Cognitive Load Theory (CLT) and the Cognitive Theory of Multimedia Learning (CTML) have long served as foundational frameworks in instructional design. However, their applicability to contemporary, technologically mediated learning environments remains under-theorized. This review critically examines CLT and CTML, focusing on their assumptions, empirical contributions, and current limitations in addressing the complexities of dynamic, AI-enhanced educational settings. The discussion is further enriched through engagement with complementary perspectives, including self-regulated learning, dual process theory, and connectivism. These frameworks illuminate conceptual convergences but also expose theoretical tensions, particularly regarding unresolved constructs such as germane cognitive load and the methodological challenges associated with real-time cognitive load measurement. In response to these gaps, this paper proposes the Cognitive Load-Aware Modulation (CLAM) strategy—a conceptual model designed to extend cognitive load principles in adaptive, ethically responsive learning environments. Synthesizing insights from cognitive psychology, educational technology, and affective computing, CLAM supports the design of personalized, data-driven instructional systems attuned to learners’ cognitive and emotional states. The model emerges not merely as a theoretical contribution, but as a future-oriented framework rooted in the critical synthesis of the reviewed literature. Its practical applications for real-world educational settings are outlined, and its empirical validation constitutes the next phase of our ongoing research project.

Background: Interactive learning environments have emerged as transformative tools in education, enhancing engagement, academic performance, and addressing challenges like learning anxiety. This study examines the influence of multiple variables, including anxiety, internet usage for problem-solving, attitude towards a history course, metacognitive awareness, and interactive learning environments, on seventh-grade students’ academic performance. Methods: Using the Exploration of Attitudes Towards History Scale (EDIS) scale to measure attitudes and the Metacognitive Awareness of Reading Strategies Inventory-Revised Two-Factor Version (MARSI-2fR) to assess metacognitive awareness, the study evaluated historical knowledge across three stages, namely pre-intervention, post-intervention, and a one-month-later retest. A comparative analysis was conducted between the control group and the intervention group. The statistical analyses involved the calculation of correlation coefficients, the implementation of general linear models, and the performance of Wilcoxon signed-rank tests. Results: The findings indicated that prior to the intervention, factors such as learning anxiety and the extratextual component of metacognition were statistically significant predictors of achievement. However, the aforementioned factors ceased to be statistically significant when the parameter of study strategies was incorporated into the statistical model. The impact of the interactive learning environment on students’ achievement is highly statistically significant in terms of post-test scores, while the influence of all other predictors becomes insignificant. The retest confirmed the continued maintenance of the achieved results as evaluated following the intervention. Conclusions: The study confirms previous research demonstrating that interactive learning environments are an effective method of enhancing students’ academic performance and reducing the negative impact of learning anxiety.

Background/Objectives: Primary health care (PHC) is the cornerstone of any high-quality healthcare system. For PHC to work well, healthcare professionals need to be skilled in critical thinking, self-reflection, and patient-centered care. However, few studies have explored the potential interplays between these factors. Therefore, this cross-sectional study evaluated the critical thinking disposition and training needs of PHC professionals, alongside patient experiences and satisfaction with PHC services. Methods: The study involved 54 PHC professionals and 100 patients from sixteen PHC facilities in Crete, Greece. Professionals completed the Critical Thinking Disposition Scale (CTDS) and Training Needs Assessment (TNA) questionnaires, while patients filled out the Quality-of-Life Instrument of Chronic Conditions in Primary Health Care (QUALICOPC) questionnaire. Results: Our findings indicated that PHC professionals exhibited high critical thinking levels (CTDS, mean score of 46.46 ± 4.24). However, TNA scores suggested moderate training needs, particularly in relationships/investigations [median: 0.50 (0, 1.50)], communication/patient-centered [median: 0.30 (0, 1.1)], and flexibility and application of knowledge [median: 0.40 (0, 1.0)]. Nevertheless, no significant correlation was found between CTDS and TNA (ρ = 0.08, p > 0.05). Patients mostly rated their health as poor (40%), and 26% lacked a family physician. Although patients were highly satisfied with communication and patient-centered care (>95% reporting positive experiences), continuity and empowerment had room for improvement. Only 37% felt their GP knew their living conditions, and 26% lacked a personal physician. Patients with chronic conditions reported significantly different experiences. Specifically, patients with chronic conditions had better continuity of care (84% vs. 59%, p = 0.01) and more comprehensive care (70% vs. 43%, p = 0.01) compared to controls. Conclusions: Our findings suggest that targeted training is needed for PHC professionals to address skill gaps. These initial findings could guide the creation of customized professional development initiatives and point to areas where PHC services could be structurally improved. Additional studies, including longitudinal ones, are required to further validate these associations.

This study focuses on the design and implementation of three narrative pedagogical agents, which act as descending guidance assistants for adolescent student-users of the Geo-Histor multimedia learning environment. The goal of creating and using pedagogical agents was to empower students to use strategies before, during, and after reading. The pedagogical agents that emerged from the bibliographic inquiry and students' choices were anthropomorphic, cheerful and attractive animations, with real human voice, discussing with humor and representing real-life peer grouping. Agents provide declining guidance to students through dialogues implementing reading strategies included as statements on the Metacognitive Awareness of Reading Strategies Inventory (Marsi 1.0). Each agent builds his character, and thus his speech, based on the fact that he represents another kind of knowledge, declarative, procedural and conditional. In the following study, comparisons were made between two groups of students who used or did not use narrative pedagogical agents for their studying. The findings show that when students use agents, they make significant progress in using reading strategies. Finally, a comparison between boys and girls showed that the reported use of strategies is greater among girls than boys.

The authors designed pedagogical agents with dual roles to be integrated into the Geo-Histor learning environment: preventing risky behavior and promoting reading strategies aimed at improving adolescent students' metacognitive awareness. In order to reduce risky behaviors, they have incorporated the use of pedagogical agents that are deemed to be appropriate for the learning environment. To inform their design, they considered the latest research on agent anthropomorphism and voices. The preferences of 53 10th graders who participated in the preliminary study were considered in the initial design phase. During the main research project, comparisons were made between the experimental group using the interactive learning environment and the control group. The use of pedagogical agents during the interactive intervention resulted in the students' focus on the academic material and not on useless internet wandering. There was an increase in comprehensive knowledge of history, distance from parroting, deeper understanding, and consolidation of the material, followed by an increase in performance.

This qualitative study examined how student motivation is described, supported, and understood by students, teachers, and parents in the Greek school located in Gökçeada (Imvros), Turkey. Drawing on Self-Determination Theory (SDT) and Bronfenbrenner’s Ecological Systems Theory (EST), the study addressed three questions: (a) how students interpret their motivation in daily school life, (b) how teachers and parents observe and foster motivation, and (c) how relational, institutional, and cultural factors shape motivational experiences across ecological levels. Data were collected through four focus group interviews with lower secondary school students ( N = 6), upper secondary school students ( N = 6), teachers ( N = 4), and parents ( N = 5), and analyzed thematically using a combined inductive–deductive approach. Participants described motivational experiences that could be situated along the SDT continuum (from disengagement to interest/enjoyment), while inductive themes across stakeholder accounts also highlighted teacher influence, perceived competence, and parental scaffolding. Teachers tended to emphasize structure, discipline, and observable engagement, whereas parents highlighted cultural identity, routines, and long-term aspirations. Viewed through an ecological lens, motivation was described as co-constructed across systems: microsystem relationships, mesosystem home–school alignment, exosystem institutional constraints, macrosystem cultural hybridity, and chronosystem disruptions such as the COVID-19 pandemic. By integrating SDT with EST analytically, the study demonstrates how the quality of motivational regulation is co-constructed across systems rather than residing solely within individual students. The findings offer context-sensitive insights into motivational processes in minority and bilingual school environments and highlight the importance of examining stakeholder perspectives comparatively to understand convergences and misalignments in motivational support.