JMIR Publications

JMIR Medical Education

 Technology, innovation and openess in medical education in the information age

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Journal Description

JMIR Medical Education (JME) is a new peer-reviewed journal with focus on technology, innovation and openess in medical education. Another focus is on how to train health professionals in the use of digital tools. We publish original research, reviews, viewpoint and policy papers on innovation and technology in medical education. As an open access journal we have a special interest in open and free tools and digitial learning objects for medical education, and urge authors to make their tools and learning objects freely available (we may also publish them as Multimedia Appendix). We also invite submissions of non-conventional articles (e.g. open medical education material and software resources that are not yet evaluated but free for others to use/implement). 

In our "Students' Corner", we invite students and trainees in the health professions to submit short essays and viewpoints on all aspects of medical education, but in particular suggestions on how to improve medical education, and suggestions for new technologies, applications and approaches (no article processing fees).

A sister journal of the Journal of Medical Internet Research (JMIR), a leading eHealth journal (Impact Factor 2014: 3.4), the scope of JME is broader and includes non-Internet approaches to improve education, training and assessment for medical professionals and allied health professions.

Articles published in JME will be submitted to PubMed and Pubmed Central. JME is open access.

 

Recent Articles:

  • Source: https://pixabay.com/en/computer-pc-workplace-home-office-1185626, CC0 Public Domain.

    Students' Perceptions of and Experiences With Educational Technology: A Survey

    Abstract:

    Background: It is generally assumed that incoming students in medical education programs will be better equipped for the “digital age” given their younger age and an educational upbringing in which technology was seemingly omnipresent. In particular, many assume that today's medical students are more likely to hold positive attitudes and increased comfortability with technology and possess greater information technology (IT) skills. Objective: The purpose of this study was to compare responses of incoming veterinary medical students to a series of IT-related questions contained in a common questionnaire over the course of a 10-year period (2005-2015) to discern whether students’ attitudes have improved and uses and comfortability with technology have increased as anticipated. Methods: A survey measuring attitudes and preferences, computing experience, and technology ownership was administered each year for the past 10 years to incoming veterinary medical students at a large veterinary school in the United States. Students' responses to survey items were compared at 3 data points (2005, 2010, and 2015). Results: Today's incoming veterinary medical students tend to indicate the same desire to improve skills using spreadsheets and web page design as incoming students from 10 years ago. It seems that despite technological advances and increased exposure to such applications and skills, there remains a challenge for students to “keep up” with the ever evolving technology. Moreover, although students continue to report they are very comfortable with using a computer (and related devices), many use their computers as typewriters or word processors, as opposed to a means for performing more advanced computing functions. Conclusions: In general, today's medical students are not expert computer users as many assume. Despite an upbringing in a digitized world, many students still lack many basic computing skills.

  • Source: https://pixabay.com/en/office-working-computer-tablet-1069207, Creative Commons 2.0 Licensed.

    Exploring Student Preconceptions of Readiness for Remote-Online Case-Based Learning: A Case Study

    Abstract:

    Background: Case-based learning (CBL) is an educational approach where students work in small, collaborative groups to solve problems. Web-conferencing software provides a platform to present information and share concepts that are vital to CBL. Previous studies have found that participants were resistant to change associated with implementing e-learning; however, strategies to reduce this resistance have not been explored. Objective: This study was designed to explore student preconceptions and understanding of remote-online case-based learning (RO-CBL). Methods: The study took place during the Bachelor of Physiotherapy program at Monash University, Victoria, Australia, in 2013. The entire third-year cohort (n=73) was invited to participate. The primary outcome of interest was students’ preconceptions of RO-CBL, collected via pre- and posttraining surveys. Results: Of the 73 students, 66 completed both surveys (attrition rate 9.6%). Three key themes relevant to student preconceptions of RO-CBL emerged: flexibility in time and location of CBL, readiness or hesitation to change to a Web-based format, and the value of training in RO-CBL that included a demonstration and trial run. Thirty-four percent of the participants were hesitant to move to an online format. Conclusions: This study explored students’ preconceptions of Web-based learning and evaluated the change in students’ attitudes after training. The results suggest that educational designers should not assume that students are confident and competent in applying these technologies to professional educational activities. By identifying students’ needs before implementation, training sessions can be designed to target these needs, and improve the understanding of RO-CBL and how it works in practice. This may reduce resistance to change, enhance students’ satisfaction, and ultimately improve the learning experience.

  • https://pixabay.com/en/blogging-blogger-office-business-336375/
CC0 Public Domain
Free for commercial use 
No attribution required.

    Student Response to Remote-Online Case-Based Learning: A Qualitative Study

    Abstract:

    Background: Case-based learning (CBL) typically involves face-to-face interaction in small collaborative groups with a focus on self-directed study. To our knowledge, no published studies report an evaluation of Web conferencing in CBL. Objective: The primary aim of this study was to explore student perceptions and attitudes in response to a remote-online case-based learning (RO-CBL) experience. Methods: This study took place over a 2-week period in 2013 at Monash University, Victoria, Australia. A third year cohort (n=73) of physiotherapy students was invited to participate. Students were required to participate in 2 training sessions, followed by RO-CBL across 2 sessions. The primary outcome of interest was the student feedback on the quality of the learning experience during RO-CBL participation. This was explored with a focus group and a survey. Results: Most students (68/73) completed the postintervention survey (nonparticipation rate 8%). RO-CBL was generally well received by participants, with 59% (40/68) of participates stating that they’d like RO-CBL to be used in the future and 78% (53/68) of participants believing they could meet the CBL’s learning objectives via RO-CBL. The 4 key themes relevant to student response to RO-CBL that emerged from the focus groups and open-ended questions on the postintervention survey were how RO-CBL compared to expectations, key benefits of RO-CBL including flexibility and time and cost savings, communication challenges in the online environment compared to face-to-face, and implications of moving to an online platform. Conclusions: Web conferencing may be a suitable medium for students to participate in CBL. Participants were satisfied with the learning activity and felt they could meet the CBL’s learning objectives. Further study should evaluate Web conferencing CBL across an entire semester in regard to student satisfaction, perceived depth of learning, and learning outcomes.

  • Clinician using Google Glass in his field of vision.

    Feasibility of Augmented Reality in Clinical Simulations: Using Google Glass With Manikins

    Abstract:

    Background: Studies show that students who use fidelity-based simulation technology perform better and have higher retention rates than peers who learn in traditional paper-based training. Augmented reality is increasingly being used as a teaching and learning tool in a continual effort to make simulations more realistic for students. Objective: The aim of this project was to assess the feasibility and acceptability of using augmented reality via Google Glass during clinical simulation scenarios for training health science students. Methods: Students performed a clinical simulation while watching a video through Google Glass of a patient actor simulating respiratory distress. Following participation in the scenarios students completed two surveys and were questioned if they would recommend continued use of this technology in clinical simulation experiences. Results: We were able to have students watch a video in their field of vision of a patient who mimicked the simulated manikin. Students were overall positive about the implications for being able to view a patient during the simulations, and most students recommended using the technology in the future. Overall, students reported perceived realism with augmented reality using Google Glass. However, there were technical and usability challenges with the device. Conclusions: As newer portable and consumer-focused technologies become available, augmented reality is increasingly being used as a teaching and learning tool to make clinical simulations more realistic for health science students. We found Google Glass feasible and acceptable as a tool for augmented reality in clinical simulations.

  • Image Source: Social-network-communities-image.jpg, courtesy of Surendar Kumar B, [Creative Commons Attribution-Share Alike 4.0 International], https://creativecommons.org/licenses/by-sa/4.0/deed.en, via https://commons.wikimedia.org/wiki/File:Social-network-communities-image.jpg.

    The Significance of Kinship for Medical Education: Reflections on the Use of a Bespoke Social Network to Support Learners’ Professional Identities

    Abstract:

    Background: Social media can support and sustain communities much better than previous generations of learning technologies, where institutional barriers undermined any initiatives for embedding formal and informal learning. Some of the many types of social media have already had an impact on student learning, based on empirical evidence. One of these, social networking, has the potential to support communication in formal and informal spaces. Objective: In this paper we report on the evaluation of an institutional social network—King's Social Harmonisation Project (KINSHIP)—established to foster an improved sense of community, enhance communication, and serve as a space to model digital professionalism for students at King’s College London, United Kingdom. Methods: Our evaluation focused on a study that examined students’ needs and perceptions with regard to the provision of a cross-university platform. Data were collected from students, including those in the field of health and social care, in order to recommend a practical way forward to address current needs in this area. Results: The findings indicate that the majority of the respondents were positive about using a social networking platform to develop their professional voice and profiles. Results suggest that timely promotion of the platform, emphasis on interface and learning design, and a clear identity are required in order to gain acceptance as the institutional social networking site. Conclusions: Empirical findings in this study project an advantage of an institutional social network such a KINSHIP over other social networks (eg, Facebook) because access is limited to staff and students and the site is mainly being used for academic purposes.

  • Source: http://www.templatescraze.com/web-design-articles/wp-content/uploads/2013/05/Online-Training.jpg.

    Developing a Curriculum to Promote Professionalism for Medical Students Using Social Media: Pilot of a Workshop and Blog-Based Intervention

    Abstract:

    Background: As the use of social media (SM) tools becomes increasingly widespread, medical trainees need guidance on applying principles of professionalism to their online behavior. Objective: To develop a curriculum to improve knowledge and skills regarding professionalism of SM use by medical students. Methods: This project was conducted in 3 phases: (1) a needs assessment was performed via a survey of medical students regarding SM use, rationale for and frequency of use, and concerns; (2) a workshop-format curriculum was designed and piloted for preclinical students to gain foundational knowledge of online professionalism; and (3) a complementary longitudinal SM-based curriculum was designed and piloted for clinical students to promote both medical humanism and professionalism. Results: A total of 72 medical students completed the survey (response rate 30%). Among the survey respondents, 71/72 (99%) reported visiting social networking sites, with 55/72 (76%) reporting daily visits. Privacy of personal information (62/72, 86%) and mixing of personal/professional identities (49/72, 68%) were the students’ most commonly endorsed concerns regarding SM use. The workshop-format curriculum was evaluated qualitatively via participant feedback. Of the 120 students who participated in the workshop, 91 completed the post workshop evaluation (response rate 76%), with 56 positive comments and 54 suggestions for improvement. The workshop was experienced by students as enjoyable, thought provoking, informative, and relevant. Suggestions for improvement included adjustments to timing, format, and content of the workshop. The SM-based curriculum was evaluated by a small-scale pilot of 11 students, randomized to the intervention group (participation in faculty-moderated blog) or the control group. Outcomes were assessed quantitatively and qualitatively via personal growth scales, participant feedback, and analysis of blog themes. There was a trend toward improvement in total personal growth scores among those students in the blog group from 3.65 (0.47) to 4.11 (0.31) (mean [SD]) with no change observed for the students in the control group (3.89 [0.11] before and after evaluation). Themes relevant to humanism and professionalism were observed in the blog discussion. Conclusions: Most medical students surveyed reported using SM and identified privacy and personal-professional boundaries as areas of concern. The workshop format and SM-based curricula were well-received by students whose formative feedback will inform the refinement and further development of efforts to promote professionalism among medical students.

  • Semantic indexing. TOC Image created by Cord Spreckelsen and can be used under cc-by 4.0.

    Semantic Indexing of Medical Learning Objects: Medical Students' Usage of a Semantic Network

    Abstract:

    Background: The Semantically Annotated Media (SAM) project aims to provide a flexible platform for searching, browsing, and indexing medical learning objects (MLOs) based on a semantic network derived from established classification systems. Primarily, SAM supports the Aachen emedia skills lab, but SAM is ready for indexing distributed content and the Simple Knowledge Organizing System standard provides a means for easily upgrading or even exchanging SAM’s semantic network. There is a lack of research addressing the usability of MLO indexes or search portals like SAM and the user behavior with such platforms. Objective: The purpose of this study was to assess the usability of SAM by investigating characteristic user behavior of medical students accessing MLOs via SAM. Methods: In this study, we chose a mixed-methods approach. Lean usability testing was combined with usability inspection by having the participants complete four typical usage scenarios before filling out a questionnaire. The questionnaire was based on the IsoMetrics usability inventory. Direct user interaction with SAM (mouse clicks and pages accessed) was logged. Results: The study analyzed the typical usage patterns and habits of students using a semantic network for accessing MLOs. Four scenarios capturing characteristics of typical tasks to be solved by using SAM yielded high ratings of usability items and showed good results concerning the consistency of indexing by different users. Long-tail phenomena emerge as they are typical for a collaborative Web 2.0 platform. Suitable but nonetheless rarely used keywords were assigned to MLOs by some users. Conclusions: It is possible to develop a Web-based tool with high usability and acceptance for indexing and retrieval of MLOs. SAM can be applied to indexing multicentered repositories of MLOs collaboratively.

  • m-OVADor assessment screen (Image created by authors who hold the copyright).

    Mobile Virtual Learning Object for the Assessment of Acute Pain as a Learning Tool to Assess Acute Pain in Nursing: An Analysis of the Mental Workload

    Abstract:

    Background: The inclusion of new technologies in education has motivated the development of studies on mental workload. These technologies are now being used in the teaching and learning process. The analysis enables identification of factors intervening in this workload as well as planning of overload prevention for educational activities using these technologies. Objective: To analyze the mental workload of an educational intervention with the Mobile Virtual Learning Object for the Assessment of Acute Pain in adults and newborns, according to the NASA Task Load Index criteria. Methods: A methodological study with data collected from 5 nurses and 75 students, from November of 2013 to February of 2014. Results: The highest students’ and specialists’ means were in the dimensions of “Mental demand” (57.20 ± 22.27; 51 ± 29.45) and “Performance” (58.47 ± 24.19; 73 ± 28.85). The specialists’ mental workload index was higher (50.20 ± 7.28) when compared with students’ (47.87 ± 16.85) on a scale from 0 to 100 (P=.557). Conclusions: The instrument allowed for the assessment of mental workload after an online educational intervention with a mobile learning virtual object. An excessive overload was not identified among participants. Assessing mental workload from the use of educational technologies at the end of a task is a key to their applicability, with the aim of providing a more effective, stimulating, and long-lasting experience of the learning process.

  • Web technology can make learning more social and offers the opportunity for trainees to contribute their own ideas and links in the form of papers, videos, audio, lectures, and more.


[Note image is a screenshot of PsychOnCall.com taken by John Torous and not subject to any copyright].

    Creating a Pilot Educational Psychiatry Website: Opportunities, Barriers, and Next Steps

    Abstract:

    Background: While medical students and residents may be utilizing websites as online learning resources, medical trainees and educators now have the opportunity to create such educational websites and digital tools on their own. However, the process and theory of building educational websites for medical education have not yet been fully explored. Objective: To understand the opportunities, barriers, and process of creating a novel medical educational website. Methods: We created a pilot psychiatric educational website to better understand the options, opportunities, challenges, and processes involved in the creation of a psychiatric educational website. We sought to integrate visual and interactive Web design elements to underscore the potential of such Web technology. Results: A pilot website (PsychOnCall) was created to demonstrate the potential of Web technology in medical and psychiatric education. Conclusions: Creating an educational website is now technically easier than ever before, and the primary challenge no longer is technology but rather the creation, validation, and maintenance of information for such websites as well as translating text-based didactics into visual and interactive tools. Medical educators can influence the design and implementation of online educational resources through creating their own websites and engaging medical students and residents in the process.

  • Image of PRADA Executive Committee receiving 2015 Harold Amos Faculty Diversity Award from Harvard Medical School's Office for Diversity Inclusion and Community Partnership (Image taken by Jeff Thibeault who holds the copyright).

    A Novel Service-Oriented Professional Development Program for Research Assistants at an Academic Hospital: A Web-Based Survey

    Abstract:

    Background: Research assistants (RAs) are hired at academic centers to staff the research and quality improvement projects that advance evidence-based medical practice. Considered a transient population, these young professionals may view their positions as stepping-stones along their path to graduate programs in medicine or public health. Objective: To address the needs of these future health professionals, a novel program—Program for Research Assistant Development and Achievement (PRADA)—was developed to facilitate the development of desirable professional skill sets (ie, leadership, teamwork, communication) through participation in peer-driven service and advocacy initiatives directed toward the hospital and surrounding communities. The authors hope that by reporting on the low-cost benefits of the program that other institutions might consider the utility of implementing such a program and recognize the importance of acknowledging the professional needs of the next generation of health care professionals. Methods: In 2011, an anonymous, Web-based satisfaction survey was distributed to the program membership through a pre-established email distribution list. The survey was used to evaluate demographics, level of participation and satisfaction with the various programming, career trajectory, and whether the program's goals were being met. Results: Upon the completion of the survey cycle, a 69.8% (125/179) response rate was achieved with the majority of respondents (94/119, 79.0%) reporting their 3-year goal to be in medical school (52/119, 43.7%) or nonmedical graduate school (42/119, 35.3%). Additionally, most respondents agreed or strongly agreed that PRADA had made them feel more a part of a research community (88/117, 75.2%), enhanced their job satisfaction (66/118, 55.9%), and provided career guidance (63/117, 53.8%). Overall, 85.6% of respondents (101/118) agreed or strongly agreed with recommending PRADA to other research assistants. Conclusions: High response rate and favorable outlook among respondents indicate that the program had been well received by the program's target population. The high percentage of respondents seeking short-term entry into graduate programs in health care-related fields supports the claim that many RAs may see their positions as stepping-stones and therefore could benefit from a professional development program such as the one described herein. Strong institutional support and sustainable growth and participation are other indications of early success. Further evaluation is necessary to assess the full impact of the program, particularly in areas such as job satisfaction, recruitment, retention, productivity, and career trajectory, but also in reproducibility in other institutions.

  • Facebook use by medical students (https://www.flickr.com/photos/officialgdc/6235163921/; GDC Online 2011_Tuesday_Show Environment; https://creativecommons.org/licenses/by/2.0/).

    Undergraduate Medical Students Using Facebook as a Peer-Mentoring Platform: A Mixed-Methods Study

    Abstract:

    Background: Peer mentoring is a powerful pedagogical approach for supporting undergraduate medical students in their learning environment. However, it remains unclear what exactly peer mentoring is and whether and how undergraduate medical students use social media for peer-mentoring activities. Objective: We aimed at describing and exploring the Facebook use of undergraduate medical students during their first 2 years at a German medical school. The data should help medical educators to effectively integrate social media in formal mentoring programs for medical students. Methods: We developed a coding scheme for peer mentoring and conducted a mixed-methods study in order to explore Facebook groups of undergraduate medical students from a peer-mentoring perspective. Results: All major peer-mentoring categories were identified in Facebook groups of medical students. The relevance of these Facebook groups was confirmed through triangulation with focus groups and descriptive statistics. Medical students made extensive use of Facebook and wrote a total of 11,853 posts and comments in the respective Facebook groups (n=2362 total group members). Posting peaks were identified at the beginning of semesters and before exam periods, reflecting the formal curriculum milestones. Conclusions: Peer mentoring is present in Facebook groups formed by undergraduate medical students who extensively use these groups to seek advice from peers on study-related issues and, in particular, exam preparation. These groups also seem to be effective in supporting responsive and large-scale peer-mentoring structures; formal mentoring programs might benefit from integrating social media into their activity portfolio.

  • Image created by authors.

    A Conceptual Analytics Model for an Outcome-Driven Quality Management Framework as Part of Professional Healthcare Education

    Abstract:

    Background: Preparing the future health care professional workforce in a changing world is a significant undertaking. Educators and other decision makers look to evidence-based knowledge to improve quality of education. Analytics, the use of data to generate insights and support decisions, have been applied successfully across numerous application domains. Health care professional education is one area where great potential is yet to be realized. Previous research of Academic and Learning analytics has mainly focused on technical issues. The focus of this study relates to its practical implementation in the setting of health care education. Objective: The aim of this study is to create a conceptual model for a deeper understanding of the synthesizing process, and transforming data into information to support educators’ decision making. Methods: A deductive case study approach was applied to develop the conceptual model. Results: The analytics loop works both in theory and in practice. The conceptual model encompasses the underlying data, the quality indicators, and decision support for educators. Conclusions: The model illustrates how a theory can be applied to a traditional data-driven analytics approach, and alongside the context- or need-driven analytics approach.

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  • Pediatric Residents’ Perceptions of the Appropriate Use of Social Media: A National Survey

    Date Submitted: May 18, 2016

    Open Peer Review Period: May 19, 2016 - Jul 14, 2016

    Background: The ubiquitous use of social media by physicians poses professionalism challenges. Regulatory bodies have disseminated guidelines related to physician use of social media. Objective: This...

    Background: The ubiquitous use of social media by physicians poses professionalism challenges. Regulatory bodies have disseminated guidelines related to physician use of social media. Objective: This study's objectives are to understand what residents view as appropriate social media use by physicians and to recognize the degree to which residents are exposed to postings which violate social media professionalism guidelines. Methods: An electronic survey was distributed to residents nationwide. The survey consisted of five Facebook postings from a "hypothetical" resident's personal Facebook page. Two questions were asked for each vignette: 1) opinion of the posting's appropriateness and 2) frequency they viewed similar posts. Results: The vignettes used highlighted common scenarios which challenge published social media professionalism guidelines. Residents are seeing postings that potentially violate professionalism standards frequently. For the two scenarios representing venting online about a patient interaction, residents overwhelmingly recognized the inappropriate use of social media. However, half of respondents said they see similar posts frequently or sometimes. In the vignette showing physicians drinking alcoholic beverages while in scrubs, most residents were neutral and frequently view similar posts. Of note, we found that over 50% of residents are using Facebook daily and another 30% at least once a week. Conclusions: Residents, like other of their generation, use social media sites to converse with peers without thinking about the implications on the profession. The frequent use of social media by learners needs to change the emphasis educators and regulatory bodies place on social media guidelines and teaching professionalism in the digital age.

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