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  New Methods and Approaches in Medical...

  Oct 20, 2020

  Developing Patient-Centered Inflammatory Bowel Disease–Related Educational Videos Optimized for Social Media: Qualitative Research Study

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  Authors List:

  • Carine Khalil  
  • Welmoed Van Deen  
  • Taylor Dupuy  
  • Nirupama Bonthala  
  • Christopher Almario  
  • Brennan Spiegel  

  Abstract:

  Background: Important knowledge gaps have been identified related to the causes and symptoms of inflammatory bowel disease (IBD) and medical treatments and their side effects. Patients with IBD turn to social media to learn more about their disease. However, such information found on the web is misleading and often of low quality. Objective: This study aims to gain an in-depth understanding of the unmet educational needs of patients with IBD and to use the resulting insights to develop a collection of freely available, evidence-based educational videos optimized for dissemination through social media. Methods: We used design thinking, a human-centered approach, to guide our qualitative research methodology. We performed focus groups and interviews with a diverse sample of 29 patients with IBD. Data collection was performed in 3 phases (inspiration, ideation, and implementation) based on IDEO design thinking. Phase 1 offered insights into the needs of patients with IBD, whereas phases 2 and 3 involved ideation, prototyping, and video testing. A thematic analysis was performed to analyze the resulting data. Results: Patients emphasized the need for educational videos that address their challenges, needs, and expectations. From the data analysis, 5 video topics and their content emerged: IBD treatments’ risks and benefits; how to be a self-advocate; how to stay healthy with IBD; how to cope with IBD; and educating families, friends, and colleagues about experiences of patients with IBD. Conclusions: Design thinking offers a deep understanding and recognition of the unmet educational needs of patients with IBD; this approach informed the development of 5 evidence-based educational videos. Future research will formally test and disseminate these freely available videos through social media.

  • JMIR Med Educ 2020;6(2):e21639

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  Social Media in Medical Education

  Oct 13, 2020

  Identification of Informed Consent in Patient Videos on Social Media: Prospective Study

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  Authors List:

  • Jane O'Sullivan  
  • Cathleen McCarrick  
  • Paul Tierney  
  • Donal B O'Connor  
  • Jack Collins  
  • Robert Franklin  

  Abstract:

  Background: The American Medical Association Code of Medical Ethics states that any clinical image taken for public education forms part of the patient’s records. Hence, a patient’s informed consent is required to collect, share, and distribute their image. Patients must be informed of the intended use of the clinical image and the intended audience as part of the informed consent. Objective: This paper aimed to determine whether a random selection of instructional videos containing footage of central venous catheter insertion on real patients on YouTube (Google LLC) would mention the presence of informed consent to post the video on social media. Methods: We performed a prospective evaluation by 2 separate researchers of the first 125 videos on YouTube with the search term “central line insertion.” After duplicates were deleted and exclusion criteria applied, 41 videos of patients undergoing central line insertion were searched for reference to patient consent. In the case of videos of indeterminate consent status, the posters were contacted privately through YouTube to clarify the status of consent to both film and disseminate the video on social media. A period of 2 months was provided to respond to initial contact. Furthermore, YouTube was contacted to clarify company policy. The primary outcome was to determine if videos on YouTube were amended to include details of consent at 2 months postcontact. The secondary outcome was a response to the initial email at 2 months. Results: The researchers compiled 143 videos. Of 41 videos that contained footage of patient procedures, 41 were of indeterminate consent status and 23 contained identifiable patient footage. From the 41 posters that were contacted, 3 responded to initial contact and none amended the video to document consent status. Response from YouTube is pending. Conclusions: There are instructional videos for clinicians on social media that contain footage of patients undergoing medical procedures and do not have any verification of informed consent. While this study investigated a small sample of available videos, the problem appears ubiquitous and should be studied more extensively.

  • JMIR Med Educ 2020;6(2):e14081

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  Students' Corner

  Oct 9, 2020

  Medical Students' Corner: Lessons From COVID-19 in Equity, Adaptability, and Community for the Future of Medical Education

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  Authors List:

  • Simran Mann  
  • Shonnelly Novintan  
  • Yasmin Hazemi-Jebelli  
  • Daniel Faehndrich  

  Abstract:

  As UK medical students, we recently completed 3 months of remote learning due to the COVID-19 pandemic, before taking online end-of-the-year exams. We are now entering our final year of medical school. Based on our experiences and our understanding of others’ experiences, we believe that three key lessons have been universal for medical students around the world. The lessons learned throughout this process address the need for a fair system for medical students, the importance of adaptability in all aspects of medical education, and the value of a strong medical school community. These lessons can be applied in the years to come to improve medical education as we know it.

  • JMIR Med Educ 2020;6(2):e23604

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  Undergraduate Education for Future...

  Oct 7, 2020

  Confronting the Challenges of Anatomy Education in a Competency-Based Medical Curriculum During Normal and Unprecedented Times (COVID-19 Pandemic):...

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  Authors List:

  • Nerissa Naidoo  
  • Aya Akhras  
  • Yajnavalka Banerjee  

  Abstract:

  Background: Anatomy is considered to be one of the keystones of undergraduate medical education. However, recently, there has been drastic reduction, both in gross anatomy teaching hours and its context. Additionally, a decrease in the number of trained anatomists and an increase in the costs associated with procuring human cadavers have been noted, causing a diminution of cadaveric dissections in anatomy education. Objective: To address these challenges, there is an ardent need for a pedagogical framework such that anatomy education can be disseminated through active learning principles, within a fixed time frame, using a small team of anatomists and a small number of cadaveric specimens (for live on-site sessions) as well as collaborative learning principles. The latter is particularly important when anatomy education is delivered through distance learning, as is the case currently during the COVID-19 pandemic. Methods: Here, we have blueprinted a pedagogical framework blending the instructional design models of Gagne’s 9 events of instruction with Peyton’s 4-step approach. The framework’s applicability was validated through the delivery of anatomical concepts, using an exemplar from the structure-function course Head and Neck during the normal and COVID-19–mandated lockdown periods, employing the archetype of Frey syndrome. Preliminary evaluation of the framework was pursued using student feedback and end-of-course feedback responses. The efficiency of the framework in knowledge transfer was also appraised. Results: The blueprinted instructional plan designed to implement the pedagogical framework was successfully executed in the dissemination of anatomy education, employing a limited number of cadaveric specimens (during normal times) and a social media application (SMA)–integrated “interactome” strategy (during the COVID-19 lockdown). Students’ response to the framework was positive. However, reluctance was expressed by a majority of the faculty in adopting the framework for anatomy education. To address this aspect, a strategy has been designed using Mento’s 12-step change management model. The long-term benefits for any medical school to adopt the blended pedagogical framework have also been explicated by applying Bourdieu’s Theory of Practice. Additionally, through the design of an SMA interactome model, the framework’s applicability to the delivery of anatomy education and content during the ongoing COVID-19 pandemic was realized. Conclusions: In conclusion, the study effectively tackles some of the contemporary key challenges associated with the delivery of anatomy content in medical education during normal and unprecedented times.

  • JMIR Med Educ 2020;6(2):e21701

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  Health Professionals' Training in...

  Oct 1, 2020

  Understanding Medical Students’ Attitudes Toward Learning eHealth: Questionnaire Study

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  Authors List:

  • Kjeld Vossen  
  • Jan-Joost Rethans  
  • Sander M J van Kuijk  
  • Cees P van der Vleuten  
  • Pieter L Kubben  

  Abstract:

  Background: Several publications on research into eHealth demonstrate promising results. Prior researchers indicated that the current generation of doctors is not trained to take advantage of eHealth in clinical practice. Therefore, training and education for everyone using eHealth are key factors to its successful implementation. We set out to review whether medical students feel prepared to take advantage of eHealth innovations in medicine. Objective: Our objective was to evaluate whether medical students desire a dedicated eHealth curriculum during their medical studies. Methods: A questionnaire assessing current education, the need for education about eHealth topics, and the didactical forms for teaching these topics was developed. Questionnaire items were scored on a scale from 1 (fully disagree with a topic) to 10 (fully agree with a topic). This questionnaire was distributed among 1468 medical students of Maastricht University in the Netherlands. R version 3.5.0 (The R Foundation) was used for all statistical procedures. Results: A total of 303 students out of 1468, representing a response rate of 20.64%, replied to our questionnaire. The aggregate statement “I feel prepared to take advantage of the technological developments within the medical field” was scored at a mean value of 4.8 out of 10. Mean scores regarding the need for education about eHealth topics ranged from 6.4 to 7.3. Medical students did not favor creating their own health apps or mobile apps; the mean score was 4.9 for this topic. The most popular didactical option, with a mean score 7.2, was to remotely follow a real-life patient under the supervision of a doctor. Conclusions: To the best of our knowledge, this is the largest evaluation of students’ opinions on eHealth training in a medical undergraduate curriculum. We found that medical students have positives attitudes toward incorporating eHealth into the medical curriculum.

  • JMIR Med Educ 2020;6(2):e17030

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  Student/Learners Perceptions and...

  Sep 23, 2020

  The Digital Skills, Experiences and Attitudes of the Northern Ireland Social Care Workforce Toward Technology for Learning and Development: Survey Study

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  Authors List:

  • Jonathan Synnott  
  • Mairead Harkin  
  • Brenda Horgan  
  • Andre McKeown  
  • David Hamilton  
  • Declan McAllister  
  • Claire Trainor  
  • Chris Nugent  

  Abstract:

  Background: Continual development of the social care workforce is a key element in improving outcomes for the users of social care services. As the delivery of social care services continues to benefit from innovation in assistive technologies, it is important that the digital capabilities of the social care workforce are aligned. Policy makers have highlighted the importance of using technology to support workforce learning and development, and the need to ensure that the workforce has the necessary digital skills to fully benefit from such provisions. Objective: This study aims to identify the digital capability of the social care workforce in Northern Ireland and to explore the workforce’s appetite for and barriers to using technology for learning and development. This study is designed to answer the following research questions: (1) What is the digital capability of the social care workforce in Northern Ireland? (2) What is the workforce’s appetite to participate in digital learning and development? and (3) If there are barriers to the uptake of technology for learning and development, what are these barriers? Methods: A survey was created and distributed to the Northern Ireland social care workforce. This survey collected data on 127 metrics that described demographics, basic digital skills, technology confidence and access, factors that influence learning and development, experience with digital learning solutions, and perceived value and challenges of using technology for learning. Results: The survey was opened from December 13, 2018, to January 18, 2019. A total of 775 survey respondents completed the survey. The results indicated a workforce with a high level of self-reported basic digital skills and confidence. Face-to-face delivery of learning is still the most common method of accessing learning, which was used by 83.7% (649/775) of the respondents; however, this is closely followed by digital learning, which was used by 79.0% (612/775) of the respondents. There was a negative correlation between age and digital skills (r_s=−0.262; P<.001), and a positive correlation between technology confidence and digital skills (r_s=0.482; P<.001). There was also a negative correlation between age and the perceived value of technology (r_s=−0.088; P=.02). The results indicated a predominantly motivated workforce in which a sizable portion is already engaged in informal digital learning. The results indicated that lower self-reported basic digital skills and confidence were associated with less interest in engaging with e-learning tools and that a portion of the workforce would benefit from additional basic digital skills training. Conclusions: These promising results provide a positive outlook for the potential of digital learning and development within the social care workforce. The findings provide clear areas of focus for the future use of technology for learning and development of the social care workforce and considerations to maximize engagement with such approaches.

  • JMIR Med Educ 2020;6(2):e15936

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  Training for Public Health...

  Sep 18, 2020

  Awareness and Preparedness of Field Epidemiology Training Program Graduates to Respond to COVID-19 in the Eastern Mediterranean Region: Cross-Sectional Study

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  Authors List:

  • Mohannad Al Nsour  
  • Yousef Khader  
  • Abdulwahed Al Serouri  
  • Haitham Bashier  
  • Shahd Osman  

  Abstract:

  Background: The Field Epidemiology Training Program (FETP) is a 2-year training program in applied epidemiology. FETP graduates have contributed significantly to improvements in surveillance systems, control of infectious diseases, and outbreak investigations in the Eastern Mediterranean Region (EMR). Objective: Considering the instrumental roles of FETP graduates during the coronavirus disease (COVID-19) crisis, this study aimed to assess their awareness and preparedness to respond to the COVID-19 pandemic in three EMR countries. Methods: An online survey was sent to FETP graduates in the EMR in March 2020. The FETP graduates were contacted by email and requested to fill out an online survey. Sufficient number of responses were received from only three countries—Jordan, Sudan, and Yemen. A few responses were received from other countries, and therefore, they were excluded from the analysis. The questionnaire comprised a series of questions pertaining to sociodemographic characteristics, knowledge of the epidemiology of COVID-19, and preparedness to respond to COVID-19. Results: This study included a total of 57 FETP graduates (20 from Jordan, 13 from Sudan, and 24 from Yemen). A total of 31 (54%) graduates had attended training on COVID-19, 29 (51%) were members of a rapid response team against COVID-19, and 54 (95%) had previous experience in response to disease outbreaks or health emergencies. The vast majority were aware of the main symptoms, mode of transmission, high-risk groups, and how to use personal protective equipment. A total of 46 (81%) respondents considered themselves well prepared for the COVID-19 outbreak, and 40 (70%) reported that they currently have a role in supporting the country’s efforts in the management of COVID-19 outbreak. Conclusions: The FETP graduates in Jordan, Sudan, and Yemen were fully aware of the epidemiology of COVID-19 and the safety measures required, and they are well positioned to investigate and respond to the COVID-19 pandemic. Therefore, they should be properly and efficiently utilized by the Ministries of Health to investigate and respond to the current COVID-19 crisis where the needs are vastly growing and access to outside experts is becoming limited.

  • JMIR Med Educ 2020;6(2):e19047

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  Reviews in Medical Education

  Sep 11, 2020

  Medical Student Training in eHealth: Scoping Review

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  Authors List:

  • Jean-François Echelard  
  • François Méthot  
  • Hue-Anh Nguyen  
  • Marie-Pascale Pomey  

  Abstract:

  Background: eHealth is the use of information and communication technologies to enable and improve health and health care services. It is crucial that medical students receive adequate training in eHealth as they will work in clinical environments that are increasingly being enabled by technology. This trend is especially accelerated by the COVID-19 pandemic as it complicates traditional face-to-face medical consultations and highlights the need for innovative approaches in health care. Objective: This review aims to evaluate the extent and nature of the existing literature on medical student training in eHealth. In detail, it aims to examine what this education consists of, the barriers, enhancing factors, and propositions for improving the medical curriculum. This review focuses primarily on some key technologies such as mobile health (mHealth), the internet of things (IoT), telehealth, and artificial intelligence (AI). Methods: Searches were performed on 4 databases, and articles were selected based on the eligibility criteria. Studies had to be related to the training of medical students in eHealth. The eligibility criteria were studies published since 2014, from a peer-reviewed journal, and written in either English or French. A grid was used to extract and chart data. Results: The search resulted in 25 articles. The most studied aspect was mHealth. eHealth as a broad concept, the IoT, AI, and programming were least covered. A total of 52% (13/25) of all studies contained an intervention, mostly regarding mHealth, electronic health records, web-based medical resources, and programming. The findings included various barriers, enhancing factors, and propositions for improving the medical curriculum. Conclusions: Trends have emerged regarding the suboptimal present state of eHealth training and barriers, enhancing factors, and propositions for optimal training. We recommend that additional studies be conducted on the following themes: barriers, enhancing factors, propositions for optimal training, competencies that medical students should acquire, learning outcomes from eHealth training, and patient care outcomes from this training. Additional studies should be conducted on eHealth and each of its aspects, especially on the IoT, AI, programming, and eHealth as a broad concept. Training in eHealth is critical to medical practice in clinical environments that are increasingly being enabled by technology. The need for innovative approaches in health care during the COVID-19 pandemic further highlights the relevance of this training.

  • JMIR Med Educ 2020;6(2):e20027

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  Students' Corner

  Jul 30, 2020

  The United States Medical Licensing Examination Step 1 Is Changing—US Medical Curricula Should Too

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  • Benjamin Liu  

  Abstract:

  In recent years, US medical students have been increasingly absent from medical school classrooms. They do so to maximize their competitiveness for a good residency program, by achieving high scores on the United States Medical Licensing Examination (USMLE) Step 1. As a US medical student, I know that most of these class-skipping students are utilizing external learning resources, which are perceived to be more efficient than traditional lectures. Now that the USMLE Step 1 is adopting a pass/fail grading system, it may be tempting to expect students to return to traditional basic science lectures. Unfortunately, my experiences tell me this will not happen. Instead, US medical schools must adapt their curricula. These new curricula should focus on clinical decision making, team-based learning, and new medical decision technologies, while leveraging the validated ability of these external resources to teach the basic sciences. In doing so, faculty will not only increase student engagement but also modernize the curricula to meet new standards on effective medical learning.

  • JMIR Med Educ 2020;6(2):e20182

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  Students' Corner

  Jul 17, 2020

  The Present and Future Applications of Technology in Adapting Medical Education Amidst the COVID-19 Pandemic

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  Authors List:

  • Ridhaa Remtulla  

  Abstract:

  The coronavirus disease (COVID-19) pandemic has not only been catastrophic toward patient health but has also proven to be incredibly disruptive to several industries and sectors, including medical education. However, many medical schools have employed various technological solutions in order to minimize the disruption to medical education during this unpredictable time. This viewpoint reviews the various current and potential applications of technology in order to adapt medical education amidst a global pandemic.

  • JMIR Med Educ 2020;6(2):e20190

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  Training Tools for Medical Students

  Jul 6, 2020

  Medical Student Utilization of a Novel Web-Based Platform (Psy-Q) for Question-Based Learning in Psychiatry: Pilot Questionnaire Study

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  Authors List:

  • John Torous  
  • Zev Nakamura  
  • Jordan Rosen  
  • Pochu Ho  
  • Christine Pelic  
  • Larkin Elderon Kao  
  • David Kasick  
  • Joseph Witowsky  
  • Fremonta Meyer  

  Abstract:

  Background: Medical students are turning to new and expanding web-based resources for learning during their psychiatry clerkships; however, there have not been concomitant efforts by educators to utilize web-based tools to promote innovative teaching. Objective: Utilizing a free learning platform (Psy-Q) created by our team, we sought to explore how digital technology may engage medical student learners, promote colearning between educators and medical students, and support sustainability of web-based platforms through crowdsourcing. Methods: Between 2017 and 2019, seven medical schools offered access to the platform during medical students’ psychiatry clerkships. Use of the web-based platform was voluntary and not monitored or related to clerkship evaluation. Medical students completed a paper and pencil assessment of the platform at the end of their clerkship. Anonymous and aggregated website use data were gathered in accordance with institutional review board approval. Results: A total of 203 medical students across seven distinct psychiatry clerkships completed the survey. Of these students, 123 (60.6%) reported using the platform and reported accessing a mean of 45 questions. The most common device used to access the platform was a laptop and the second most common was a smartphone. The most common location to access the platform was home and the second most common was the hospital. Although few students contributed new questions, website utilization data suggested that all rated the quality and difficulty of the questions. Higher quality questions were medical students’ main suggestion for further improvement. Conclusions: Our results suggest the feasibility and potential of educator- and learner-created web-based platforms to augment psychiatry education and develop relevant accessible resources in the digital sphere. Future work should focus on measuring objective educational outcomes of question taking and writing, as well as optimizing technology and exploring sustainable trainee-faculty partnership models for the creation and curation of content.

  • JMIR Med Educ 2020;6(2):e18340

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  New Methods and Approaches in Medical...

  Jun 30, 2020

  Artificial Intelligence Education and Tools for Medical and Health Informatics Students: Systematic Review

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  Authors List:

  • A Hasan Sapci  
  • H Aylin Sapci  

  Abstract:

  Background: The use of artificial intelligence (AI) in medicine will generate numerous application possibilities to improve patient care, provide real-time data analytics, and enable continuous patient monitoring. Clinicians and health informaticians should become familiar with machine learning and deep learning. Additionally, they should have a strong background in data analytics and data visualization to use, evaluate, and develop AI applications in clinical practice. Objective: The main objective of this study was to evaluate the current state of AI training and the use of AI tools to enhance the learning experience. Methods: A comprehensive systematic review was conducted to analyze the use of AI in medical and health informatics education, and to evaluate existing AI training practices. PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols) guidelines were followed. The studies that focused on the use of AI tools to enhance medical education and the studies that investigated teaching AI as a new competency were categorized separately to evaluate recent developments. Results: This systematic review revealed that recent publications recommend the integration of AI training into medical and health informatics curricula. Conclusions: To the best of our knowledge, this is the first systematic review exploring the current state of AI education in both medicine and health informatics. Since AI curricula have not been standardized and competencies have not been determined, a framework for specialized AI training in medical and health informatics education is proposed.

  • JMIR Med Educ 2020;6(1):e19285

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