Each mixed environment in MARE has its own focus on different learning activities, and the environments should complement and reinforce one another.Personal ParadigmThe personal paradigm is compiled from the frames of reference that shape learners’ beliefs regarding guiding action in LLY-507 site transformative learning theory. The personal paradigm combines the individual’s mind-sets, habits, and meaning perspectives,http://mededu.jmir.org/2015/2/e10/and encompasses cognitive, conative, and affective components. This paradigm is affected by sociolinguistics, moral and ethical values, learning styles, religious beliefs, psychological heath, and aesthetic preferences [43], and is developed through the learners’ learning and/or practice experience. Problematic frames of reference can be caused by poor teaching, disjointed practice,JMIR Medical Education 2015 | vol. 1 | iss. 2 | e10 | p.9 (page number not for citation purposes)XSL?FORenderXJMIR MEDICAL EDUCATION bad example by colleagues, patient pressure, and salesmanship [47].Zhu et al for easy understanding. Attitudes within each level will be surveyed through an attitude questionnaire instrument.Learning Environment, Assets, and ActivitiesThe learning environment provides the conditions and external stimuli that facilitate learning and transform the learners’ paradigms. Learning assets provide the content for learning [48]. Learning assets are composed of different media forms, such as text, sound, and video; various media can be used in MARE to create different learning environments and realize the valuable functions of different media [49]. MARE mixes real clinical environments and virtual environments in a learning environment within which learners feel, think, watch, and act. Real clinical environments are an immediate context in which learners connect with the learning and practice. These environments include physical environments and social environments. As expected by situation learning theory [39], the clinical environments provide the anchor and scaffold in which learning is encouraged. The virtual environment is useful for learners who learn in different ways and transforms the problematic frames of reference in their personal paradigms. These types of environments conform to create safe environments, in which learners experience learning theories including transformative learning theory [42]. Learning activities are the approach by which learners obtain meaning from learning material, context, and other people in the learning environment. The three learning theories suggest various learning activities, as seen in Table 1. Although an individual’s learning style preferences may be inclined toward specific activities, using diverse learning activities is effective for all learning styles [42].Knowledge LevelKnowledge-level expectations for GPs regarding the rational use of order PP58 antibiotics are shown in Table 1. When GPs use MARE as a tool for evaluating knowledge, they ca.Rld context could be dangerous, expensive, or even impossible [46]. Computer-generated content, such as sound, graphics, 3D, video, or text, shows learners an indirect view of surroundings and enhances learners’ different senses to achieve the learning objectives. In these environments, learning activities are added, which will help medical learners to recognize and build their personal paradigm as they develop skills, gain insights, and determine the dispositions that are essential for translating what they learn into action. Each mixed environment in MARE has its own focus on different learning activities, and the environments should complement and reinforce one another.Personal ParadigmThe personal paradigm is compiled from the frames of reference that shape learners’ beliefs regarding guiding action in transformative learning theory. The personal paradigm combines the individual’s mind-sets, habits, and meaning perspectives,http://mededu.jmir.org/2015/2/e10/and encompasses cognitive, conative, and affective components. This paradigm is affected by sociolinguistics, moral and ethical values, learning styles, religious beliefs, psychological heath, and aesthetic preferences [43], and is developed through the learners’ learning and/or practice experience. Problematic frames of reference can be caused by poor teaching, disjointed practice,JMIR Medical Education 2015 | vol. 1 | iss. 2 | e10 | p.9 (page number not for citation purposes)XSL?FORenderXJMIR MEDICAL EDUCATION bad example by colleagues, patient pressure, and salesmanship [47].Zhu et al for easy understanding. Attitudes within each level will be surveyed through an attitude questionnaire instrument.Learning Environment, Assets, and ActivitiesThe learning environment provides the conditions and external stimuli that facilitate learning and transform the learners’ paradigms. Learning assets provide the content for learning [48]. Learning assets are composed of different media forms, such as text, sound, and video; various media can be used in MARE to create different learning environments and realize the valuable functions of different media [49]. MARE mixes real clinical environments and virtual environments in a learning environment within which learners feel, think, watch, and act. Real clinical environments are an immediate context in which learners connect with the learning and practice. These environments include physical environments and social environments. As expected by situation learning theory [39], the clinical environments provide the anchor and scaffold in which learning is encouraged. The virtual environment is useful for learners who learn in different ways and transforms the problematic frames of reference in their personal paradigms. These types of environments conform to create safe environments, in which learners experience learning theories including transformative learning theory [42]. Learning activities are the approach by which learners obtain meaning from learning material, context, and other people in the learning environment. The three learning theories suggest various learning activities, as seen in Table 1. Although an individual’s learning style preferences may be inclined toward specific activities, using diverse learning activities is effective for all learning styles [42].Knowledge LevelKnowledge-level expectations for GPs regarding the rational use of antibiotics are shown in Table 1. When GPs use MARE as a tool for evaluating knowledge, they ca.