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Journal Description

JMIR Medical Education (JME) is a Pubmed-indexed, 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 (eg, 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).

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

 

Recent Articles:

  • Students attending an electronic case seminar with free choice of teaching format. Source: Image created by the Authors; Copyright: The Authors; URL: http://mededu.jmir.org/2019/2/e13386/; License: Licensed by JMIR.

    The Impact of Medical Students’ Individual Teaching Format Choice on the Learning Outcome Related to Clinical Reasoning

    Abstract:

    Background: Repeated formative assessments using key feature questions have been shown to enhance clinical reasoning. Key feature questions augmented by videos presenting clinical vignettes may be more effective than text-based questions, especially in a setting where medical students are free to choose the format they would like to work with. This study investigated learning outcomes related to clinical reasoning in students using video- or text-based key feature questions according to their individual preferences. Objective: The aim of this study was to test the hypothesis that repeated exposure to video-based key feature questions enhances clinical reasoning to a greater extent than repeated exposure to text-based key feature questions if students are allowed to choose between those different formats on their own. Methods: In this monocentric, prospective, nonrandomized trial, fourth-year medical students attended 12 computer-based case seminars during which they worked on case histories containing key feature questions. Cases were available in a text- and a video-based format. Students chose their preferred presentation format at the beginning of each case seminar. Student performance in key feature questions was assessed in formative entry, exit, and retention exams and was analyzed with regard to preceding exposure to video- or text-based case histories. Results: Of 102 eligible students, 75 provided written consent and complete data at all study exams (response rate=73.5%). A majority of students (n=52) predominantly chose the text-based format. Compared with these, students preferring the video-based format achieved a nonsignificantly higher score in the exit exam (mean 76.2% [SD 12.6] vs 70.0% [SD 19.0]; P=.15) and a significantly higher score in the retention exam (mean 75.3% [SD 16.6] vs 63.4% [SD 20.3]; P=.02). The effect was independent of the video- or text-based presentation format, which was set as default in the respective exams. Conclusions: Despite students’ overall preference for text-based case histories, the learning outcome with regard to clinical reasoning was higher in students with higher exposure to video-based items. Time-on-task is one conceivable explanation for these effects as working with video-based items was more time-consuming. The baseline performance levels of students do not account for the results as the preceding summative exam results were comparable across the 2 groups. Given that a substantial number of students chose a presentation format that was less effective, students might need to be briefed about the beneficial effects of using video-based case histories to be able to make informed choices about their study methods.

  • The 9 steps model. Source: The Authors / CanStockPhoto; Copyright: The Authors; URL: https://mededu.jmir.org/2019/2/e13004; License: Creative Commons Attribution (CC-BY).

    A 9-Step Theory- and Evidence-Based Postgraduate Medical Digital Education Development Model: Empirical Development and Validation

    Abstract:

    Background: Digital education tools (e-learning, technology-enhanced learning) can be defined as any educational intervention that is electronically mediated. Decveloping and applying such tools and interventions for postgraduate medical professionals who work and learn after graduation can be called postgraduate medical digital education (PGMDE), which is increasingly being used and evaluated. However, evaluation has focused mainly on reaching the learning goals and little on the design. Design models for digital education (instructional design models) help educators create a digital education curriculum, but none have been aimed at PGMDE. Studies show the need for efficient, motivating, useful, and satisfactory digital education. Objective: Our objective was (1) to create an empirical instructional design model for PGMDE founded in evidence and theory, with postgraduate medical professionals who work and learn after graduation as the target audience, and (2) to compare our model with existing models used to evaluate and create PGMDE. Methods: Previously we performed an integrative literature review, focus group discussions, and a Delphi procedure to determine which building blocks for such a model would be relevant according to experts and users. This resulted in 37 relevant items. We then used those 37 items and arranged them into chronological steps. After we created the initial 9-step plan, we compared these steps with other models reported in the literature. Results: The final 9 steps were (1) describe who, why, what, (2) select educational strategies, (3) translate to the real world, (4) choose the technology, (5) complete the team, (6) plan the budget, (7) plan the timing and timeline, (8) implement the project, and (9) evaluate continuously. On comparing this 9-step model with other models, we found that no other was as complete, nor were any of the other models aimed at PGMDE. Conclusions: Our 9-step model is the first, to our knowledge, to be based on evidence and theory building blocks aimed at PGMDE. We have described a complete set of evidence-based steps, expanding a 3-domain model (motivate, learn, and apply) to an instructional design model that can help every educator in creating efficient, motivating, useful, and satisfactory PGMDE. Although certain steps are more robust and have a deeper theoretical background in current research (such as education), others (such as budget) have been barely touched upon and should be investigated more thoroughly in order that proper guidelines may also be provided for them.

  • Student working with the Web-based electrocardiogram learning resource. Source: Image created by the Authors; Copyright: Mikael Nilsson; URL: https://mededu.jmir.org/2019/2/e12791/; License: Creative Commons Attribution (CC-BY).

    Why Medical Students Choose to Use or Not to Use a Web-Based Electrocardiogram Learning Resource: Mixed Methods Study

    Abstract:

    Background: Electrocardiogram (ECG) interpretation is a core competence and can make a significant difference to patient outcomes. However, ECG interpretation is a complex skill to learn, and research has showed that students often lack enough competence. Web-based learning has been shown to be effective. However, little is known regarding why and how students use Web-based learning when offered in a blended learning situation. Objective: The aim of this paper was to study students’ use of Web-based ECG learning resources which has not previously been studied in relation to study strategies. Methods: A qualitative explanatory design using mixed methods was adopted to explore how medical students reason around their choice to use or not to use a Web-based ECG learning resource. Overall, 15 of 33 undergraduate medical students attending a course in clinical medicine were interviewed. Data on usage of the resource were obtained via the learning management system for all students. At the final examination, all the students answered a questionnaire on study strategies and questions about internet access and estimated their own skills in ECG interpretation. Furthermore, study strategies and use patterns were correlated with results from an ECG Objective Structured Clinical Examination (OSCE) and a written course examination. Results: In total, 2 themes were central in the students’ reasoning about usage of Web-based ECG: assessment of learning needs and planning according to learning goals. Reasons for using the Web resource were to train in skills, regarding it as a valuable complement to books and lectures. The main reasons for not using the resource were believing they already had good enough skills and a lack of awareness of its availability. Usage data showed that 21 students (63%) used the Web resource. Of these, 11 were minimal users and 10 were major users based on usage activity. Large variations were found in the time spent in different functional parts of the resource. No differences were found between users and nonusers regarding the OSCE score, final examination score, self-estimate of knowledge, or favoring self-regulated learning. Conclusions: To use or not to use a Web-based ECG learning resource is largely based on self-regulated learning aspects. Decisions to use such a resource are based on multifactorial aspects such as experiences during clinical rotations, former study experiences, and perceived learning needs. The students’ own judgment of whether there was a need for a Web-based resource to achieve the learning goals and to pass the examination was crucial for their decisions to use it or not. An increased understanding of students’ regulation of learning and awareness of variations in their ECG learning needs can contribute to the improvement of course design for blended learning of ECG contexts for medical students.

  • Source: Flickr; Copyright: Berkeley Lab; URL: https://www.flickr.com/photos/berkeleylab/4863700123/in/photolist-8pMJAF-amR8XL-87uWSr-dc2t12-9dpJuR-hQc9Rq-DMiHu-4k9E3F-fjNmeX-83cbP7-dgqQmm-8Jhfwq-dPcqJ1-4m5ojv-eenL8S-8UGVJb-23jnPH9-7fYHhY-3apksQ-7SeMmq-7Mi2yv-cHF3VJ-8cx2Mj-ass94X-5WCvsj-2bDkus-8rMqoS-; License: Creative Commons Attribution + Noncommercial + NoDerivatives (CC-BY-NC-ND).

    Applications and Challenges of Implementing Artificial Intelligence in Medical Education: Integrative Review

    Abstract:

    Background: Since the advent of artificial intelligence (AI) in 1955, the applications of AI have increased over the years within a rapidly changing digital landscape where public expectations are on the rise, fed by social media, industry leaders, and medical practitioners. However, there has been little interest in AI in medical education until the last two decades, with only a recent increase in the number of publications and citations in the field. To our knowledge, thus far, a limited number of articles have discussed or reviewed the current use of AI in medical education. Objective: This study aims to review the current applications of AI in medical education as well as the challenges of implementing AI in medical education. Methods: Medline (Ovid), EBSCOhost Education Resources Information Center (ERIC) and Education Source, and Web of Science were searched with explicit inclusion and exclusion criteria. Full text of the selected articles was analyzed using the Extension of Technology Acceptance Model and the Diffusions of Innovations theory. Data were subsequently pooled together and analyzed quantitatively. Results: A total of 37 articles were identified. Three primary uses of AI in medical education were identified: learning support (n=32), assessment of students’ learning (n=4), and curriculum review (n=1). The main reasons for use of AI are its ability to provide feedback and a guided learning pathway and to decrease costs. Subgroup analysis revealed that medical undergraduates are the primary target audience for AI use. In addition, 34 articles described the challenges of AI implementation in medical education; two main reasons were identified: difficulty in assessing the effectiveness of AI in medical education and technical challenges while developing AI applications. Conclusions: The primary use of AI in medical education was for learning support mainly due to its ability to provide individualized feedback. Little emphasis was placed on curriculum review and assessment of students’ learning due to the lack of digitalization and sensitive nature of examinations, respectively. Big data manipulation also warrants the need to ensure data integrity. Methodological improvements are required to increase AI adoption by addressing the technical difficulties of creating an AI application and using novel methods to assess the effectiveness of AI. To better integrate AI into the medical profession, measures should be taken to introduce AI into the medical school curriculum for medical professionals to better understand AI algorithms and maximize its use.

  • The airRX app (montage). Source: The Authors / Placeit; Copyright: JMIR Publications; URL: https://mededu.jmir.org/2019/1/e10955; License: Creative Commons Attribution (CC-BY).

    Impact of an Electronic App on Resident Responses to Simulated In-Flight Medical Emergencies: Randomized Controlled Trial

    Abstract:

    Background: Health care providers are often called to respond to in-flight medical emergencies, but lack familiarity with expected supplies, interventions, and ground medical control support. Objective: The objective of this study was to determine whether a mobile phone app (airRx) improves responses to simulated in-flight medical emergencies. Methods: This was a randomized study of volunteer, nonemergency resident physician participants who managed simulated in-flight medical emergencies with or without the app. Simulations took place in a mock-up cabin in the simulation center. Standardized participants played the patient, family member, and flight attendant roles. Live, nonblinded rating was used with occasional video review for data clarification. Participants participated in two simulated in-flight medical emergencies (shortness of breath and syncope) and were evaluated with checklists and global rating scales (GRS). Checklist item success rates, key critical action times, GRS, and pre-post simulation confidence in managing in-flight medical emergencies were compared. Results: There were 29 participants in each arm (app vs control; N=58) of the study. Mean percentages of completed checklist items for the app versus control groups were mean 56.1 (SD 10.3) versus mean 49.4 (SD 7.4) for shortness of breath (P=.001) and mean 58 (SD 8.1) versus mean 49.8 (SD 7.0) for syncope (P<.001). The GRS improved with the app for the syncope case (mean 3.14, SD 0.89 versus control mean 2.6, SD 0.97; P=.003), but not the shortness of breath case (mean 2.90, SD 0.97 versus control mean 2.81, SD 0.80; P=.43). For timed checklist items, the app group contacted ground support faster for both cases, but the control group was faster to complete vitals and basic exam. Both groups indicated higher confidence in their postsimulation surveys, but the app group demonstrated a greater increase in this measure. Conclusions: Use of the airRx app prompted some actions, but delayed others. Simulated performance and feedback suggest the app is a useful adjunct for managing in-flight medical emergencies.

  • A physical therapist reading the latest evidence-based articles. Source: Image created by the Authors; Copyright: The Authors; URL: https://mededu.jmir.org/2019/1/e12795; License: Creative Commons Attribution (CC-BY).

    Evidence-Based Physical Therapy Practice in the State of Kuwait: A Survey of Attitudes, Beliefs, Knowledge, Skills, and Barriers

    Abstract:

    Background: Evidence-based practice (EBP) is necessary to improve the practice of physical therapy. However, a lack of knowledge and skills among physical therapists and the presence of barriers may hinder the implementation of EBP in the State of Kuwait. Objective: The objectives of this study were to extensively (1) investigate attitudes toward EBP, (2) assess the current level of knowledge and skills necessary for EBP, and (3) identify the barriers to EBP among physical therapists in the State of Kuwait. Methods: The following methods were used: (1) a previously validated self-reported questionnaire and (2) a face-to-face semistructured interview. The questionnaire, which was distributed to 200 physical therapists, examined the attitudes and beliefs of physical therapists about EBP; the interest in and motivation to engage in EBP; educational background, knowledge, and skills related to accessing and interpreting information; the level of attention to and use of the literature; access to and availability of information to promote EBP; and the perceived barriers to using EBP. The interview explored the factors that promote or discourage EBP. Descriptive statistics and logistic regression analyses were used. Results: Of the 200 nonrandomly distributed questionnaires, 92% (184/200) were completed and returned. In general, the physical therapists had positive attitudes, beliefs, and interests in EBP. Their educational background, knowledge, and skills related to assessing and interpreting information were well-founded. The top 3 barriers included insufficient time (59.2%, 109/184), lack of information resources (49.4%, 91/184), and inapplicability of the research findings to the patient population (40.7%, 75/184). Conclusions: EBP lacks support from superiors at work. Thus, identifying methods and strategies to support physical therapists in adopting EBP in the State of Kuwait is necessary.

  • YouTube videos about immunology for medical students. Source: The Authors / Placeit; Copyright: The Authors; URL: http://mededu.jmir.org/2019/1/e12605/; License: Creative Commons Attribution (CC-BY).

    YouTube Videos as a Source of Information About Immunology for Medical Students: Cross-Sectional Study

    Abstract:

    Background: The use of the internet as a source of information has grown exponentially in the last decade. YouTube is currently the second most visited website and a major Web-based educational resource for medical students. Objective: The aim of this study was to evaluate the quality, accuracy, and attractiveness of the information acquired from YouTube videos about 2 central concepts in immunology. Methods: YouTube videos posted before August 27, 2018 were searched using selected keywords related to either antigen presentation or immunoglobulin gene rearrangement. Video characteristics were recorded, and the Video Power Index (VPI) was calculated. Videos were assessed using 5 validated scoring systems: understandability and attractiveness, reliability, content and comprehensiveness, global quality score (GQS), and a subjective score. Videos were categorized by educational usefulness and by source. Results: A total of 82 videos about antigen presentation and 70 about immunoglobulin gene rearrangement were analyzed. Videos had a mean understandability and attractiveness score of 6.57/8 and 5.84/8, content and comprehensiveness score of 9.84/20 and 5.84/20, reliability score of 1.65/4 and 1.53/4, GQS of 3.38/5 and 2.76/5, and subjective score of 2.00/3 and 2.00/3, respectively. The organized channels group tended to have the highest VPI and GQS. Conclusions: YouTube can provide medical students with some useful information about immunology, although content wise it cannot substitute textbooks and academic courses. Students and teachers should be aware of the educational quality of available videos if they intend to use them in the context of blended learning.

  • Source: Freepik; Copyright: yanalya; URL: https://www.freepik.com/free-photo/thoughtful-man-thinking-new-idea-writing-notes-cafe_3955478.htm; License: Licensed by JMIR.

    Development and Evaluation of the Online Addiction Medicine Certificate: Free Novel Program in a Canadian Setting

    Abstract:

    Background: Despite the enormous bur­den of disease attributable to drug and alcohol addiction, there remain major challenges in implementing evi­dence-based addiction care and treatment modalities. This is partly because of a persistent lack of accessible, specialized training in addiction medicine. In response, a new online certificate in addiction medicine has been established in Vancouver, Canada, free of charge to participants globally. Objective: The objective of this study was to evaluate and examine changes in knowledge acquisition among health care professionals before and after the completion of an online certificate in addiction medicine. Methods: Learners enrolled in a 17-module certificate program and completed pre- and postknowledge tests using online multiple-choice questionnaires. Knowledge acquisition was then evaluated using a repeated measures t test of mean test scores before and after the online course. Following the certificate completion, a subset of learners completed the online course evaluation form. Results: Of the total 6985 participants who registered for the online course between May 15, 2017 and February 22, 2018, 3466 (49.62%) completed the online pretest questionnaire. A total of 1010 participants completed the full course, achieving the required 70% scores. TThe participants self-reported working in a broad range of health-related fields, including nursing (n=371), medicine (n=92), counseling or social work (n=69), community health (n=44), and pharmacy (n=34). The median graduation year was 2010 (n=363, interquartile range 2002-2015). Knowledge of the addiction medicine increased significantly postcertificate (mean difference 28.21; 95% CI 27.32 to 29.10; P<.001). Physicians scored significantly higher on the pretest than any other health discipline, whereas the greatest improvement in scores was seen in the counseling professions and community outreach. Conclusions: This free, online, open-access certificate in addiction medicine appeared to improve knowledge of learners from a variety of disciplines and backgrounds. Scaling up low threshold learning opportunities may further advance addiction medicine training, thereby helping to narrow the evidence-to-practice gap.

  • Source: The Authors / Placeit; Copyright: JMIR Publications; URL: http://mededu.jmir.org/2019/1/e11971/; License: Creative Commons Attribution (CC-BY).

    Not Just a Medical Student: Delivering Medical Education Through a Short Video Series on Social Media

    Abstract:

    “Not Just a Medical Student” is an innovative bite-size medical education video series founded and hosted on social media. Its primary aim is to inspire tomorrow’s doctors to be creative while engaging and informing them with the latest innovations, technology, and conferences within various specialties. To our knowledge, these themes are scarcely covered in the structured medical curriculum. Created and launched in August 2017, “Not Just a Medical Student” quickly gained traction; with over 1000 followers on Facebook and a rapidly increasing number of views, it reached the medical community across the globe. The video series features a trailblazer in virtual reality surgery and its potential impact on the evolution of medical education, reviewing future medical technology apps, such as Touch Surgery, and reporting on the latest medical education and health apps. The series engaged in topical medico-politics at the British Medical Association House and reported on global health issues and innovations at the Royal Society of Medicine Conference. The video series has further received several national awards including the Association and Study of Medical Education (ASME) Educator Innovator 2017 award, runner up to the Zeshan Qureshi Outstanding Contribution to Medical Education Award, and the Alternative Docs National Social Media Influencer award. The concept has been presented at international conferences (eg, the Healthcare Leadership Academy conference) and gained international recognition upon personal invitation at the Norwegian Annual Junior Doctors Conference. With the rise of the social media generation, innovative methods to inspire, engage, and inform students contributing to the continuous evolution of medical education should be encouraged and further explored.

  • Source: Wikepedia Commons; Copyright: Germanna CC; URL: https://commons.wikimedia.org/wiki/File:20160412_GCC_Nursing_Birth_Unit_(26126497060).jpg; License: Creative Commons Attribution (CC-BY).

    Exploring Care Providers’ Perceptions and Current Use of Telehealth Technology at Work, in Daily Life, and in Education: Qualitative and Quantitative Study

    Abstract:

    Background: A telehealth technology education curriculum designed to integrate information technology and telecommunication well has great potential to prepare care providers for health care delivery across space, time, and social and cultural barriers. It is important to assess the readiness level of care providers to use and maximize the benefits of telehealth technology in the health care delivery process. Therefore, this study explored care providers’ existing experience using technology in various use contexts and compared their familiarity with telehealth technology’s relevant features. Objective: This study’s objective was to explore care providers’ familiarity with using technology in different settings and their perceptions of telehealth-driven care performance to lay a foundation for the design of an effective telehealth education program. Methods: The study used quantitative and qualitative analyses. The online survey included four items that measured care providers’ perceptions of care performance when using telehealth technology. Advanced practice registered nurse students rated each item on a 7-point Likert scale, ranging from 1 (“strongly disagree”) to 7 (“strongly agree”). They also responded to three open-ended questions about what kinds of health information technology they use at work, after work, and in their current educational program. Results: A total of 109 advanced practice registered nurse students responded to the online survey and open-ended questionnaire. Most indicated that using telehealth technology enhances care performance (mean 5.67, median 6.0, SD 1.36), helps make their care tasks more effective (mean 5.73, median 6.0, SD 1.30), improves the quality of performing care tasks (mean 5.71, median 6.0, SD 1.30), and decreases error in communicating and sharing information with others (mean 5.35, median 6.0, SD 1.53). In addition, our qualitative analyses revealed that the students used the electronic health records technology primarily at work, combined with clinical decision support tools for medication and treatment management. Outside work, they primarily used video-text communication tools and were exposed to some telehealth technology in their education setting. Further, they believe that use of nonhealth technology helps them use health information technology to access health information, confirm their diagnoses, and ensure patient safety. Conclusions: This research highlights the importance of identifying care providers’ existing experience of using technology to better design a telehealth technology education program. By focusing explicitly on the characteristics of care providers’ existing technology use in work, nonwork, and educational settings, we found a potential consistency between practice and education programs in care providers’ requirements for technology use, as well as areas of focus to complement their frequent use of nonhealth technologies that resemble telehealth technology. Health policymakers and practitioners need to provide compatible telehealth education programs tailored to the level of care providers’ technological familiarity in both their work and nonwork environments.

  • Vietnamese health professionals taking continuing medical education examinations. Source: Image created by the Authors; Copyright: The Authors; URL: https://mededu.jmir.org/2019/1/e12058; License: Creative Commons Attribution (CC-BY).

    Motivating HIV Providers in Vietnam to Learn: A Mixed-Methods Analysis of a Mobile Health Continuing Medical Education Intervention

    Abstract:

    Background: The Mobile Continuing Medical Education Project (mCME V.2.0) was a randomized controlled trial designed to test the efficacy of a text messaging (short message service [SMS])–based distance learning program in Vietnam that included daily quiz questions, links to readings and online courses, and performance feedback. The trial resulted in significant increases in self-study behaviors and higher examination scores for intervention versus control participants. Objective: The objective of this mixed-methods study was to conduct qualitative and quantitative investigations to understand participants’ views of the intervention. We also developed an explanatory framework for future trial replication. Methods: At the endline examination, all intervention participants completed a survey on their perspectives of mCME and self-study behaviors. We convened focus group discussions to assess their experiences with the intervention and attitudes toward continuing medical education. Results: A total of 48 HIV specialists in the intervention group completed the endline survey, and 30 participated in the focus group discussions. Survey and focus group data suggested that most clinicians liked the daily quizzes, citing them as convenient mechanisms to convey information in a relevant manner. A total of 43 of the 48 (90%) participants reported that the daily quizzes provided motivation to study for continuing medical education purposes. Additionally, 83% (40/48) of intervention participants expressed that they were better prepared to care for patients with HIV in their communities, compared with 67% (32/48) at baseline. Participation in the online coursework component was low (only 32/48, 67% of intervention participants ever accessed the courses), but most of those who did participate thought the lectures were engaging (26/32, 81%) and relevant (29/32, 91%). Focus group discussions revealed that various factors influenced the clinicians’ decision to engage in higher learning, or “lateral learning,” including the participant’s availability to study, professional relevance of the topic area, and feedback. These variables serve as modifying factors that fit within an adapted version of the health belief model, which can explain behavior change in this context. Conclusions: Qualitative and quantitative endline data suggested that mCME V.2.0 was highly acceptable. Participant behaviors during the trial fit within the health belief model and can explain the intervention’s impact on improving self-study behaviors. The mCME platform is an evidence-based approach with the potential for adoption at a national scale as a method for promoting continuing medical education. Trial Registration: ClinicalTrials.gov NCT02381743; https://clinicaltrials.gov/ct2/show/NCT02381743

  • Source: The Authors / Placeit; Copyright: JMIR Publications; URL: http://mededu.jmir.org/2019/1/e11351/; License: Creative Commons Attribution (CC-BY).

    Supporting Students With Electronic Health Record–Embedded Learning Aids: A Mixed-Methods Study

    Abstract:

    Background: Students often perceive workplace-based learning as disconnected from what they learn in medical school. Interventions that deal with this issue regularly involve feedback and/or learning aids. Feedback has frequently been encouraged in previous research, whereas the use of aids is less understood. Objective: This study aims to investigate the added value of learning aids in making the connection and enhancing the transfer of learning between medical school and workplace-based learning. Methods: First-year students in postgraduate general practice training participated in a mixed-methods study. Within a quasi-experimental design, two conditions were investigated: (1) students having access to electronic health record (EHR)–embedded learning aids and feedback and (2) students only receiving feedback. Semistructured interviews were conducted and analyzed according to the thematic analysis approach. Results: Forty-four students participated in this study. No significant difference was found between the two conditions (t42=–0.511, P=.61, 95% CI –4.86 to 2.90). Nevertheless, students used the aids frequently and found them useful. Given that the aids were familiar to students and contained practice-based instructions in an easily accessible format, they were perceived as feasible to use during workplace-based learning. They also appeared to stimulate transfer of learning, self-confidence, reflection, and interaction between student and supervisor. Conclusions: Access to EHR-embedded learning aids offers additional support during, but also before and after, patient encounters. The aids can be easily implemented into workplace-based learning.

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  • Not Just a Medical Student: Opportunities and Obstacles of Medical Education Through Social Media

    Date Submitted: Jun 28, 2019

    Open Peer Review Period: Jul 2, 2019 - Aug 27, 2019

    Social media has drastically altered the way in which people communicate. No longer a matter of science fiction, global communication has evolved so much over the last decade, such that large quantiti...

    Social media has drastically altered the way in which people communicate. No longer a matter of science fiction, global communication has evolved so much over the last decade, such that large quantities of public and private data can now be exchanged in minutes. The YouTube platform “Not Just a Medical Student” attempts to innovatively apply social media for the advancement of medical education [1]. As a recently graduated doctor and current undergraduate medical student who regularly use social media for medical education, we would like to share our perspectives on the “Not Just a Medical Student” report and future advances within this field. Firstly, we agree with the authors that medical school curricula often lack teaching on leadership, teamwork and innovation. Despite saturated syllabi and an increasingly restrictive definition of “essential” learning, we believe that these elements are key to healthcare advancement and so thank Abbas et al. for highlighting their importance. At the same time, we acknowledge that medical students are unlikely to have a significant leadership or innovation roles at such a junior stage, and so suggest this teaching may have greater relevance during postgraduate years. On a broader scale, the benefits of educational social media are clear. Geographical and time differences are overcome, allowing students equal access to high quality teaching from healthcare experts, irrespective of location. Evidence also suggests that educational social media, in particular that which facilitates rapid communication, increases student satisfaction [2]. However, application of social media to medical education is not without risks. Firstly, professionals and patients alike are susceptible to false information. Though rapid data-sharing is advantageous in many instances, false content can be shared just as fast and may remain online for a long time before correction or removal. If physicians go on to follow unmoderated, non-peer reviewed advice in their practice, this could harm the professional reputation of an individual or institution and more importantly harm public perception of medical practice, even dissuading patients from choosing truly beneficial treatments. Lack of regulation further allows spread of biased information, such as promotional material from pharmaceutical or device companies. The financial interests of these industries, declared or not, may lead to exaggerated or misleading claims being presented, further spreading misinformation. Lastly, discussion of real patient cases leaves physicians at risk of accidentally sharing personal information and so breaching confidentiality. Ultimately, this could harm the patient and may leave doctors liable for damages. Therefore, all content should first be checked for adherence to guidance from regulatory bodies before publication. Future work in this field should address the lack of quantitative evidence to support claims that social media is an effective educational tool [3]. Presently used metrics such as the number of likes, shares and comments a post receives also require validation. Overall, we believe that social media is a powerful tool with potential to improve education and patient lives worldwide. We thank the “Not Just a Medical Student” team for producing such innovative content and look forward to seeing how this field progresses.

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