JMIR Publications

JMIR Medical Education

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


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 2015: 4.532), 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:

  • IT for Health Professionals. Image sourced and copyright owned by authors.

    Information and Communication Technologies for the Dissemination of Clinical Practice Guidelines to Health Professionals: A Systematic Review


    Background: The transfer of research knowledge into clinical practice can be a continuous challenge for researchers. Information and communication technologies, such as websites and email, have emerged as popular tools for the dissemination of evidence to health professionals. Objective: The objective of this systematic review was to identify research on health professionals’ perceived usability and practice behavior change of information and communication technologies for the dissemination of clinical practice guidelines. Methods: We used a systematic approach to retrieve and extract data about relevant studies. We identified 2248 citations, of which 21 studies met criteria for inclusion; 20 studies were randomized controlled trials, and 1 was a controlled clinical trial. The following information and communication technologies were evaluated: websites (5 studies), computer software (3 studies), Web-based workshops (2 studies), computerized decision support systems (2 studies), electronic educational game (1 study), email (2 studies), and multifaceted interventions that consisted of at least one information and communication technology component (6 studies). Results: Website studies demonstrated significant improvements in perceived usefulness and perceived ease of use, but not for knowledge, reducing barriers, and intention to use clinical practice guidelines. Computer software studies demonstrated significant improvements in perceived usefulness, but not for knowledge and skills. Web-based workshop and email studies demonstrated significant improvements in knowledge, perceived usefulness, and skills. An electronic educational game intervention demonstrated a significant improvement from baseline in knowledge after 12 and 24 weeks. Computerized decision support system studies demonstrated variable findings for improvement in skills. Multifaceted interventions demonstrated significant improvements in beliefs about capabilities, perceived usefulness, and intention to use clinical practice guidelines, but variable findings for improvements in skills. Most multifaceted studies demonstrated significant improvements in knowledge. Conclusions: The findings suggest that health professionals’ perceived usability and practice behavior change vary by type of information and communication technology. Heterogeneity and the paucity of properly conducted studies did not allow for a clear comparison between studies and a conclusion on the effectiveness of information and communication technologies as a knowledge translation strategy for the dissemination of clinical practice guidelines.

  • Social Media. Image source: License:CC0 Public Domain.

    Use of Social Media for Professional Development by Health Care Professionals: A Cross-Sectional Web-Based Survey

    Authors List:


    Background: Social media can be used in health care settings to enhance professional networking and education; patient communication, care, and education; public health programs; organizational promotion; and research. Objective: The aim of this study was to explore the use of social media networks for the purpose of professional development among health care professionals in Saudi Arabia using a purpose-designed Web-based survey. Methods: A cross-sectional web-based survey was undertaken. A link to the survey was posted on the investigator’s personal social media accounts including Twitter, LinkedIn, and WhatsApp. Results: A total of 231 health care professionals, who are generally social media users, participated in the study. Of these professionals, 70.6% (163/231) use social media for their professional development. The social media applications most frequently used, in the descending order, for professional development were Twitter, YouTube, Instagram, Facebook, Snapchat, and LinkedIn. The majority of respondents used social media for professional development irrespective of their age group, with the highest proportion seen in those aged 20-30 years. Social media were perceived as being most beneficial for professional development in terms of their impact on the domains of knowledge and problem solving and least helpful for enhancing clinical skills. Twitter was perceived as the most helpful type of social media for all domains listed. Respondents most frequently reported that social media were useful for professional development for the reasons of knowledge exchange and networking. Conclusions: Social media are frequently used by health care professionals in Saudi Arabia for the purposes of professional development, with Twitter most frequently used for this purpose. These findings suggest that social media networks can be powerful tools for engaging health care professionals in their professional development.

  • Source:; CC-BY; Designed by Onlyyouqj -

    A Virtual Community of Practice for General Practice Training: A Preimplementation Survey


    Background: Professional isolation is an important factor in low rural health workforce retention. Objective: The aim of this study was to gain insights to inform the development of an implementation plan for a virtual community of practice (VCoP) for general practice (GP) training in regional Australia. The study also aimed to assess the applicability of the findings of an existing framework in developing this plan. This included ascertaining the main drivers of usage, or usefulness, of the VCoP for users and establishing the different priorities between user groups. Methods: A survey study, based on the seven-step health VCoP framework, was conducted with general practice supervisors and registrars—133 usable responses; 40% estimated response rate. Data was analyzed using the t test and the chi-square test for comparisons between groups. Factor analysis and generalized linear regression modeling were used to ascertain factors which may independently predict intention to use the VCoP. Results: In establishing a VCoP, facilitation was seen as important. Regarding stakeholders, the GP training provider was an important sponsor. Factor analysis showed a single goal of usefulness. Registrars had a higher intention to use the VCoP (P<.001) and to perceive it as useful (P<.001) than supervisors. Usefulness independently predicted intention to actively use the VCoP (P<.001). Regarding engagement of a broad church of users, registrars were more likely than supervisors to want allied health professional and specialist involvement (P<.001). A supportive environment was deemed important, but most important was the quality of the content. Participants wanted regular feedback about site activity. Regarding technology and community, training can be online, but trust is better built face-to-face. Supervisors were significantly more likely than registrars to perceive that registrars needed help with knowledge (P=.01) and implementation of knowledge (P<.001). Conclusions: Important factors for a GP training VCoP include the following: facilitation covering administration and expertise, the perceived usefulness of the community, focusing usefulness around knowledge sharing, and overcoming professional isolation with high-quality content. Knowledge needs of different users should be acknowledged and help can be provided online, but trust is better built face-to-face. In conclusion, the findings of the health framework for VCoPs are relevant when developing an implementation plan for a VCoP for GP training. The main driver of success for a GP training VCoP is the perception of its usefulness by participants. Overcoming professional isolation for GP registrars using a VCoP has implications for training and retention of health workers in rural areas.

  • Used under CC BY-SA 3.0 Orginal by Andreas Prinz

    A Critical Analysis of Anesthesiology Podcasts: Identifying Determinants of Success


    Background: Audio and video podcasts have gained popularity in recent years. Increasingly, podcasts are being used in the field of medicine as a tool to disseminate information. This format has multiple advantages including highly accessible creation tools, low distribution costs, and portability for the user. However, despite its ongoing use in medical education, there are no data describing factors associated with the success or quality of podcasts. Objective: The goal of the study was to assess the landscape of anesthesia podcasts in Canada and develop a methodology for evaluating the quality of the podcast. To achieve our objective, we identified the scope of podcasts in anesthesia specifically, constructed an algorithmic model for measuring success, and identified factors linked to both successful podcasts and a peer-review process. Methods: Independent reviewers performed a systematic search of anesthesia-related podcasts on iTunes Canada. Data and metrics recorded for each podcast included podcast’s authorship, number posted, podcast series duration, target audience, topics, and social media presence. Descriptive statistics summarized mined data, and univariate analysis was used to identify factors associated with podcast success and a peer-review process. Results: Twenty-two podcasts related to anesthesia were included in the final analysis. Less than a third (6/22=27%) were still active. The median longevity of the podcasts’ series was just 13 months (interquartile range: 1-39 months). Anesthesiologists were the target audience for 77% of podcast series with clinical topics being most commonly addressed. We defined a novel algorithm for measuring success: Podcast Success Index. Factors associated with a high Podcast Success Index included podcasts targeting fellows (Spearman R=0.434; P=.04), inclusion of professional topics (Spearman R=0.456-0.603; P=.01-.03), and the use of Twitter as a means of social media (Spearman R=0.453;P=.03). In addition, more than two-thirds (16/22=73%) of podcasts demonstrated evidence of peer review with podcasts targeting anesthesiologists most strongly associated with peer-reviewed podcasts (Spearman R=0.886; P=.004) Conclusions: We present the first report on the scope of anesthesia podcasts in Canada. We have developed a novel tool for assessing the success of an anesthesiology podcast series and identified factors linked to this success measure as well as evidence of a peer-review process for a given podcast. To enable advancement in this area of anesthesia e-resources, podcast creators and users should consider factors associated with success when creating podcasts. The lack of these aspects may be associated with the early demise of a podcast series.

  • Image Source: Periodista, copyright Esther Vargas,,
Licensed under Creative Commons Attribution cc-by 2.0

    Spaced Education and the Importance of Raising Awareness of the Personal Data Protection Act: A Medical Student Population-Based Study


    Background: The Personal Data Protection Act (PDPA) of Singapore was first passed in 2012, with subsequent enforcement regulations effective in 2014. Although medical education via digital platforms is not often used in medical schools in Singapore as of yet, many current means of communication at all levels in the medical community from medical schools to clinics to hospitals are unsecure and noncompliant with the PDPA. Objective: This pilot study will assess the effectiveness of MyDoc, a secure, mobile telehealth application and messaging platform, as an educational tool, secure communications tool, and a tool to raise awareness of the PDPA. Methods: By replacing current methods of communication with MyDoc and using weekly clinical case discussions in the form of unidentifiable clinical photos and questions and answers, we raised awareness the PDPA among medical students and gained feedback and determined user satisfaction with this innovative system via questionnaires handed to 240 medical students who experienced using MyDoc over a 6-week period. Results: All 240 questionnaires were answered with very positive and promising results, including all 100 students who were not familiar with the PDPA prior to the study attributing their awareness of it to MyDoc. Conclusions: Potential uses of MyDoc in a medical school setting include PDPA-compliant student-to-student and student-to-doctor communication and clinical group case discussions with the sharing of patient-sensitive data, including clinical images and/or videos of hospital patients that students may benefit from viewing from an educational perspective. With our pilot study having excellent results in terms of acceptance and satisfaction from medical students and raising awareness of the PDPA, the integration of a secure, mobile digital health application and messaging platform is something all medical schools should consider, because our students of today are our doctors of tomorrow.

  • Image Source: Smartphone use, copyright Intel Free Press,, Licensed under Creative Commons Attribution cc-by 2.0

    Considerations for the Telehealth Systems of Tomorrow: An Analysis of Student Perceptions of Telehealth Technologies


    Background: While much is known about factors that facilitate telehealth adoption, less is known about why adoption does or does not occur in specific populations, such as students. Objective: This study aims to examine the perceptions of telehealth systems within a large student sample. Methods: Undergraduate students (N=315) participated in a survey of the perceived advantages and disadvantages of telehealth technologies. The responses to the survey were analyzed using thematic analysis. Results: We found that students were likely to adopt telehealth systems for the following reasons: (1) the system worked efficiently, (2) the convenience of telehealth, and (3) to gain access to health services. Students also perceived several disadvantages to telehealth systems, such as issues of trust (ie, security, privacy), the impersonal nature of telehealth systems, and they were concerned about the potential for major system errors. Conclusion: By understanding the current barriers to telehealth adoption in a cohort of students, we can not only better anticipate the future needs of this group, but also incorporate such needs into the design of future telehealth systems.

  • Photo credit: (cc) Some rights reserved by Alexander Kachkaev via FlickR, licensed under Creative Commons Attribution 2.0.

    Does Academic Blogging Enhance Promotion and Tenure? A Survey of US and Canadian Medicine and Pediatric Department Chairs


    Background: Electronic educational (e-learning) technology usage continues to grow. Many medical journals operate companion blogs (an application of e-learning technology) that enable rapid dissemination of scientific knowledge and discourse. Faculty members participating in promotion and tenure academic tracks spend valuable time and effort contributing, editing, and directing these medical journal blogs. Objective: We sought to understand whether chairs of medicine and pediatric departments acknowledge blog authorship as academic achievement. Methods: The authors surveyed 267 chairs of US and Canadian medicine and pediatric departments regarding their attitudes toward the role of faculty participation in e-learning and blogging in the promotion and tenure process. The survey completion rate was 22.8% (61/267). Results: A majority of respondents (87%, 53/61) viewed educational scholarship as either important or very important for promotion. However, only 23% (14/61) perceived importance to faculty effort in producing content for journal-based blogs. If faculty were to participate in blog authorship, 72% (44/61) of surveyed chairs favored involvement in a journal-based versus a society-based or a personal (nonaffiliated) blog. We identified a “favorable group” of chairs (19/59, 32%), who rated leadership roles in e-learning tools as important or very important, and an “unfavorable group” of chairs (40/59, 68%), who rated leadership roles in e-learning tools as somewhat important or not important. The favorable group were more likely to be aware of faculty bloggers within their departments (58%, 11/19 vs 25%, 10/40), viewed serving on editorial boards of e-learning tools more favorably (79%, 15/19 vs 31%, 12/39), and were more likely to value effort spent contributing to journal-based blogs (53%, 10/19 vs 10%, 4/40). Conclusions: Our findings demonstrate that although the majority of department chairs value educational scholarship, only a minority perceive value in faculty blogging effort.

  • Student use ICT in medical education. Image source and copyright: the authors.

    Health Sciences Students’ Self-Assessment of Information and Communication Technology Skills and Attitude Toward e-Learning


    Background: In medical education, information and communication technology (ICT) knowledge and skills have become a necessity and an integral part of preparing tomorrow’s doctors to be sufficiently competent to use informatics resources effectively and efficiently for the best practice of medicine. Objective: This research aimed to study the literacy of the preprofessional students in ICT before and after taking the basic informatics course at the Health Sciences Center at Kuwait University, to understand their potential and their attitudes toward using ICT, including e-learning. Methods: A validated questionnaire was used to collect data from 200 students in 2 stages: before and after the informatics course on the preprofessional program. In addition, the tutors’ observational assessments of the students’ achievements during the informatics course were obtained. Results: The response rate of students before the course was 85.5% (171/200) and after was 77% (154/200). Of 200 students, 85% were female, and 15% were male. This disproportional representation of genders was due to the fact that 85% of registered students were female. Approximately 59% (101/171) of the students assessed themselves before the course as computer literate; afterward, this increased to 70.1% (108/154). Students who were still computer illiterate (29.2%; 45/154) mostly used the excuse of a lack of time (60%; 27/45). In generic ICT skills, the highest levels were for word processing, email, and Web browsing, whereas the lowest levels were for spreadsheets and database. In specific ICT skills, most respondents were reported low levels for statistical package use and Web page design. The results found that there was a significant improvement between students’ general ICT skills before and after the course. The results showed that there were significant improvement between how frequently students were using Medline (P<.001), Google Scholar (P<.001), and Cochrane Library (P<.001) before and after the informatics course. Furthermore, most of the students who completed the course (72.8%; 110/151) chose the learning management system as the most useful e-learning tool. The results of the tutors’ assessments confirmed the obvious improvement in most of the students’ skills in using ICT. Conclusions: The ICT knowledge and skills of the students before the course seemed insufficient, and the magnitude of the improvements that were acquired throughout the informatics course was obvious in most of the students’ performance. However, the findings reveal that more practice was required. The attitudes of most of the students toward the potential of e-learning were considered positive, although the potential of Web-based learning in medical training was not well known among the students.

  • Source and Copyright: the authors; license to use under CC-3.0.

    A Critical Review of Mechanical Ventilation Virtual Simulators: Is It Time to Use Them?


    Background: Teaching mechanical ventilation at the bedside with real patients is difficult with many logistic limitations. Mechanical ventilators virtual simulators (MVVS) may have the potential to facilitate mechanical ventilation (MV) training by allowing Web-based virtual simulation. Objective: We aimed to identify and describe the current available MVVS, to compare the usability of their interfaces as a teaching tool and to review the literature on validation studies. Methods: We performed a comparative evaluation of the MVVS, based on a literature/Web review followed by usability tests according to heuristic principles evaluation of their interfaces as performed by professional experts on MV. Results: Eight MVVS were identified. They showed marked heterogeneity, mainly regarding virtual patient's anthropomorphic parameters, pulmonary gas exchange, respiratory mechanics and muscle effort configurations, ventilator terminology, basic ventilatory modes, settings alarms, monitoring parameters, and design. The Hamilton G5 and the Xlung covered a broader number of parameters, tools, and have easier Web-based access. Except for the Xlung, none of the simulators displayed monitoring of arterial blood gases and alternatives to load and save the simulation. The Xlung obtained the greater scores on heuristic principles assessments and the greater score of easiness of use, being the preferred MVVS for teaching purposes. No strong scientific evidence on the use and validation of the current MVVS was found. Conclusions: There are only a few MVVS currently available. Among them, the Xlung showed a better usability interface. Validation tests and development of new or improvement of the current MVVS are needed.

  • Medical and Health Education. Image sourced and copyright owned by authors Jean Christophe Rusatira et al.

    Enabling Access to Medical and Health Education in Rwanda Using Mobile Technology: Needs Assessment for the Development of Mobile Medical Educator Apps


    Background: Lack of access to health and medical education resources for doctors in the developing world is a serious global health problem. In Rwanda, with a population of 11 million, there is only one medical school, hence a shortage in well-trained medical staff. The growth of interactive health technologies has played a role in the improvement of health care in developed countries and has offered alternative ways to offer continuous medical education while improving patient's care. However, low and middle-income countries (LMIC) like Rwanda have struggled to implement medical education technologies adapted to local settings in medical practice and continuing education. Developing a user-centered mobile computing approach for medical and health education programs has potential to bring continuous medical education to doctors in rural and urban areas of Rwanda and influence patient care outcomes. Objective: The aim of this study is to determine user requirements, currently available resources, and perspectives for potential medical education technologies in Rwanda. Methods: Information baseline and needs assessments data collection were conducted in all 44 district hospitals (DHs) throughout Rwanda. The research team collected qualitative data through interviews with 16 general practitioners working across Rwanda and 97 self-administered online questionnaires for rural areas. Data were collected and analyzed to address two key questions: (1) what are the currently available tools for the use of mobile-based technology for medical education in Rwanda, and (2) what are user's requirements for the creation of a mobile medical education technology in Rwanda? Results: General practitioners from different hospitals highlighted that none of the available technologies avail local resources such as the Ministry of Health (MOH) clinical treatment guidelines. Considering the number of patients that doctors see in Rwanda, an average of 32 patients per day, there is need for a locally adapted mobile education app that utilizes specific Rwandan medical education resources. Based on our results, we propose a mobile medical education app that could provide many benefits such as rapid decision making with lower error rates, increasing the quality of data management and accessibility, and improving practice efficiency and knowledge. In areas where Internet access is limited, the proposed mobile medical education app would need to run on a mobile device without Internet access. Conclusions: A user-centered design approach was adopted, starting with a needs assessment with representative end users, which provided recommendations for the development of a mobile medical education app specific to Rwanda. Specific app features were identified through the needs assessment and it was evident that there will be future benefits to ongoing incorporation of user-centered design methods to better inform the software development and improve its usability. Results of the user-centered design reported here can inform other medical education technology developments in LMIC to ensure that technologies developed are usable by all stakeholders.

  • Asklepian from a Roman Aesculapian temple and caduceus from a Florentine sculpture. (a) Tiber Island, Rome 2004 [2]. The arrow indicates the travertine ship’s prow, which is seen in (b,c); (b,c) Asklepian carved into the travertine ship’s prow from the 1st century BCE at the site of an Aesculapian temple [2], 300 m from the current-day Ospedale Fatebenefratelli (photo by author, 2008); (d) Bronze by Gianbologna, Mercurio (Mercury, the Roman name for Hermes), 1580, Museo Nazionale del Bargello, Florence, Italy (excerpt of photo by author, 2013).

    Branding Asklepios and the Traditional and Variant Serpent Symbol Display Among Health Professional Schools in the United States, Puerto Rico, and Canada: A...


    Background: History supports the staff and single serpent, the asklepian, as the symbol of healing and medicine, yet its confusion with the caduceus (a winged staff with two snakes wrapped around it) persists. No population-based information on serpent symbol use exists. Objective: To determine the prevalence of asklepian and caduceus display among Internet images of medical and health professional schools’ emblems, and to compare asklepian and caduceus display between medical and health professional schools, examining the effects of school longevity and geographic location on symbol display. Methods: This cross-sectional survey examined Internet websites and Google Images associated with medical and other health professional schools in the United States, Puerto Rico, and Canada from 2013 to 2015. The primary outcome was display of a traditional or variant asklepian or caduceus among current and past emblems in Google Images. Odds ratios (ORs) and 95% confidence intervals for the comparison of medical versus other health professional schools were calculated by logistic regression. Differences among schools' longevity were assessed with Student's t-tests and linear regression. Results: Among images of current and past emblems of 482 schools—159 medical schools and 323 health professional schools—107 (22.2%) emblems displayed only the traditional, and 205 (42.5%) any, asklepian. Adjusting for geographic region and longevity, medical schools were 59% less likely than health professional schools to display the traditional asklepian (OR 0.41, 95% CI 0.24-0.71, P=.001), and were 7.7 times more likely than health professional schools to display the traditional caduceus. Medical schools were 8% less likely than health professional schools to display any asklepian (OR 0.92, 95% CI 0.62-1.38, P=.70), and were 3.3 times more likely than health professional schools to display any caduceus. Conclusions: Schools’ preference of the asklepian over the caduceus confirmed historical origins. Less asklepian and more caduceus display by medical schools suggests an educational opportunity for the medical profession to define for itself and the public the correct symbol of an interdisciplinary mission of healing.

  • Source:, CC0 Public Domain.

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


    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.

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  • Tips for PowerPoint based interactive lectures grounded on educational theories

    Date Submitted: Oct 27, 2016

    Open Peer Review Period: Nov 1, 2016 - Dec 27, 2016

    PowerPoint, a strong tool for presentation, has been very commonly criticized for its shortcomings. Sentences like ‘death by PowerPoint’ almost always do the rounds whenever PowerPoint is discusse...

    PowerPoint, a strong tool for presentation, has been very commonly criticized for its shortcomings. Sentences like ‘death by PowerPoint’ almost always do the rounds whenever PowerPoint is discussed as a teaching tool. Nonetheless, PowerPoint continues to be used as a major teaching tool in lecture classes. This paper aims to address and thus abolish majority of shortcomings in 10 tips grounded in learning theories. The paper attempts to revive the art and importance of creating line diagrams and simplifying graphs, which we have conveniently shoved away with coming of PowerPoint. It also highlights well known but under or mis-utilised features of bulleted text and grids and their importance in higher order learning. However, reader should keep in mind, like any teaching tool to be effectively utilized, substantial effort, at least initially, is required on teachers’ part to implement the tips.