@Article{info:doi/10.2196/64179,
author="Gavarkovs, Adam
and Miller, Erin
and Coleman, Jaimie
and Gunasegaran, Tharsiga
and Kusurkar, A. Rashmi
and Kulasegaram, Kulamakan
and Anderson, Melanie
and Brydges, Ryan",
title="Motivation Theories and Constructs in Experimental Studies of Online Instruction: Systematic Review and Directed Content Analysis",
journal="JMIR Med Educ",
year="2025",
month="Apr",
day="11",
volume="11",
pages="e64179",
keywords="motivation",
keywords="internet",
keywords="systematic review",
keywords="experimental studies",
keywords="online instruction",
keywords="educator",
keywords="learner",
keywords="researcher",
keywords="health professional",
keywords="education",
keywords="tool-kit",
keywords="autonomy",
abstract="Background: The motivational design of online instruction is critical in influencing learners' motivation. Given the multifaceted and situated nature of motivation, educators need access to a range of evidence-based motivational design strategies that target different motivational constructs (eg, interest or confidence). Objective: This systematic review and directed content analysis aimed to catalog the motivational constructs targeted in experimental studies of online motivational design strategies in health professions education. Identifying which motivational constructs have been most frequently targeted by design strategies---and which remain under-studied---can offer valuable insights into potential areas for future research. Methods: Medline, Embase, Emcare, PsycINFO, ERIC, and Web of Science were searched from 1990 to August 2022. Studies were included if they compared online instructional design strategies intending to support a motivational construct (eg, interest) or motivation in general among learners in licensed health professions. Two team members independently screened and coded the studies, focusing on the motivational theories that researchers used and the motivational constructs targeted by their design strategies. Motivational constructs were coded into the following categories: intrinsic value beliefs, extrinsic value beliefs, competence and control beliefs, social connectedness, autonomy, and goals. Results: From 10,584 records, 46 studies were included. Half of the studies (n=23) tested strategies aimed at making instruction more interesting, enjoyable, and fun (n=23), while fewer studies tested strategies aimed at influencing extrinsic value beliefs (n=9), competence and control beliefs (n=6), social connectedness (n=4), or autonomy (n=2). A focus on intrinsic value beliefs was particularly evident in studies not informed by a theory of motivation. Conclusions: Most research in health professions education has focused on motivating learners by making online instruction more interesting, enjoyable, and fun. We recommend that future research expand this focus to include other motivational constructs, such as relevance, confidence, and autonomy. Investigating design strategies that influence these constructs would help generate a broader toolkit of strategies for educators to support learners' motivation in online settings. Trial Registration: PROSPERO CRD42022359521; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022359521 ",
doi="10.2196/64179",
url="https://mededu.jmir.org/2025/1/e64179"
}


@Article{info:doi/10.2196/69881,
author="El Arab, Adel Rabie
and Al Moosa, Abdulaziz Omayma
and Abuadas, H. Fuad
and Somerville, Joel",
title="The Role of AI in Nursing Education and Practice: Umbrella Review",
journal="J Med Internet Res",
year="2025",
month="Apr",
day="4",
volume="27",
pages="e69881",
keywords="artificial intelligence",
keywords="nursing practice",
keywords="nursing education",
keywords="ethical implications",
keywords="social implications",
keywords="AI integration",
keywords="AI literacy",
keywords="ethical frameworks",
abstract="Background: Artificial intelligence (AI) is rapidly transforming health care, offering substantial advancements in patient care, clinical workflows, and nursing education. Objective: This umbrella review aims to evaluate the integration of AI into nursing practice and education, with a focus on ethical and social implications, and to propose evidence-based recommendations to support the responsible and effective adoption of AI technologies in nursing. Methods: We included systematic reviews, scoping reviews, rapid reviews, narrative reviews, literature reviews, and meta-analyses focusing on AI integration in nursing, published up to October 2024. A new search was conducted in January 2025 to identify any potentially eligible reviews published thereafter. However, no new reviews were found. Eligibility was guided by the Sample, Phenomenon of Interest, Design, Evaluation, Research type framework; databases (PubMed or MEDLINE, CINAHL, Web of Science, Embase, and IEEE Xplore) were searched using comprehensive keywords. Two reviewers independently screened records and extracted data. Risk of bias was assessed with Risk of Bias in Systematic Reviews (ROBIS) and A Measurement Tool to Assess Systematic Reviews, version 2 (AMSTAR 2), which we adapted for systematic and nonsystematic review types. A thematic synthesis approach, conducted independently by 2 reviewers, identified recurring patterns across the included reviews. Results: The search strategy yielded 18 eligible studies after screening 274 records. These studies encompassed diverse methodologies and focused on nursing professionals, students, educators, and researchers. First, ethical and social implications were consistently highlighted, with studies emphasizing concerns about data privacy, algorithmic bias, transparency, accountability, and the necessity for equitable access to AI technologies. Second, the transformation of nursing education emerged as a critical area, with an urgent need to update curricula by integrating AI-driven educational tools and fostering both technical competencies and ethical decision-making skills among nursing students and professionals. Third, strategies for integration were identified as essential for effective implementation, calling for scalable models, robust ethical frameworks, and interdisciplinary collaboration, while also addressing key barriers such as resistance to AI adoption, lack of standardized AI education, and disparities in technology access. Conclusions: AI holds substantial promises for revolutionizing nursing practice and education. However, realizing this potential necessitates a strategic approach that addresses ethical concerns, integrates AI literacy into nursing curricula, and ensures equitable access to AI technologies. Limitations of this review include the heterogeneity of included studies and potential publication bias. Our findings underscore the need for comprehensive ethical frameworks and regulatory guidelines tailored to nursing applications, updated nursing curricula to include AI literacy and ethical training, and investments in infrastructure to promote equitable AI access. Future research should focus on developing standardized implementation strategies and evaluating the long-term impacts of AI integration on nursing practice and patient outcomes. ",
doi="10.2196/69881",
url="https://www.jmir.org/2025/1/e69881",
url="http://www.ncbi.nlm.nih.gov/pubmed/40072926"
}


@Article{info:doi/10.2196/71844,
author="Ba, Hongjun
and Zhang, Lili
and He, Xiufang
and Li, Shujuan",
title="Knowledge Mapping and Global Trends in Simulation in Medical Education: Bibliometric and Visual Analysis",
journal="JMIR Med Educ",
year="2025",
month="Mar",
day="26",
volume="11",
pages="e71844",
keywords="medical education",
keywords="simulation-based teaching",
keywords="bibliometrics",
keywords="visualization analysis",
keywords="knowledge mapping",
abstract="Background: With the increasing recognition of the importance of simulation-based teaching in medical education, research in this field has developed rapidly. To comprehensively understand the research dynamics and trends in this area, we conducted an analysis of knowledge mapping and global trends. Objective: This study aims to reveal the research hotspots and development trends in the field of simulation-based teaching in medical education from 2004 to 2024 through bibliometric and visualization analyses. Methods: Using CiteSpace and VOSviewer, we conducted bibliometric and visualization analyses of 6743 articles related to simulation-based teaching in medical education, published in core journals from 2004 to 2024. The analysis included publication trends, contributions by countries and institutions, author contributions, keyword co-occurrence and clustering, and keyword bursts. Results: From 2004 to 2008, the number of articles published annually did not exceed 100. However, starting from 2009, the number increased year by year, reaching a peak of 850 articles in 2024, indicating rapid development in this research field. The United States, Canada, the United Kingdom, Australia, and China published the most articles. Harvard University emerged as a research hub with 1799 collaborative links, although the overall collaboration density was low. Among the 6743 core journal articles, a total of 858 authors were involved, with Lars Konge and Adam Dubrowski being the most prolific. However, collaboration density was low, and the collaboration network was relatively dispersed. A total of 812 common keywords were identified, forming 4189 links. The keywords ``medical education,'' ``education,'' and ``simulation'' had the highest frequency of occurrence. Cluster analysis indicated that ``cardiopulmonary resuscitation'' and ``surgical education'' were major research hotspots. From 2004 to 2024, a total of 20 burst keywords were identified, among which ``patient simulation,'' ``randomized controlled trial,'' ``clinical competence,'' and ``deliberate practice'' had high burst strength. In recent years, ``application of simulation in medical education,'' ``3D printing,'' ``augmented reality,'' and ``simulation training'' have become research frontiers. Conclusions: Research on the application of simulation-based teaching in medical education has become a hotspot, with expanding research areas and hotspots. Future research should strengthen interinstitutional collaboration and focus on the application of emerging technologies in simulation-based teaching. ",
doi="10.2196/71844",
url="https://mededu.jmir.org/2025/1/e71844"
}


@Article{info:doi/10.2196/66157,
author="Potter, Alison
and Munsch, Chris
and Watson, Elaine
and Hopkins, Emily
and Kitromili, Sofia
and O'Neill, Cameron Iain
and Larbie, Judy
and Niittymaki, Essi
and Ramsay, Catriona
and Burke, Joshua
and Ralph, Neil",
title="Identifying Research Priorities in Digital Education for Health Care: Umbrella Review and Modified Delphi Method Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="19",
volume="27",
pages="e66157",
keywords="digital education",
keywords="health professions education",
keywords="research priorities",
keywords="umbrella review",
keywords="Delphi",
keywords="artificial intelligence",
keywords="AI",
abstract="Background: In recent years, the use of digital technology in the education of health care professionals has surged, partly driven by the COVID-19 pandemic. However, there is still a need for focused research to establish evidence of its effectiveness. Objective: This study aimed to define the gaps in the evidence for the efficacy of digital education and to identify priority areas where future research has the potential to contribute to our understanding and use of digital education. Methods: We used a 2-stage approach to identify research priorities. First, an umbrella review of the recent literature (published between 2020 and 2023) was performed to identify and build on existing work. Second, expert consensus on the priority research questions was obtained using a modified Delphi method. Results: A total of 8857 potentially relevant papers were identified. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, we included 217 papers for full review. All papers were either systematic reviews or meta-analyses. A total of 151 research recommendations were extracted from the 217 papers. These were analyzed, recategorized, and consolidated to create a final list of 63 questions. From these, a modified Delphi process with 42 experts was used to produce the top-five rated research priorities: (1) How do we measure the learning transfer from digital education into the clinical setting? (2) How can we optimize the use of artificial intelligence, machine learning, and deep learning to facilitate education and training? (3) What are the methodological requirements for high-quality rigorous studies assessing the outcomes of digital health education? (4) How does the design of digital education interventions (eg, format and modality) in health professionals' education and training curriculum affect learning outcomes? and (5) How should learning outcomes in the field of health professions' digital education be defined and standardized? Conclusions: This review provides a prioritized list of research gaps in digital education in health care, which will be of use to researchers, educators, education providers, and funding agencies. Additional proposals are discussed regarding the next steps needed to advance this agenda, aiming to promote meaningful and practical research on the use of digital technologies and drive excellence in health care education. ",
doi="10.2196/66157",
url="https://www.jmir.org/2025/1/e66157",
url="http://www.ncbi.nlm.nih.gov/pubmed/39969988"
}


@Article{info:doi/10.2196/58161,
author="Gazquez-Garcia, Javier
and S{\'a}nchez-Bocanegra, Luis Carlos
and Sevillano, Luis Jose",
title="AI in the Health Sector: Systematic Review of Key Skills for Future Health Professionals",
journal="JMIR Med Educ",
year="2025",
month="Feb",
day="5",
volume="11",
pages="e58161",
keywords="artificial intelligence",
keywords="healthcare competencies",
keywords="systematic review",
keywords="healthcare education",
keywords="AI regulation",
abstract="Background: Technological advancements have significantly reshaped health care, introducing digital solutions that enhance diagnostics and patient care. Artificial intelligence (AI) stands out, offering unprecedented capabilities in data analysis, diagnostic support, and personalized medicine. However, effectively integrating AI into health care necessitates specialized competencies among professionals, an area still in its infancy in terms of comprehensive literature and formalized training programs. Objective: This systematic review aims to consolidate the essential skills and knowledge health care professionals need to integrate AI into their clinical practice effectively, according to the published literature. Methods: We conducted a systematic review, across databases PubMed, Scopus, and Web of Science, of peer-reviewed literature that directly explored the required skills for health care professionals to integrate AI into their practice, published in English or Spanish from 2018 onward. Studies that did not refer to specific skills or training in digital health were not included, discarding those that did not directly contribute to understanding the competencies necessary to integrate AI into health care practice. Bias in the examined works was evaluated following Cochrane's domain-based recommendations. Results: The initial database search yielded a total of 2457 articles. After deleting duplicates and screening titles and abstracts, 37 articles were selected for full-text review. Out of these, only 7 met all the inclusion criteria for this systematic review. The review identified a diverse range of skills and competencies, that we categorized into 14 key areas classified based on their frequency of appearance in the selected studies, including AI fundamentals, data analytics and management, and ethical considerations. Conclusions: Despite the broadening of search criteria to capture the evolving nature of AI in health care, the review underscores a significant gap in focused studies on the required competencies. Moreover, the review highlights the critical role of regulatory bodies such as the US Food and Drug Administration in facilitating the adoption of AI technologies by establishing trust and standardizing algorithms. Key areas were identified for developing competencies among health care professionals for the implementation of AI, including: AI fundamentals knowledge (more focused on assessing the accuracy, reliability, and validity of AI algorithms than on more technical abilities such as programming or mathematics), data analysis skills (including data acquisition, cleaning, visualization, management, and governance), and ethical and legal considerations. In an AI-enhanced health care landscape, the ability to humanize patient care through effective communication is paramount. This balance ensures that while AI streamlines tasks and potentially increases patient interaction time, health care professionals maintain a focus on compassionate care, thereby leveraging AI to enhance, rather than detract from, the patient experience.\emspace ",
doi="10.2196/58161",
url="https://mededu.jmir.org/2025/1/e58161"
}


@Article{info:doi/10.2196/66114,
author="Zong, Hui
and Wu, Rongrong
and Cha, Jiaxue
and Wang, Jiao
and Wu, Erman
and Li, Jiakun
and Zhou, Yi
and Zhang, Chi
and Feng, Weizhe
and Shen, Bairong",
title="Large Language Models in Worldwide Medical Exams: Platform Development and Comprehensive Analysis",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="27",
volume="26",
pages="e66114",
keywords="large language models",
keywords="LLMs",
keywords="generative pretrained transformer",
keywords="ChatGPT",
keywords="medical exam",
keywords="medical education",
keywords="artifical intelligence",
keywords="AI",
abstract="Background: Large language models (LLMs) are increasingly integrated into medical education, with transformative potential for learning and assessment. However, their performance across diverse medical exams globally has remained underexplored. Objective: This study aims to introduce MedExamLLM, a comprehensive platform designed to systematically evaluate the performance of LLMs on medical exams worldwide. Specifically, the platform seeks to (1) compile and curate performance data for diverse LLMs on worldwide medical exams; (2) analyze trends and disparities in LLM capabilities across geographic regions, languages, and contexts; and (3) provide a resource for researchers, educators, and developers to explore and advance the integration of artificial intelligence in medical education. Methods: A systematic search was conducted on April 25, 2024, in the PubMed database to identify relevant publications. Inclusion criteria encompassed peer-reviewed, English-language, original research articles that evaluated at least one LLM on medical exams. Exclusion criteria included review articles, non-English publications, preprints, and studies without relevant data on LLM performance. The screening process for candidate publications was independently conducted by 2 researchers to ensure accuracy and reliability. Data, including exam information, data process information, model performance, data availability, and references, were manually curated, standardized, and organized. These curated data were integrated into the MedExamLLM platform, enabling its functionality to visualize and analyze LLM performance across geographic, linguistic, and exam characteristics. The web platform was developed with a focus on accessibility, interactivity, and scalability to support continuous data updates and user engagement. Results: A total of 193 articles were included for final analysis. MedExamLLM comprised information for 16 LLMs on 198 medical exams conducted in 28 countries across 15 languages from the year 2009 to the year 2023. The United States accounted for the highest number of medical exams and related publications, with English being the dominant language used in these exams. The Generative Pretrained Transformer (GPT) series models, especially GPT-4, demonstrated superior performance, achieving pass rates significantly higher than other LLMs. The analysis revealed significant variability in the capabilities of LLMs across different geographic and linguistic contexts. Conclusions: MedExamLLM is an open-source, freely accessible, and publicly available online platform providing comprehensive performance evaluation information and evidence knowledge about LLMs on medical exams around the world. The MedExamLLM platform serves as a valuable resource for educators, researchers, and developers in the fields of clinical medicine and artificial intelligence. By synthesizing evidence on LLM capabilities, the platform provides valuable insights to support the integration of artificial intelligence into medical education. Limitations include potential biases in the data source and the exclusion of non-English literature. Future research should address these gaps and explore methods to enhance LLM performance in diverse contexts. ",
doi="10.2196/66114",
url="https://www.jmir.org/2024/1/e66114",
url="http://www.ncbi.nlm.nih.gov/pubmed/39729356"
}


@Article{info:doi/10.2196/60312,
author="Ogundiya, Oluwadamilola
and Rahman, Jasmine Thahmina
and Valnarov-Boulter, Ioan
and Young, Michael Tim",
title="Looking Back on Digital Medical Education Over the Last 25 Years and Looking to the Future: Narrative Review",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="19",
volume="26",
pages="e60312",
keywords="digital health",
keywords="digital medical education",
keywords="health education",
keywords="medical education",
keywords="mobile phone",
keywords="artificial intelligence",
keywords="AI",
abstract="Background: The last 25 years have seen enormous progression in digital technologies across the whole of the health service, including health education. The rapid evolution and use of web-based and digital techniques have been significantly transforming this field since the beginning of the new millennium. These advancements continue to progress swiftly, even more so after the COVID-19 pandemic. Objective: This narrative review aims to outline and discuss the developments that have taken place in digital medical education across the defined time frame. In addition, evidence for potential opportunities and challenges facing digital medical education in the near future was collated for analysis. Methods: Literature reviews were conducted using PubMed, Web of Science Core Collection, Scopus, Google Scholar, and Embase. The participants and learners in this study included medical students, physicians in training or continuing professional development, nurses, paramedics, and patients. Results: Evidence of the significant steps in the development of digital medical education in the past 25 years was presented and analyzed in terms of application, impact, and implications for the future. The results were grouped into the following themes for discussion: learning management systems; telemedicine (in digital medical education); mobile health; big data analytics; the metaverse, augmented reality, and virtual reality; the COVID-19 pandemic; artificial intelligence; and ethics and cybersecurity. Conclusions: Major changes and developments in digital medical education have occurred from around the start of the new millennium. Key steps in this journey include technical developments in teleconferencing and learning management systems, along with a marked increase in mobile device use for accessing learning over this time. While the pace of evolution in digital medical education accelerated during the COVID-19 pandemic, further rapid progress has continued since the resolution of the pandemic. Many of these changes are currently being widely used in health education and other fields, such as augmented reality, virtual reality, and artificial intelligence, providing significant future potential. The opportunities these technologies offer must be balanced against the associated challenges in areas such as cybersecurity, the integrity of web-based assessments, ethics, and issues of digital privacy to ensure that digital medical education continues to thrive in the future. ",
doi="10.2196/60312",
url="https://www.jmir.org/2024/1/e60312"
}


@Article{info:doi/10.2196/58165,
author="Han, Qing",
title="Topics and Trends of Health Informatics Education Research: Scientometric Analysis",
journal="JMIR Med Educ",
year="2024",
month="Dec",
day="11",
volume="10",
pages="e58165",
keywords="health informatics education",
keywords="scientometric analysis",
keywords="structural topic model",
keywords="health informatics",
keywords="medical informatics",
keywords="medical education",
abstract="Background: Academic and educational institutions are making significant contributions toward training health informatics professionals. As research in health informatics education (HIE) continues to grow, it is useful to have a clearer understanding of this research field. Objective: This study aims to comprehensively explore the research topics and trends of HIE from 2014 to 2023. Specifically, it aims to explore (1) the trends of annual articles, (2) the prolific countries/regions, institutions, and publication sources, (3) the scientific collaborations of countries/regions and institutions, and (4) the major research themes and their developmental tendencies. Methods: Using publications in Web of Science Core Collection, a scientometric analysis of 575 articles related to the field of HIE was conducted. The structural topic model was used to identify topics discussed in the literature and to reveal the topic structure and evolutionary trends of HIE research. Results: Research interest in HIE has clearly increased from 2014 to 2023, and is continually expanding. The United States was found to be the most prolific country in this field. Harvard University was found to be the leading institution with the highest publication productivity. Journal of Medical Internet Research, Journal of The American Medical Informatics Association, and Applied Clinical Informatics were the top 3 journals with the highest articles in this field. Countries/regions and institutions having higher levels of international collaboration were more impactful. Research on HIE could be modeled into 7 topics related to the following areas: clinical (130/575, 22.6\%), mobile application (123/575, 21.4\%), consumer (99/575, 17.2\%), teaching (61/575, 10.6\%), public health (56/575, 9.7\%), discipline (55/575, 9.6\%), and nursing (51/575, 8.9\%). The results clearly indicate the unique foci for each year, depicting the process of development for health informatics research. Conclusions: This is believed to be the first scientometric analysis exploring the research topics and trends in HIE. This study provides useful insights and implications, and the findings could be used as a guide for HIE contributors. ",
doi="10.2196/58165",
url="https://mededu.jmir.org/2024/1/e58165"
}


@Article{info:doi/10.2196/57929,
author="Vanderhout, Shelley
and Bird, Marissa
and Giannarakos, Antonia
and Panesar, Balpreet
and Whitmore, Carly",
title="Evaluation Methods, Indicators, and Outcomes in Learning Health Systems: Protocol for a Jurisdictional Scan",
journal="JMIR Res Protoc",
year="2024",
month="Dec",
day="6",
volume="13",
pages="e57929",
keywords="learning health systems",
keywords="evaluation",
keywords="jurisdictional scan",
keywords="counterfactuals",
keywords="LHS",
keywords="health system",
keywords="real-time evidence",
keywords="informatics",
keywords="organizational culture",
keywords="learning cycles",
keywords="benchmark",
keywords="patient care",
keywords="gaps",
keywords="health care",
keywords="inequities",
keywords="development",
keywords="implementation",
keywords="intervention",
keywords="new approach",
abstract="Background: In learning health systems (LHSs), real-time evidence, informatics, patient-provider partnerships and experiences, and organizational culture are combined to conduct ``learning cycles'' that support improvements in care. Although the concept of LHSs is fairly well established in the literature, evaluation methods, mechanisms, and indicators are less consistently described. Furthermore, LHSs often use ``usual care'' or ``status quo'' as a benchmark for comparing new approaches to care, but disentangling usual care from multifarious care modalities found across settings is challenging. There is a need to identify which evaluation methods are used within LHSs, describe how LHS growth and maturity are conceptualized, and determine what tools and measures are being used to evaluate LHSs at the system level. Objective: This study aimed to (1) identify international examples of LHSs and describe their evaluation approaches, frameworks, indicators, and outcomes; and (2) describe common characteristics, emphases, assumptions, or challenges in establishing counterfactuals in LHSs. Methods: A jurisdictional scan, which is a method used to explore, understand, and assess how problems have been framed by others in a given field, will be conducted according to modified PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. LHSs will be identified through a search of peer-reviewed and gray literature using Ovid MEDLINE, EBSCO CINAHL, Ovid Embase, Clarivate Web of Science, PubMed non-MEDLINE databases, and the web. We will describe evaluation approaches used both at the LHS learning cycle and system levels. To gain a comprehensive understanding of each LHS, including details specific to evaluation, self-identified LHSs will be included if they are described according to at least 4 of 11 prespecified criteria (core functionalities, analytics, use of evidence, co-design or implementation, evaluation, change management or governance structures, data sharing, knowledge sharing, training or capacity building, equity, and sustainability). Search results will be screened, extracted, and analyzed to inform a descriptive review pertaining to our main objectives. Evaluation methods and approaches, both within learning cycles and at the system level, as well as frameworks, indicators, and target outcomes, will be identified and summarized descriptively. Across evaluations, common challenges, assumptions, contextual factors, and mechanisms will be described. Results: As of October 2024, the database searches described above yielded 3503 citations after duplicate removal. Full-text screening of 117 articles is complete, and 49 articles are under analysis. Results are expected in early 2025. Conclusions: This research will characterize the current landscape of LHS evaluation approaches and provide a foundation for developing consistent and scalable metrics of LHS growth, maturity, and success. This work will also serve to identify opportunities for improving the alignment of current evaluation approaches and metrics with population health needs, community priorities, equity, and health system strategic aims. Trial Registration: Open Science Framework b5u7e; https://osf.io/b5u7e International Registered Report Identifier (IRRID): DERR1-10.2196/57929 ",
doi="10.2196/57929",
url="https://www.researchprotocols.org/2024/1/e57929"
}


@Article{info:doi/10.2196/58084,
author="Robertson, Sandra
and Thomson, Katie
and Bannigan, Katrina",
title="Characteristics of Student-Led Clinics in the Allied Health Professions: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2024",
month="Nov",
day="27",
volume="13",
pages="e58084",
keywords="student-run clinic",
keywords="student-facilitated clinic",
keywords="allied health profession",
keywords="interprofessional",
keywords="higher education",
keywords="university",
keywords="tertiary education",
keywords="preregistration",
keywords="social care environment",
keywords="practice based learning",
abstract="Background: Student-led clinics can provide students from allied health professions with the opportunity to gain valuable placement experience as an integral component of their preregistration program, enabling them to develop their competencies, professional skills, and administrative and leadership skills. Student-led clinics have the capacity to help meet the demand for appropriate practice-based learning opportunities, as there is an expectation that all allied health professions students should have high-quality learning experiences, ensuring the future workforce is fit for purpose. An overview of existing student-led clinics will increase our understanding of key characteristics, assisting education providers who may be considering the development of their own clinics. This will include key factors to ensure that this model of practice-based learning meets the needs of service users, students, and education providers. Objective: This scoping review aims to increase our understanding of the characteristics of student-led clinics by answering the questions (1) what student-led clinics exist in the allied health professions, and (2) what are their characteristics? Methods: This scoping review has been developed in conjunction with Joanna Briggs Institute methodology. We will consider studies and publications that include student-led clinics as an integral part of the preregistration curriculum for allied health professions students as defined by the Health and Care Professions Council. An extensive search of electronic databases will be conducted, including PubMed, MEDLINE, and CINAHL, among others. Search strategies, including the identified keywords and index terms, will be modified for each included database used. Reference lists of all included evidence will be screened for additional relevant studies. Studies published in English with no date limitations will be included. Relevant sources will be imported into Covidence for screening conducted by 2 reviewers (SR and KB). Data extraction will be conducted by 2 reviewers using a piloted data extraction tool, and data will be charted and tabulated using the Template for Intervention Description and Replication (TIDieR) checklist. Data will be presented with a narrative summary and illustrated by graphs and figures. The scoping review will be reported in conjunction with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews) and the STORIES (Structured Approach to the Reporting In health care education of Evidence Synthesis) statement for health care education evidence synthesis. Results: An initial limited search was conducted in February 2024. The study will be conducted in 2025. Publication of the results is expected in late 2025. Conclusions: This scoping review will provide key information regarding the characteristics of student-led clinics and will be of interest to preregistration education programs within the allied health professions who have an interest in exploring opportunities to address placement capacity issues. International Registered Report Identifier (IRRID): PRR1-10.2196/58084 ",
doi="10.2196/58084",
url="https://www.researchprotocols.org/2024/1/e58084"
}


@Article{info:doi/10.2196/54297,
author="Zhou, You
and Li, Si-Jia
and Tang, Xing-Yi
and He, Yi-Chen
and Ma, Hao-Ming
and Wang, Ao-Qi
and Pei, Run-Yuan
and Piao, Mei-Hua",
title="Using ChatGPT in Nursing: Scoping Review of Current Opinions",
journal="JMIR Med Educ",
year="2024",
month="Nov",
day="19",
volume="10",
pages="e54297",
keywords="ChatGPT",
keywords="large language model",
keywords="nursing",
keywords="artificial intelligence",
keywords="scoping review",
keywords="generative AI",
keywords="nursing education",
abstract="Background: Since the release of ChatGPT in November 2022, this emerging technology has garnered a lot of attention in various fields, and nursing is no exception. However, to date, no study has comprehensively summarized the status and opinions of using ChatGPT across different nursing fields. Objective: We aim to synthesize the status and opinions of using ChatGPT according to different nursing fields, as well as assess ChatGPT's strengths, weaknesses, and the potential impacts it may cause. Methods: This scoping review was conducted following the framework of Arksey and O'Malley and guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A comprehensive literature research was conducted in 4 web-based databases (PubMed, Embase, Web of Science, and CINHAL) to identify studies reporting the opinions of using ChatGPT in nursing fields from 2022 to September 3, 2023. The references of the included studies were screened manually to further identify relevant studies. Two authors conducted studies screening, eligibility assessments, and data extraction independently. Results: A total of 30 studies were included. The United States (7 studies), Canada (5 studies), and China (4 studies) were countries with the most publications. In terms of fields of concern, studies mainly focused on ``ChatGPT and nursing education'' (20 studies), ``ChatGPT and nursing practice'' (10 studies), and ``ChatGPT and nursing research, writing, and examination'' (6 studies). Six studies addressed the use of ChatGPT in multiple nursing fields. Conclusions: As an emerging artificial intelligence technology, ChatGPT has great potential to revolutionize nursing education, nursing practice, and nursing research. However, researchers, institutions, and administrations still need to critically examine its accuracy, safety, and privacy, as well as academic misconduct and potential ethical issues that it may lead to before applying ChatGPT to practice. ",
doi="10.2196/54297",
url="https://mededu.jmir.org/2024/1/e54297"
}


@Article{info:doi/10.2196/56727,
author="Costa, Silva Carlos Dario da
and Silva, Gouvea Gabriela
and Santos, dos Emerson Roberto
and Engel, Carvalho Ana Maria Rita Pedroso Vilela Torres de
and Costa, Santos Ana Caroline dos
and da Silva, Morete Taisa
and da Concei{\c{c}}{\~a}o, Henrique Washington
and Crist{\'o}v{\~a}o, Helena
and Lima, Abreu Alba Regina de
and Brienze, MS V{\^a}nia
and Bizotto, Gastardelo Tha{\'i}s Santana
and Oliani, H{\'e}lio Antonio
and Andr{\'e}, C{\'e}sar J{\'u}lio",
title="Surgical Residents' Perception of Feedback on Their Education: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2024",
month="Aug",
day="19",
volume="13",
pages="e56727",
keywords="medical education",
keywords="occupational training",
keywords="surgical residents",
keywords="feedback",
keywords="perception",
abstract="Background: Feedback is an essential tool for learning and improving performance in any sphere of education, including training of resident physicians. The learner's perception of the feedback they receive is extremely relevant to their learning progress, which must aim at providing qualified care for patients. Studies pertinent to the matter differ substantially with respect to methodology, population, context, and objective, which makes it even more difficult to achieve a clear understanding of the topic. A scoping review on this theme will unequivocally enhance and organize what is already known. Objective: The aim of this study is to identify and map out data from studies that report surgical residents' perception of the feedback received during their education. Methods: The review will consider studies on the feedback perception of resident physicians of any surgical specialty and age group, attending any year of residency, regardless of the type of feedback given and the way the perceptions were measured. Primary studies published in English, Spanish, and Portuguese since 2017 will be considered. The search will be carried out in 6 databases and reference lists will also be searched for additional studies. Duplicates will be removed, and 2 independent reviewers will screen the selected studies' titles, abstracts, and full texts. Data extraction will be performed through a tool developed by the researchers. Descriptive statistics and qualitative analysis (content analysis) will be used to analyze the data. A summary of the results will be presented in the form of diagrams, narratives, and tables. Results: The findings of this scoping review were submitted to an indexed journal in July 2024, currently awaiting reviewer approval. The search was executed on March 15, 2024, and resulted in 588 articles. After the exclusion of the duplicate articles and those that did not meet the eligibility criteria as well as the inclusion of articles through a manual search, 13 articles were included in the review. Conclusions: Conducting a scoping review is the best way to map what is known about a subject. By focusing on the feedback perception more than the feedback itself, the results of this study will surely contribute to gaining a deeper understanding of how to proceed to enhance internal feedback and surgical residents' learning progress. Trial Registration: Open Science Framework yexb; https://osf.io/yexkb. International Registered Report Identifier (IRRID): PRR1-10.2196/56727 ",
doi="10.2196/56727",
url="https://www.researchprotocols.org/2024/1/e56727",
url="http://www.ncbi.nlm.nih.gov/pubmed/39158942"
}


@Article{info:doi/10.2196/50667,
author="Rohani, Narjes
and Sowa, Stephen
and Manataki, Areti",
title="Identifying Learning Preferences and Strategies in Health Data Science Courses: Systematic Review",
journal="JMIR Med Educ",
year="2024",
month="Aug",
day="12",
volume="10",
pages="e50667",
keywords="health data science",
keywords="bioinformatics",
keywords="learning approach",
keywords="learning preference",
keywords="learning tactic",
keywords="learning strategy",
keywords="interdisciplinary",
keywords="systematic review",
keywords="medical education",
abstract="Background: Learning and teaching interdisciplinary health data science (HDS) is highly challenging, and despite the growing interest in HDS education, little is known about the learning experiences and preferences of HDS students. Objective: We conducted a systematic review to identify learning preferences and strategies in the HDS discipline. Methods: We searched 10 bibliographic databases (PubMed, ACM Digital Library, Web of Science, Cochrane Library, Wiley Online Library, ScienceDirect, SpringerLink, EBSCOhost, ERIC, and IEEE Xplore) from the date of inception until June 2023. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included primary studies written in English that investigated the learning preferences or strategies of students in HDS-related disciplines, such as bioinformatics, at any academic level. Risk of bias was independently assessed by 2 screeners using the Mixed Methods Appraisal Tool, and we used narrative data synthesis to present the study results. Results: After abstract screening and full-text reviewing of the 849 papers retrieved from the databases, 8 (0.9\%) studies, published between 2009 and 2021, were selected for narrative synthesis. The majority of these papers (7/8, 88\%) investigated learning preferences, while only 1 (12\%) paper studied learning strategies in HDS courses. The systematic review revealed that most HDS learners prefer visual presentations as their primary learning input. In terms of learning process and organization, they mostly tend to follow logical, linear, and sequential steps. Moreover, they focus more on abstract information, rather than detailed and concrete information. Regarding collaboration, HDS students sometimes prefer teamwork, and sometimes they prefer to work alone. Conclusions: The studies' quality, assessed using the Mixed Methods Appraisal Tool, ranged between 73\% and 100\%, indicating excellent quality overall. However, the number of studies in this area is small, and the results of all studies are based on self-reported data. Therefore, more research needs to be conducted to provide insight into HDS education. We provide some suggestions, such as using learning analytics and educational data mining methods, for conducting future research to address gaps in the literature. We also discuss implications for HDS educators, and we make recommendations for HDS course design; for example, we recommend including visual materials, such as diagrams and videos, and offering step-by-step instructions for students. ",
doi="10.2196/50667",
url="https://mededu.jmir.org/2024/1/e50667"
}


@Article{info:doi/10.2196/60807,
author="Liu, Mingxin
and Okuhara, Tsuyoshi
and Chang, XinYi
and Shirabe, Ritsuko
and Nishiie, Yuriko
and Okada, Hiroko
and Kiuchi, Takahiro",
title="Performance of ChatGPT Across Different Versions in Medical Licensing Examinations Worldwide: Systematic Review and Meta-Analysis",
journal="J Med Internet Res",
year="2024",
month="Jul",
day="25",
volume="26",
pages="e60807",
keywords="large language model, ChatGPT, medical licensing examination, medical education",
keywords="LLMs",
keywords="NLP",
keywords="natural language processing",
keywords="artificial intelligence",
keywords="language models",
keywords="review methods",
keywords="systematic",
keywords="meta-analysis",
abstract="Background: Over the past 2 years, researchers have used various medical licensing examinations to test whether ChatGPT (OpenAI) possesses accurate medical knowledge. The performance of each version of ChatGPT on the medical licensing examination in multiple environments showed remarkable differences. At this stage, there is still a lack of a comprehensive understanding of the variability in ChatGPT's performance on different medical licensing examinations. Objective: In this study, we reviewed all studies on ChatGPT performance in medical licensing examinations up to March 2024. This review aims to contribute to the evolving discourse on artificial intelligence (AI) in medical education by providing a comprehensive analysis of the performance of ChatGPT in various environments. The insights gained from this systematic review will guide educators, policymakers, and technical experts to effectively and judiciously use AI in medical education. Methods: We searched the literature published between January 1, 2022, and March 29, 2024, by searching query strings in Web of Science, PubMed, and Scopus. Two authors screened the literature according to the inclusion and exclusion criteria, extracted data, and independently assessed the quality of the literature concerning Quality Assessment of Diagnostic Accuracy Studies-2. We conducted both qualitative and quantitative analyses. Results: A total of 45 studies on the performance of different versions of ChatGPT in medical licensing examinations were included in this study. GPT-4 achieved an overall accuracy rate of 81\% (95\% CI 78-84; P<.01), significantly surpassing the 58\% (95\% CI 53-63; P<.01) accuracy rate of GPT-3.5. GPT-4 passed the medical examinations in 26 of 29 cases, outperforming the average scores of medical students in 13 of 17 cases. Translating the examination questions into English improved GPT-3.5's performance but did not affect GPT-4. GPT-3.5 showed no difference in performance between examinations from English-speaking and non--English-speaking countries (P=.72), but GPT-4 performed better on examinations from English-speaking countries significantly (P=.02). Any type of prompt could significantly improve GPT-3.5's (P=.03) and GPT-4's (P<.01) performance. GPT-3.5 performed better on short-text questions than on long-text questions. The difficulty of the questions affected the performance of GPT-3.5 and GPT-4. In image-based multiple-choice questions (MCQs), ChatGPT's accuracy rate ranges from 13.1\% to 100\%. ChatGPT performed significantly worse on open-ended questions than on MCQs. Conclusions: GPT-4 demonstrates considerable potential for future use in medical education. However, due to its insufficient accuracy, inconsistent performance, and the challenges posed by differing medical policies and knowledge across countries, GPT-4 is not yet suitable for use in medical education. Trial Registration: PROSPERO CRD42024506687; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=506687 ",
doi="10.2196/60807",
url="https://www.jmir.org/2024/1/e60807"
}


@Article{info:doi/10.2196/54793,
author="Tolentino, Raymond
and Baradaran, Ashkan
and Gore, Genevieve
and Pluye, Pierre
and Abbasgholizadeh-Rahimi, Samira",
title="Curriculum Frameworks and Educational Programs in AI for Medical Students, Residents, and Practicing Physicians: Scoping Review",
journal="JMIR Med Educ",
year="2024",
month="Jul",
day="18",
volume="10",
pages="e54793",
keywords="artificial intelligence",
keywords="machine learning",
keywords="curriculum",
keywords="framework",
keywords="medical education",
keywords="review",
abstract="Background: The successful integration of artificial intelligence (AI) into clinical practice is contingent upon physicians' comprehension of AI principles and its applications. Therefore, it is essential for medical education curricula to incorporate AI topics and concepts, providing future physicians with the foundational knowledge and skills needed. However, there is a knowledge gap in the current understanding and availability of structured AI curriculum frameworks tailored for medical education, which serve as vital guides for instructing and facilitating the learning process. Objective: The overall aim of this study is to synthesize knowledge from the literature on curriculum frameworks and current educational programs that focus on the teaching and learning of AI for medical students, residents, and practicing physicians. Methods: We followed a validated framework and the Joanna Briggs Institute methodological guidance for scoping reviews. An information specialist performed a comprehensive search from 2000 to May 2023 in the following bibliographic databases: MEDLINE (Ovid), Embase (Ovid), CENTRAL (Cochrane Library), CINAHL (EBSCOhost), and Scopus as well as the gray literature. Papers were limited to English and French languages. This review included papers that describe curriculum frameworks for teaching and learning AI in medicine, irrespective of country. All types of papers and study designs were included, except conference abstracts and protocols. Two reviewers independently screened the titles and abstracts, read the full texts, and extracted data using a validated data extraction form. Disagreements were resolved by consensus, and if this was not possible, the opinion of a third reviewer was sought. We adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist for reporting the results. Results: Of the 5104 papers screened, 21 papers relevant to our eligibility criteria were identified. In total, 90\% (19/21) of the papers altogether described 30 current or previously offered educational programs, and 10\% (2/21) of the papers described elements of a curriculum framework. One framework describes a general approach to integrating AI curricula throughout the medical learning continuum and another describes a core curriculum for AI in ophthalmology. No papers described a theory, pedagogy, or framework that guided the educational programs. Conclusions: This review synthesizes recent advancements in AI curriculum frameworks and educational programs within the domain of medical education. To build on this foundation, future researchers are encouraged to engage in a multidisciplinary approach to curriculum redesign. In addition, it is encouraged to initiate dialogues on the integration of AI into medical curriculum planning and to investigate the development, deployment, and appraisal of these innovative educational programs. International Registered Report Identifier (IRRID): RR2-10.11124/JBIES-22-00374 ",
doi="10.2196/54793",
url="https://mededu.jmir.org/2024/1/e54793",
url="http://www.ncbi.nlm.nih.gov/pubmed/39023999"
}


@Article{info:doi/10.2196/52224,
author="He, Zonglin
and Zhou, Botao
and Feng, Haixiao
and Bai, Jian
and Wang, Yuechun",
title="Inverted Classroom Teaching of Physiology in Basic Medical Education: Bibliometric Visual Analysis",
journal="JMIR Med Educ",
year="2024",
month="Jun",
day="25",
volume="10",
pages="e52224",
keywords="flipped classroom",
keywords="flipped classroom teaching",
keywords="physiology",
keywords="scientific knowledge map",
keywords="hot topics",
keywords="frontier progress",
keywords="evolution trend",
keywords="classroom-based",
keywords="bibliometric visual analysis",
keywords="bibliometric",
keywords="visual analysis",
keywords="medical education",
keywords="teaching method",
keywords="bibliometric analysis",
keywords="visualization tool",
keywords="academic",
keywords="academic community",
keywords="inverted classroom",
abstract="Background: Over the last decade, there has been growing interest in inverted classroom teaching (ICT) and its various forms within the education sector. Physiology is a core course that bridges basic and clinical medicine, and ICT in physiology has been sporadically practiced to different extents globally. However, students' and teachers' responses and feedback to ICT in physiology are diverse, and the effectiveness of a modified ICT model integrated into regular teaching practice in physiology courses is difficult to assess objectively and quantitatively. Objective: This study aimed to explore the current status and development direction of ICT in physiology in basic medical education using bibliometric visual analysis of the related literature. Methods: A bibliometric analysis of the ICT-related literature in physiology published between 2000 and 2023 was performed using CiteSpace, a bibliometric visualization tool, based on the Web of Science database. Moreover, an in-depth review was performed to summarize the application of ICT in physiology courses worldwide, along with identification of research hot spots and development trends. Results: A total of 42 studies were included for this bibliometric analysis, with the year 2013 marking the commencement of the field. University staff and doctors working at affiliated hospitals represent the core authors of this field, with several research teams forming cooperative relationships and developing research networks. The development of ICT in physiology could be divided into several stages: the introduction stage (2013?2014), extensive practice stage (2015?2019), and modification and growth stage (2020?2023). Gopalan C is the author with the highest citation count of 5 cited publications and has published 14 relevant papers since 2016, with a significant surge from 2019 to 2022. Author collaboration is generally limited in this field, and most academic work has been conducted in independent teams, with minimal cross-team communication. Authors from the United States published the highest number of papers related to ICT in physiology (18 in total, accounting for over 43\% of the total papers), and their intermediary centrality was 0.24, indicating strong connections both within the country and internationally. Chinese authors ranked second, publishing 8 papers in the field, although their intermediary centrality was only 0.02, suggesting limited international influence and lower overall research quality. The topics of ICT in physiology research have been multifaceted, covering active learning, autonomous learning, student performance, teaching effect, blended teaching, and others. Conclusions: This bibliometric analysis and literature review provides a comprehensive overview of the history, development process, and future direction of the field of ICT in physiology. These findings can help to strengthen academic exchange and cooperation internationally, while promoting the diversification and effectiveness of ICT in physiology through building academic communities to jointly train emerging medical talents. ",
doi="10.2196/52224",
url="https://mededu.jmir.org/2024/1/e52224"
}


@Article{info:doi/10.2196/54987,
author="Zhang, Fang
and Liu, Xiaoliu
and Wu, Wenyan
and Zhu, Shiben",
title="Evolution of Chatbots in Nursing Education: Narrative Review",
journal="JMIR Med Educ",
year="2024",
month="Jun",
day="13",
volume="10",
pages="e54987",
keywords="nursing education",
keywords="chatbots",
keywords="artificial intelligence",
keywords="narrative review",
keywords="ChatGPT",
abstract="Background: The integration of chatbots in nursing education is a rapidly evolving area with potential transformative impacts. This narrative review aims to synthesize and analyze the existing literature on chatbots in nursing education. Objective: This study aims to comprehensively examine the temporal trends, international distribution, study designs, and implications of chatbots in nursing education. Methods: A comprehensive search was conducted across 3 databases (PubMed, Web of Science, and Embase) following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram. Results: A total of 40 articles met the eligibility criteria, with a notable increase of publications in 2023 (n=28, 70\%). Temporal analysis revealed a notable surge in publications from 2021 to 2023, emphasizing the growing scholarly interest. Geographically, Taiwan province made substantial contributions (n=8, 20\%), followed by the United States (n=6, 15\%) and South Korea (n=4, 10\%). Study designs varied, with reviews (n=8, 20\%) and editorials (n=7, 18\%) being predominant, showcasing the richness of research in this domain. Conclusions: Integrating chatbots into nursing education presents a promising yet relatively unexplored avenue. This review highlights the urgent need for original research, emphasizing the importance of ethical considerations. ",
doi="10.2196/54987",
url="https://mededu.jmir.org/2024/1/e54987"
}


@Article{info:doi/10.2196/53164,
author="Chelli, Mika{\"e}l
and Descamps, Jules
and Lavou{\'e}, Vincent
and Trojani, Christophe
and Azar, Michel
and Deckert, Marcel
and Raynier, Jean-Luc
and Clowez, Gilles
and Boileau, Pascal
and Ruetsch-Chelli, Caroline",
title="Hallucination Rates and Reference Accuracy of ChatGPT and Bard for Systematic Reviews: Comparative Analysis",
journal="J Med Internet Res",
year="2024",
month="May",
day="22",
volume="26",
pages="e53164",
keywords="artificial intelligence",
keywords="large language models",
keywords="ChatGPT",
keywords="Bard",
keywords="rotator cuff",
keywords="systematic reviews",
keywords="literature search",
keywords="hallucinated",
keywords="human conducted",
abstract="Background: Large language models (LLMs) have raised both interest and concern in the academic community. They offer the potential for automating literature search and synthesis for systematic reviews but raise concerns regarding their reliability, as the tendency to generate unsupported (hallucinated) content persist. Objective: The aim of the study is to assess the performance of LLMs such as ChatGPT and Bard (subsequently rebranded Gemini) to produce references in the context of scientific writing. Methods: The performance of ChatGPT and Bard in replicating the results of human-conducted systematic reviews was assessed. Using systematic reviews pertaining to shoulder rotator cuff pathology, these LLMs were tested by providing the same inclusion criteria and comparing the results with original systematic review references, serving as gold standards. The study used 3 key performance metrics: recall, precision, and F1-score, alongside the hallucination rate. Papers were considered ``hallucinated'' if any 2 of the following information were wrong: title, first author, or year of publication. Results: In total, 11 systematic reviews across 4 fields yielded 33 prompts to LLMs (3 LLMs{\texttimes}11 reviews), with 471 references analyzed. Precision rates for GPT-3.5, GPT-4, and Bard were 9.4\% (13/139), 13.4\% (16/119), and 0\% (0/104) respectively (P<.001). Recall rates were 11.9\% (13/109) for GPT-3.5 and 13.7\% (15/109) for GPT-4, with Bard failing to retrieve any relevant papers (P<.001). Hallucination rates stood at 39.6\% (55/139) for GPT-3.5, 28.6\% (34/119) for GPT-4, and 91.4\% (95/104) for Bard (P<.001). Further analysis of nonhallucinated papers retrieved by GPT models revealed significant differences in identifying various criteria, such as randomized studies, participant criteria, and intervention criteria. The study also noted the geographical and open-access biases in the papers retrieved by the LLMs. Conclusions: Given their current performance, it is not recommended for LLMs to be deployed as the primary or exclusive tool for conducting systematic reviews. Any references generated by such models warrant thorough validation by researchers. The high occurrence of hallucinations in LLMs highlights the necessity for refining their training and functionality before confidently using them for rigorous academic purposes. ",
doi="10.2196/53164",
url="https://www.jmir.org/2024/1/e53164",
url="http://www.ncbi.nlm.nih.gov/pubmed/38776130"
}


@Article{info:doi/10.2196/52953,
author="Shetty, Shishir
and Bhat, Supriya
and Al Bayatti, Saad
and Al Kawas, Sausan
and Talaat, Wael
and El-Kishawi, Mohamed
and Al Rawi, Natheer
and Narasimhan, Sangeetha
and Al-Daghestani, Hiba
and Madi, Medhini
and Shetty, Raghavendra",
title="The Scope of Virtual Reality Simulators in Radiology Education: Systematic Literature Review",
journal="JMIR Med Educ",
year="2024",
month="May",
day="8",
volume="10",
pages="e52953",
keywords="virtual reality",
keywords="simulators",
keywords="radiology education",
keywords="medical imaging",
keywords="radiology",
keywords="education",
keywords="systematic review",
keywords="literature review",
keywords="imaging",
keywords="meta analysis",
keywords="student",
keywords="students",
keywords="VR",
keywords="PRISMA",
keywords="Preferred Reporting Items for Systematic Reviews and Meta-Analyses",
abstract="Background: In recent years, virtual reality (VR) has gained significant importance in medical education. Radiology education also has seen the induction of VR technology. However, there is no comprehensive review in this specific area. This review aims to fill this knowledge gap. Objective: This systematic literature review aims to explore the scope of VR use in radiology education. Methods: A literature search was carried out using PubMed, Scopus, ScienceDirect, and Google Scholar for articles relating to the use of VR in radiology education, published from database inception to September 1, 2023. The identified articles were then subjected to a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)--defined study selection process. Results: The database search identified 2503 nonduplicate articles. After PRISMA screening, 17 were included in the review for analysis, of which 3 (18\%) were randomized controlled trials, 7 (41\%) were randomized experimental trials, and 7 (41\%) were cross-sectional studies. Of the 10 randomized trials, 3 (30\%) had a low risk of bias, 5 (50\%) showed some concerns, and 2 (20\%) had a high risk of bias. Among the 7 cross-sectional studies, 2 (29\%) scored ``good'' in the overall quality and the remaining 5 (71\%) scored ``fair.'' VR was found to be significantly more effective than traditional methods of teaching in improving the radiographic and radiologic skills of students. The use of VR systems was found to improve the students' skills in overall proficiency, patient positioning, equipment knowledge, equipment handling, and radiographic techniques. Student feedback was also reported in the included studies. The students generally provided positive feedback about the utility, ease of use, and satisfaction of VR systems, as well as their perceived positive impact on skill and knowledge acquisition. Conclusions: The evidence from this review shows that the use of VR had significant benefit for students in various aspects of radiology education. However, the variable nature of the studies included in the review reduces the scope for a comprehensive recommendation of VR use in radiology education. ",
doi="10.2196/52953",
url="https://mededu.jmir.org/2024/1/e52953"
}


@Article{info:doi/10.2196/56415,
author="Mahsusi, Mahsusi
and Hudaa, Syihaabul
and Nuryani, Nuryani
and Fahmi, Mustofa
and Tsurayya, Ghina
and Iqhrammullah, Muhammad",
title="Global Rate of Willingness to Volunteer Among Medical and Health Students During Pandemic: Systemic Review and Meta-Analysis",
journal="JMIR Med Educ",
year="2024",
month="Apr",
day="15",
volume="10",
pages="e56415",
keywords="COVID-19",
keywords="education",
keywords="health crisis",
keywords="human resource management",
keywords="volunteer",
abstract="Background: During health crises such as the COVID-19 pandemic, shortages of health care workers often occur. Recruiting students as volunteers could be an option, but it is uncertain whether the idea is well-accepted. Objective: This study aims to estimate the global rate of willingness to volunteer among medical and health students in response to the COVID-19 pandemic. Methods: A systematic search was conducted on PubMed, Embase, Scopus, and Google Scholar for studies reporting the number of health students willing to volunteer during COVID-19 from 2019 to November 17, 2023. The meta-analysis was performed using a restricted maximum-likelihood model with logit transformation. Results: A total of 21 studies involving 26,056 health students were included in the meta-analysis. The pooled estimate of the willingness-to-volunteer rate among health students across multiple countries was 66.13\%, with an I2 of 98.99\% and P value of heterogeneity (P-Het)<.001. Removing a study with the highest influence led to the rate being 64.34\%. Our stratified analyses indicated that those with older age, being first-year students, and being female were more willing to volunteer (P<.001). From highest to lowest, the rates were 77.38\%, 77.03\%, 65.48\%, 64.11\%, 62.71\%, and 55.23\% in Africa, Western Europe, East and Southeast Asia, Middle East, and Eastern Europe, respectively. Because of the high heterogeneity, the evidence from this study has moderate strength. Conclusions: The majority of students are willing to volunteer during COVID-19, suggesting that volunteer recruitment is well-accepted. ",
doi="10.2196/56415",
url="https://mededu.jmir.org/2024/1/e56415",
url="http://www.ncbi.nlm.nih.gov/pubmed/38621233"
}


@Article{info:doi/10.2196/55737,
author="Mainz, Anne
and Nitsche, Julia
and Weirauch, Vera
and Meister, Sven",
title="Measuring the Digital Competence of Health Professionals: Scoping Review",
journal="JMIR Med Educ",
year="2024",
month="Mar",
day="29",
volume="10",
pages="e55737",
keywords="digital competence",
keywords="digital literacy",
keywords="digital health",
keywords="health care",
keywords="health care professional",
keywords="health care professionals",
keywords="scoping review",
abstract="Background: Digital competence is listed as one of the key competences for lifelong learning and is increasing in importance not only in private life but also in professional life. There is consensus within the health care sector that digital competence (or digital literacy) is needed in various professional fields. However, it is still unclear what exactly the digital competence of health professionals should include and how it can be measured. Objective: This scoping review aims to provide an overview of the common definitions of digital literacy in scientific literature in the field of health care and the existing measurement instruments. Methods: Peer-reviewed scientific papers from the last 10 years (2013-2023) in English or German that deal with the digital competence of health care workers in both outpatient and inpatient care were included. The databases ScienceDirect, Scopus, PubMed, EBSCOhost, MEDLINE, OpenAIRE, ERIC, OAIster, Cochrane Library, CAMbase, APA PsycNet, and Psyndex were searched for literature. The review follows the JBI methodology for scoping reviews, and the description of the results is based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. Results: The initial search identified 1682 papers, of which 46 (2.73\%) were included in the synthesis. The review results show that there is a strong focus on technical skills and knowledge with regard to both the definitions of digital competence and the measurement tools. A wide range of competences were identified within the analyzed works and integrated into a validated competence model in the areas of technical, methodological, social, and personal competences. The measurement instruments mainly used self-assessment of skills and knowledge as an indicator of competence and differed greatly in their statistical quality. Conclusions: The identified multitude of subcompetences illustrates the complexity of digital competence in health care, and existing measuring instruments are not yet able to reflect this complexity. ",
doi="10.2196/55737",
url="https://mededu.jmir.org/2024/1/e55737",
url="http://www.ncbi.nlm.nih.gov/pubmed/38551628"
}


@Article{info:doi/10.2196/39915,
author="Jitmun, Waritsara
and Palee, Patison
and Choosri, Noppon
and Surapunt, Tisinee",
title="The Success of Serious Games and Gamified Systems in HIV Prevention and Care: Scoping Review",
journal="JMIR Serious Games",
year="2023",
month="Sep",
day="5",
volume="11",
pages="e39915",
keywords="HIV",
keywords="serious game",
keywords="gamification",
keywords="public health",
keywords="primary health care",
keywords="patient care",
keywords="behavioral health",
abstract="Background: AIDS, which is caused by HIV, has long been one of the most significant global public health issues. Since the beginning of the HIV epidemic, various types of nonelectronic communication tools have been commonly used in HIV/AIDS prevention and care, but studies that apply the potential of electronic games are still limited. Objective: We aimed to identify, compare, and describe serious games and gamified systems currently used in HIV/AIDS prevention and care that were studied over a specific period of time. Methods: A scoping review was conducted into serious games and gamified systems used in HIV prevention and care in various well-known digital libraries from January 2010 to July 2021. Results: After identifying research papers and completing the article selection process, 49 of the 496 publications met the inclusion criteria and were examined. A total of 32 articles described 22 different serious games, while 17 articles described 13 gamified systems for HIV prevention and care. Conclusions: Most of the studies described in the publications were conducted in the United States, while only a few studies were performed in sub-Saharan African countries, which have the highest global HIV/AIDS infection rates. Regarding the development platform, the vast majority of HIV/AIDS gaming systems were typically deployed on mobile devices. This study demonstrates the effectiveness of using serious games and gamified systems. Both can improve the efficacy of HIV/AIDS prevention strategies, particularly those that encourage behavior change. ",
doi="10.2196/39915",
url="https://games.jmir.org/2023/1/e39915",
url="http://www.ncbi.nlm.nih.gov/pubmed/37669098"
}


@Article{info:doi/10.2196/44084,
author="Kanzow, Friederike Amelie
and Schmidt, Dennis
and Kanzow, Philipp",
title="Scoring Single-Response Multiple-Choice Items: Scoping Review and Comparison of Different Scoring Methods",
journal="JMIR Med Educ",
year="2023",
month="May",
day="19",
volume="9",
pages="e44084",
keywords="alternate-choice",
keywords="best-answer",
keywords="education",
keywords="education system",
keywords="educational assessment",
keywords="educational measurement",
keywords="examination",
keywords="multiple choice",
keywords="results",
keywords="scoring",
keywords="scoring system",
keywords="single choice",
keywords="single response",
keywords="scoping review",
keywords="test",
keywords="testing",
keywords="true/false",
keywords="true-false",
keywords="Type A",
abstract="Background: Single-choice items (eg, best-answer items, alternate-choice items, single true-false items) are 1 type of multiple-choice items and have been used in examinations for over 100 years. At the end of every examination, the examinees' responses have to be analyzed and scored to derive information about examinees' true knowledge. Objective: The aim of this paper is to compile scoring methods for individual single-choice items described in the literature. Furthermore, the metric expected chance score and the relation between examinees' true knowledge and expected scoring results (averaged percentage score) are analyzed. Besides, implications for potential pass marks to be used in examinations to test examinees for a predefined level of true knowledge are derived. Methods: Scoring methods for individual single-choice items were extracted from various databases (ERIC, PsycInfo, Embase via Ovid, MEDLINE via PubMed) in September 2020. Eligible sources reported on scoring methods for individual single-choice items in written examinations including but not limited to medical education. Separately for items with n=2 answer options (eg, alternate-choice items, single true-false items) and best-answer items with n=5 answer options (eg, Type A items) and for each identified scoring method, the metric expected chance score and the expected scoring results as a function of examinees' true knowledge using fictitious examinations with 100 single-choice items were calculated. Results: A total of 21 different scoring methods were identified from the 258 included sources, with varying consideration of correctly marked, omitted, and incorrectly marked items. Resulting credit varied between --3 and +1 credit points per item. For items with n=2 answer options, expected chance scores from random guessing ranged between --1 and +0.75 credit points. For items with n=5 answer options, expected chance scores ranged between --2.2 and +0.84 credit points. All scoring methods showed a linear relation between examinees' true knowledge and the expected scoring results. Depending on the scoring method used, examination results differed considerably: Expected scoring results from examinees with 50\% true knowledge ranged between 0.0\% (95\% CI 0\% to 0\%) and 87.5\% (95\% CI 81.0\% to 94.0\%) for items with n=2 and between --60.0\% (95\% CI --60\% to --60\%) and 92.0\% (95\% CI 86.7\% to 97.3\%) for items with n=5. Conclusions: In examinations with single-choice items, the scoring result is not always equivalent to examinees' true knowledge. When interpreting examination scores and setting pass marks, the number of answer options per item must usually be taken into account in addition to the scoring method used. ",
doi="10.2196/44084",
url="https://mededu.jmir.org/2023/1/e44084",
url="http://www.ncbi.nlm.nih.gov/pubmed/37001510"
}


@Article{info:doi/10.2196/36380,
author="Amod, Hafaza
and Mkhize, Wellington Sipho",
title="Supporting Midwifery Students During Clinical Practice: Results of a Systematic Scoping Review",
journal="Interact J Med Res",
year="2023",
month="Apr",
day="21",
volume="12",
pages="e36380",
keywords="clinical support",
keywords="mentorship training program",
keywords="midwifery clinical education",
keywords="midwife",
keywords="midwifery",
keywords="mentor",
keywords="mentorship",
keywords="clinical education training",
keywords="midwifery student",
keywords="South Africa",
keywords="Africa",
keywords="framework",
keywords="medical education",
abstract="Background: Midwifery educators are highly concerned about the quality of clinical support offered to midwifery students during clinical placement. The unpreparedness of midwifery practitioners in mentorship roles and responsibilities affects the competence levels of the next-generation midwives being produced. Objective: The aim of this paper is to highlight various clinical support interventions to support midwifery students globally and propose a framework to guide mentorship training in South Africa. Methods: This paper adopts a mixed methodology approach guided by the Arksey and O'Malley framework. Keywords such as midwifery students, clinical support, mentorship, preceptorship, and midwifery clinical practice were used during the literature search. The review included primary quantitative, qualitative, and mixed methods design papers published between 2010 and 2020, and studies on clinical support interventions available to midwifery students during clinical placement. The search strategy followed a 3-stage system of title, abstract, and full-text screening using inclusion and exclusion criteria. All included papers were quality appraised with a mixed methods appraisal tool. Extracted data were analyzed and presented in themes following a thematic content analysis approach. Results: The screening results attained 10 papers for data extraction. In total, 7 of the 10 (70\%) studies implemented a mentorship training program, 2 (20\%) used a training workshop, and 1 (10\%) used an intervention guide to support midwifery students in clinical practice. Of these 10 papers, 5 were qualitative, 4 mixed methods, and 1 quantitative in approach. In total, 9 of the 10 (90\%) studies were conducted in high-income countries with only 1 study done in Uganda but supported by the United Kingdom. The quality of included papers ranged between 50\% and 100\%, showing moderate to high appraisal results. Significant findings highlighted that the responsibility of mentorship is shared between key role players (midwifery practitioners, students, and educators) and thus a 3-fold approach to mentorship. Mentorship training and support are essential to strengthen the clinical support of midwifery students during placement. The main findings produced 2 main themes and 2 subthemes each. The main themes included strengthening partnerships and consultation; and providing mentor support through training. The 4 subthemes were: establishing stronger partnerships between nursing education institutions and clinical facilities; improving consultation between midwifery educators, practitioners, and students; the quality of clinical support depends on the training content; and the training duration and structure. Hence, the researchers proposed these subthemes in a framework to guide mentorship training. Conclusions: Mentorship training and support for midwifery practitioners will likely strengthen the quality of midwifery clinical support. A framework to guide mentorship training will encourage midwifery educators to develop and conduct mentorship training with ease. More studies using quantitative approaches in research and related to midwifery clinical support are required in African countries. International Registered Report Identifier (IRRID): RR2-10.2196/29707 ",
doi="10.2196/36380",
url="https://www.i-jmr.org/2023/1/e36380",
url="http://www.ncbi.nlm.nih.gov/pubmed/37083750"
}


@Article{info:doi/10.2196/39210,
author="Bhatti, Faheem
and Mowforth, Oliver
and Butler, Max
and Bhatti, Zainab
and Rafati Fard, Amir
and Kuhn, Isla
and Davies, M. Benjamin",
title="Meeting the Shared Goals of a Student-Selected Component: Pilot Evaluation of a Collaborative Systematic Review",
journal="JMIR Med Educ",
year="2023",
month="Mar",
day="15",
volume="9",
pages="e39210",
keywords="medical education",
keywords="medical student",
keywords="research training",
keywords="research methodology",
keywords="systematic review",
keywords="methodology",
keywords="review",
keywords="collaboration",
keywords="collaborative",
keywords="medical school",
keywords="medical librarian",
keywords="library science",
keywords="information science",
keywords="search strategy",
keywords="student-selected component",
keywords="curriculum",
keywords="curricula",
abstract="Background: Research methodology is insufficiently featured in undergraduate medical curricula. Student-selected components are designed to offer some research opportunities but frequently fail to meet student or supervisor expectations, such as completion or publication. We hypothesized that a collaborative, educational approach to a systematic review (SR), whereby medical students worked together, may improve student experience and increase success. Objective: This study aimed to establish whether offering a small team of students the opportunity to take part in the screening phase of SRs led by an experienced postgraduate team could enhance the learning experience of students, overcome the barriers to successful research engagement, and deliver published output. Methods: Postgraduate researchers from the University of Cambridge led a team of 14 medical students to work on 2 neurosurgical SRs. One student was appointed as the lead for each SR. All students were provided with training on SR methodology and participated in title and abstract screening using Rayyan software. Students completed prepilot, midscreening, and postscreening questionnaires on their research background, perceptions, knowledge, confidence, and experience. Questions were scored on a Likert scale of 1 (strongly disagree) to 10 (strongly agree). Results: Of the 14 students involved, 29\% (n=4) reported that they had received sufficient training in research methodology at medical school. Positive trends in student knowledge, confidence, and experience of SR methodology were noted across the 3 questionnaire time points. Mean responses to ``I am satisfied with the level of guidance I am receiving,'' ``I am enjoying being involved in the SR process,'' and ``I could not gain this understanding of research from passive learning e.g., textbook or lecture'' were greater than 8.0 at all time points. Students reported ``being involved in this research has made me more likely to do research in the future'' (mean 8.57, SD 1.50) and that ``this collaborative SR improved my research experience'' (mean 8.50, SD 1.56). Conclusions: This collaborative approach appears to be a potentially useful method of providing students with research experience; however, it requires further evaluation. ",
doi="10.2196/39210",
url="https://mededu.jmir.org/2023/1/e39210",
url="http://www.ncbi.nlm.nih.gov/pubmed/36920459"
}


@Article{info:doi/10.2196/41589,
author="Lie, Stangeland Silje
and Helle, Nikolina
and Sletteland, Vahl Nina
and Vikman, Dubland Miriam
and Bonsaksen, Tore",
title="Implementation of Virtual Reality in Health Professions Education: Scoping Review",
journal="JMIR Med Educ",
year="2023",
month="Jan",
day="24",
volume="9",
pages="e41589",
keywords="implementation",
keywords="virtual reality",
keywords="higher education",
keywords="medical education",
keywords="health professions education",
keywords="continuing education",
keywords="scoping review",
keywords="health professional",
keywords="technology",
abstract="Background: Virtual reality has been gaining ground in health professions education and may offer students a platform to experience and master situations without endangering patients or themselves. When implemented effectively, virtual reality technologies may enable highly engaging learning activities and interactive simulations. However, implementation processes present challenges, and the key to successful implementation is identifying barriers and facilitators as well as finding strategies to address them. Objective: This scoping review aimed to identify the literature on virtual reality implementation in health professions education, identify barriers to and facilitators of implementation, and highlight gaps in the literature in this area. Methods: The scoping review was conducted based on the Joanna Briggs Institute Evidence Synthesis methodologies. Electronic searches were conducted in the Academic Search Elite, Education Source, and CINAHL databases on January 5, 2022, in Google Scholar on February 2 and November 18, 2022, and in PubMed database on November 18, 2022. We conducted hand searches of key items, reference tracking, and citation tracking and searches on government webpages on February 2, 2022. At least 2 reviewers screened the identified literature. Eligible studies were considered based on predefined inclusion criteria. The results of the identified items were analyzed and synthesized using qualitative content analysis. Results: We included 7 papers and identified 7 categories related to facilitators of and barriers to implementation---collaborative participation, availability, expenses, guidelines, technology, careful design and evaluation, and training---and developed a model that links the categories to the 4 constructs from Carl May's general theory of implementation. All the included reports provided recommendations for implementation, including recommendations for careful design and evaluation, training of faculty and students, and faculty presence during use. Conclusions: Virtual reality implementation in health professions education appears to be a new and underexplored research field. This scoping review has several limitations, including definitions and search words, language, and that we did not assess the included papers' quality. Important implications from our findings are that ensuring faculty's and students' competence in using virtual reality technology is necessary for the implementation processes. Collaborative participation by including end users in the development process is another factor that may ensure successful implementation in higher education contexts. To ensure stakeholders' motivation and potential to use virtual reality, faculty and students could be invited to participate in the development process to ensure that the educational content is valued. Moreover, technological challenges and usability issues should be resolved before implementation to ensure that pedagogical content is the focus. This accentuates the importance of piloting, sufficient time resources, basic testing, and sharing of experiences before implementation. International Registered Report Identifier (IRRID): RR2-10.2196/37222 ",
doi="10.2196/41589",
url="https://mededu.jmir.org/2023/1/e41589",
url="http://www.ncbi.nlm.nih.gov/pubmed/36692934"
}


@Article{info:doi/10.2196/42033,
author="Diouf, Thiab Ndeye
and Musabyimana, Ang{\`e}le
and Blanchette, Virginie
and L{\'e}pine, Johanie
and Guay-B{\'e}langer, Sabrina
and Tremblay, Marie-Claude
and Dogba, Joyce Maman
and L{\'e}gar{\'e}, France",
title="Effectiveness of Shared Decision-making Training Programs for Health Care Professionals Using Reflexivity Strategies: Secondary Analysis of a Systematic Review",
journal="JMIR Med Educ",
year="2022",
month="Dec",
day="7",
volume="8",
number="4",
pages="e42033",
keywords="shared decision-making",
keywords="reflexivity",
keywords="training",
keywords="health care professionals",
keywords="implementation",
abstract="Background: Shared decision-making (SDM) leads to better health care processes through collaboration between health care professionals and patients. Training is recognized as a promising intervention to foster SDM by health care professionals. However, the most effective training type is still unclear. Reflexivity is an exercise that leads health care professionals to question their own values to better consider patient values and support patients while least influencing their decisions. Training that uses reflexivity strategies could motivate them to engage in SDM and be more open to diversity. Objective: In this secondary analysis of a 2018 Cochrane review of interventions for improving SDM by health care professionals, we aimed to identify SDM training programs that included reflexivity strategies and were assessed as effective. In addition, we aimed to explore whether further factors can be associated with or enhance their effectiveness. Methods: From the Cochrane review, we first extracted training programs targeting health care professionals. Second, we developed a grid to help identify training programs that used reflexivity strategies. Third, those identified were further categorized according to the type of strategy used. At each step, we identified the proportion of programs that were classified as effective by the Cochrane review (2018) so that we could compare their effectiveness. In addition, we wanted to see whether effectiveness was similar between programs using peer-to-peer group learning and those with an interprofessional orientation. Finally, the Cochrane review selected programs that were evaluated using patient-reported or observer-reported outcome measurements. We examined which of these measurements was most often used in effective training programs. Results: Of the 31 training programs extracted, 24 (77\%) were interactive, among which 10 (42\%) were considered effective. Of these 31 programs, 7 (23\%) were unidirectional, among which 1 (14\%) was considered effective. Of the 24 interactive programs, 7 (29\%) included reflexivity strategies. Of the 7 training programs with reflexivity strategies, 5 (71\%) used a peer-to-peer group learning strategy, among which 3 (60\%) were effective; the other 2 (29\%) used a self-appraisal individual learning strategy, neither of which was effective. Of the 31 training programs extracted, 5 (16\%) programs had an interprofessional orientation, among which 3 (60\%) were effective; the remaining 26 (84\%) of the 31 programs were without interprofessional orientation, among which 8 (31\%) were effective. Finally, 12 (39\%) of 31 programs used observer-based measurements, among which more than half (7/12, 58\%) were effective. Conclusions: Our study is the first to evaluate the effectiveness of SDM training programs that include reflexivity strategies. Its conclusions open avenues for enriching future SDM training programs with reflexivity strategies. The grid developed to identify training programs that used reflexivity strategies, when further tested and validated, can guide future assessments of reflexivity components in SDM training. ",
doi="10.2196/42033",
url="https://mededu.jmir.org/2022/4/e42033",
url="http://www.ncbi.nlm.nih.gov/pubmed/36318726"
}


@Article{info:doi/10.2196/40580,
author="Khalaf, Zahra
and Khan, Shaheer",
title="Education During Ward Rounds: Systematic Review",
journal="Interact J Med Res",
year="2022",
month="Nov",
day="9",
volume="11",
number="2",
pages="e40580",
keywords="education",
keywords="learning",
keywords="rounds",
keywords="trainee",
keywords="ward rounds",
keywords="medical education",
keywords="simulation-based learning",
keywords="digital health",
keywords="digital learning",
keywords="education intervention",
abstract="Background: Enhancing the educational experience provided by ward rounds requires an understanding of current perceptions of the educational value of rounds. Objective: This systematic review examines perceptions of education in ward rounds, educational activities in ward rounds, barriers to learning, and perceptions of simulation-based ward rounds. Methods: The 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. MEDLINE (EBSCO), Cochrane, and Scopus were searched on May 29, 2022, for studies assessing learning during ward rounds. The search terms included ``ward rounds,'' ``education,'' and ``trainees.'' Then, the selected articles were reference searched. In total, 354 articles were retrieved. The articles were assessed for eligibility by 2 independent reviewers who screened titles, abstracts, and full-length texts. Articles addressing trainees' education in all ward rounds were included. Articles were excluded if they were specific to certain disciplines, were reviews, were not published in scholarly journals, were published before 2015, were published in languages other than English, or did not concern human participants. Following the removal of 63 duplicates, a total of 268 articles were excluded. The risk of bias within the selected articles was also assessed via the Critical Appraisal Skills Programme checklist for qualitative research. Qualitative data were used to describe results in a narrative synthesis and in tables. Results: A total of 23 articles were included. Perceptions of teaching in rounds were addressed by 6 studies, of which 3 showed negative perceptions among participants, 2 reported ambivalent perceptions, and 1 showed positive perceptions. Perceived barriers to teaching during rounds were assessed by 7 studies. The reported barriers included time constraints, workloads, schedules, interruptions, the service-oriented nature of rounds, the lack of feedback, hierarchies, the lack of opportunities to ask questions and be engaged in patient management, and divergent learner needs. Further, 8 studies identified types of educational activities, including observation, patient-specific teaching, and discussion. Perceptions of learning through simulated ward rounds were assessed by 8 studies, and a consensus of satisfaction was noted among learners. The interventions that were explored to improve education included using teaching frameworks, involving clinical librarians, and changing the setting of ward rounds. Conclusions: The main limitations of this review are the predominant use of qualitative data in the included articles and the lack of standardization for the educational compositions of ward rounds among articles, which made the articles hard to compare. In conclusion, learning opportunities in ward rounds are often missed, and trainees perceive rounds to have low educational value. It is important to recognize the barriers to education during ward rounds and address them to maximize the benefits of ward rounds. Finally, there is a need to develop plans that incorporate teaching regularly during ward rounds in the inpatient setting. Trial Registration: PROSPERO CRD42022337736; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=337736 ",
doi="10.2196/40580",
url="https://www.i-jmr.org/2022/2/e40580",
url="http://www.ncbi.nlm.nih.gov/pubmed/36285742"
}


@Article{info:doi/10.2196/42681,
author="Gavarkovs, Adam
and Kusurkar, A. Rashmi
and Kulasegaram, Kulamakan
and Crukley, Jeff
and Miller, Erin
and Anderson, Melanie
and Brydges, Ryan",
title="Motivational Design for Web-Based Instruction in Health Professions Education: Protocol for a Systematic Review and Directed Content Analysis",
journal="JMIR Res Protoc",
year="2022",
month="Nov",
day="9",
volume="11",
number="11",
pages="e42681",
keywords="medical education",
keywords="nursing education",
keywords="e-learning",
keywords="serious games",
keywords="instructional design",
keywords="motivation",
keywords="health care",
keywords="health professional",
keywords="professional education",
keywords="digital learning",
keywords="web-based learning",
abstract="Background: Web-based instruction plays an essential role in health professions education (HPE) by facilitating learners' interactions with educational content, teachers, peers, and patients when they would not be feasible in person. Within the unsupervised settings where web-based instruction is often delivered, learners must effectively self-regulate their learning to be successful. Effective self-regulation places heavy demands on learners' motivation, so effective web-based instruction must be designed to instigate and maintain learners' motivation to learn. Models of motivational design integrate theories of motivation with design strategies intended to create the conditions for motivated engagement. Teachers can use such models to develop their procedural and conceptual knowledge in ways that help them design motivating instruction in messy real-world contexts. Studies such as randomized controlled trials (RCTs) and other quasi-experimental designs that compare different motivational design strategies play a critical role in advancing models of motivational design. Synthesizing the evidence from those studies can identify effective strategies and help teachers and researchers understand the mechanisms governing why strategies work, for whom, and under what circumstances. Objective: The planned review aims to analyze how studies comparing motivational design strategies for web-based instruction in HPE support and advance models of motivational design by (1) controlling for established risks to internal validity, (2) leveraging authentic educational contexts to afford ecological validity, (3) drawing on established theories of motivation, (4) investigating a wide breadth of motivational constructs, and (5) analyzing mediators and moderators of strategy effects. Methods: The planned review will use database searching, registry searching, and hand searching to identify studies comparing motivational design strategies for web-based instruction, delivered to learners in HPE. Studies will be considered from 1990 onward. Two team members will independently screen studies and extract data from the included studies. During extraction, we will record information on the design characteristics of the studies, the theories of motivation they are informed by, the motivational constructs they target, and the mediators and moderators they consider. Results: We have executed our database and registry searches and have begun screening titles and abstracts. Conclusions: By appraising the characteristics of studies that have focused on the motivational design of web-based instruction in HPE, the planned review will produce recommendations that will ensure impactful programs of future research in this crucial educational space. Trial Registration: PROSPERO CRD42022359521; https://tinyurl.com/57chuzf6 International Registered Report Identifier (IRRID): DERR1-10.2196/42681 ",
doi="10.2196/42681",
url="https://www.researchprotocols.org/2022/11/e42681",
url="http://www.ncbi.nlm.nih.gov/pubmed/36350706"
}


@Article{info:doi/10.2196/41828,
author="Salman, Hira
and Powell, Leigh
and Alsuwaidi, Laila
and Nair, Bhavana
and Tegginmani, Ahmed Shakeel
and Mohamadeya, Jalal
and Zary, Nabil",
title="Profiling of Learners in Medical Schools as a Move Toward Precision Education: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2022",
month="Oct",
day="28",
volume="11",
number="10",
pages="e41828",
keywords="learners",
keywords="medical students",
keywords="medical undergraduates",
keywords="medical graduates",
keywords="profiling of learner",
keywords="learner profile",
keywords="medical education",
keywords="medical universities",
keywords="precision education",
keywords="student record",
keywords="graduate education",
keywords="data extraction tool",
abstract="Background: Academic experiences seek to get the best out of learners, maximizing performance and developing the skills and competencies needed to foster lifelong learning. The more personalized and tailored the academic experience among learners, the better the outcome. Precision education is a novel approach to research and practice, which is concerned with identifying and tailoring education to the precise needs of the learner. An emerging area of precision education is using data to develop learner profiles for a better understanding of individual learners relative to the characteristics and competencies of lifelong learners. Objective: This scoping review aims to identify literature that reports on profiling learners within medical schools. Our review, as described in this paper, will describe the characteristics being measured, the methods and data sources used to generate profiles, and the resulting profiles that emerge. This review aims to provide guidance to those supporting medical school learners on the current state of learner profiling. Methods: This scoping review will use the Population, Concept, and Context framework, published by Joanna Briggs Institute, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The search strategy was developed in collaboration with a library specialist. An initial search was conducted in PubMed, ERIC, Google Scholar, Cochrane, CINAHL, and SCOPUS. Data will be extracted, and 2 authors will undertake the screening procedure using the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews checklist. Results: The database searches yielded 166 results, and title and abstract screening of 135 extracted articles is currently underway after eliminating 31 duplicates. We anticipate the scoping review to be completed in the first week of October 2022. The final scoping review will present the findings in a narrative and pictorial fashion. Conclusions: This review will help guide scholars looking to understand the current state of learner profiling within medical schools. International Registered Report Identifier (IRRID): PRR1-10.2196/41828 ",
doi="10.2196/41828",
url="https://www.researchprotocols.org/2022/10/e41828",
url="http://www.ncbi.nlm.nih.gov/pubmed/36209414"
}


@Article{info:doi/10.2196/39023,
author="Grepmeier, Eva-Maria
and Pawellek, Maja
and Curbach, Janina
and Sommoggy, von Julia
and Drewitz, Philipp Karl
and Hasenpusch, Claudia
and Bitzer, Maria Eva
and Apfelbacher, Christian
and Matterne, Uwe",
title="Health Literacy in Health Professionals Two Years into the COVID-19 Pandemic: Results From a Scoping Review",
journal="JMIR Med Educ",
year="2022",
month="Oct",
day="17",
volume="8",
number="4",
pages="e39023",
keywords="SARS-CoV-2",
keywords="COVID-19",
keywords="health competence",
keywords="COVID-19--related health literacy",
keywords="health care worker",
abstract="Background: Health literacy (HL) is an important public health goal but also crucial in individuals providing medical care. During the pandemic, COVID-19--related HL of health professionals (HPs) has gained momentum; it helps to minimize the risk of self-infection, on the one hand, and to protect patients and relatives from infection, on the other. However, comprehensive information about the levels of individual pandemic-related HL in HPs is scarce. Objective: In this paper, we aimed at describing the extent of existing research on HL (concept) conducted in HPs (population) in the COVID-19 pandemic (context). The review intends to map the literature on HL in HPs, thereby highlighting research gaps. Methods: This scoping review was conducted using the methodology of Khalil et al (2016). This involved an electronic search of PubMed (MEDLINE) and PsycInfo and a hand search. The included studies were iteratively examined to find items representing the four HL dimensions of access, understand, critically appraise, and apply COVID-19--related health information. Results: The search yielded a total of 3875 references. Only 7 (1.4\%) of the 489 included studies explicitly stated to have addressed HL; 2 (0.4\%) studies attempted to develop an instrument measuring COVID-19--related HL in HPs; 6 (1.2\%) studies included an HL measure in an observational survey design. Of the remainder, the vast majority used a cross-sectional design. The dimensions access and understand were frequently examined, but few studies looked at the dimensions critical appraisal or apply. Very few studies reported an intervention aiming to improve a COVID-19--related HL outcome. Conclusions: High levels of COVID-19--related HL among HPs are necessary to ensure not only safe practice with necessary protection of HPs, their patients, and relatives, but also successful care delivery and subsequently improved health outcomes in the long term. To advance our understanding of how high COVID-19--related HL manifests itself in HPs, how it relates to health outcomes, and how it can be improved, more research is necessary. Trial Registration: Open Science Framework dbfa5; https://osf.io/dbfa5/ ",
doi="10.2196/39023",
url="https://mededu.jmir.org/2022/4/e39023",
url="http://www.ncbi.nlm.nih.gov/pubmed/36179148"
}


@Article{info:doi/10.2196/34230,
author="Henshall, Catherine
and Ostinelli, Edoardo
and Harvey, Jade
and Davey, Zoe
and Aghanenu, Bemigho
and Cipriani, Andrea
and Attenburrow, Mary-Jane",
title="Examining the Effectiveness of Web-Based Interventions to Enhance Resilience in Health Care Professionals: Systematic Review",
journal="JMIR Med Educ",
year="2022",
month="Sep",
day="6",
volume="8",
number="3",
pages="e34230",
keywords="resilience",
keywords="health care professionals",
keywords="depression",
keywords="psychological stress",
keywords="internet",
keywords="mental health",
abstract="Background: Internationally, the impact of continued exposure to workplace environmental and psychological stressors on health care professionals' mental health is associated with increased depression, substance misuse, sleep disorders, and posttraumatic stress. This can lead to staff burnout, poor quality health care, and reduced patient safety outcomes. Strategies to improve the psychological health and well-being of health care staff have been highlighted as a critical priority worldwide. The concept of resilience for health care professionals as a tool for negotiating workplace adversity has gained increasing prominence. Objective: This systematic review aims to examine the effectiveness of web-based interventions to enhance resilience in health care professionals. Methods: We searched the PubMed, CINAHL, PsycINFO, and Ovid SP databases for relevant records published after 1990 until July 2021. We included studies that focused on internet-delivered interventions aiming at enhancing resilience. Study quality was assessed with the Risk of Bias 2 tool for randomized controlled trial designs and Joanna Briggs Institute critical appraisal tool for other study designs. The protocol was registered on PROSPERO (International Prospective Register of Systematic Reviews; CRD42021253190). PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Results: A total of 8 studies, conducted between 2014 and 2020 and involving 1573 health care workers, were included in the review. In total, 4 randomized controlled trial designs and 4 pre- and postdesign studies were conducted across a range of international settings and health care disciplines. All of these studies aimed to evaluate the impact of web-based interventions on resilience or related symptoms in health care professionals involved in patient-facing care. Interventions included various web-based formats and therapeutic approaches over variable time frames. One randomized controlled trial directly measured resilience, whereas the remaining 3 used proxy measures to measure psychological concepts linked to resilience. Three pretest and posttest studies directly measured resilience, whereas the fourth study used a proxy resilience measure. Owing to the heterogeneity of outcome measures and intervention designs, meta-analysis was not possible, and qualitative data synthesis was undertaken. All studies found that resilience or proxy resilience levels were enhanced in health care workers following the implementation of web-based interventions. The overall risk of bias of all 8 studies was low. Conclusions: The findings indicate that web-based interventions designed to enhance resilience may be effective in clinical practice settings and have the potential to provide support to frontline staff experiencing prolonged workplace stress across a range of health care professional groups. However, the heterogeneity of included studies means that findings should be interpreted with caution; more web-based interventions need rigorous testing to further develop the evidence base. Trial Registration: PROSPERO CRD42021253190; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=253190 ",
doi="10.2196/34230",
url="https://mededu.jmir.org/2022/3/e34230",
url="http://www.ncbi.nlm.nih.gov/pubmed/36066962"
}


@Article{info:doi/10.2196/37473,
author="Khan, Nagina
and van Mook, Walther
and Dave, Subodh
and Ha, Sohyun
and Sagisi, Joshua
and Davi, Nicole
and Aftab, Chantel
and Tiwari, Sucheta
and Hickman, Marie
and Gilliar, Wolfgang",
title="Learners' Perspectives of Professionalism: Protocol for a Mixed Methods Systematic Review",
journal="JMIR Res Protoc",
year="2022",
month="Aug",
day="25",
volume="11",
number="8",
pages="e37473",
keywords="professionalism",
keywords="undergraduate medical education",
keywords="medical school",
keywords="medical education",
keywords="medical curriculum",
keywords="teaching methods",
keywords="teaching",
keywords="medical students",
keywords="student",
keywords="undergraduate",
keywords="convergent integrated synthesis",
keywords="integrated synthesis",
keywords="curriculum",
keywords="recommendation",
keywords="learner",
keywords="perspective",
keywords="review",
abstract="Background: Professionalism has come to be associated with competence in medical education, with the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served. Recent studies indicate students should have the opportunity to observe the application of knowledge and skills by their mentors to improve patient health and safety. A noticeable detail that needs implementation into the curriculum is the inclusion of student perspectives. This review will explore students' understanding and experience of professionalism in undergraduate medical education (UME). Objective: This paper presents the protocol for a review that aims to develop an integrated synthesis of qualitative and quantitative studies resulting in recommendations for medical school curricula to incorporate the learners' perspectives in teaching professionalism in UME. Methods: We will take an integrated approach to synthesis. Data will be extracted from the included studies, and quantitative data will be ``qualitized.'' PubMed (Medline), Embase, PsycInfo, and ERIC (Education Resources Information Center) will be searched for studies published in English from 2010 to 2021. Studies will be screened and critically appraised for methodological quality using the Mixed Methods Appraisal Tool by 2 researchers, with disagreements resolved by a third researcher. Qualitative, quantitative, and mixed methods studies will be considered. Our population of interest is undergraduate medical students; hence, studies on medical residents and graduate medical students will be excluded. We will consider studies that explore how concepts of professionalism are understood, experienced, and taught in undergraduate medicine and on how medical students understand and develop the identified constructs of professionalism. Results: This study is in the screening phase; therefore, no results are available at this time. However, we had initiated the searches, screening, and are currently in the critical appraisal stage. We will commence preparation to clean and convert the data for coding in July 2022, and analysis will be ongoing from the end of July 2022 until submission for publication in November 2022. Conclusions: This research will contribute to the student perspectives on professionalism in medical education literature. The findings will aid in the creation of a checklist to guide the development of a curriculum on professionalism in UME. International Registered Report Identifier (IRRID): PRR1-10.2196/37473 ",
doi="10.2196/37473",
url="https://www.researchprotocols.org/2022/8/e37473",
url="http://www.ncbi.nlm.nih.gov/pubmed/36006688"
}


@Article{info:doi/10.2196/37222,
author="Lie, Stangeland Silje
and Helle, Nikolina
and Sletteland, Vahl Nina
and Vikman, Dubland Miriam
and Bonsaksen, Tore",
title="Implementation of Virtual Reality in Health Professional Higher Education: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2022",
month="Jul",
day="5",
volume="11",
number="7",
pages="e37222",
keywords="virtual reality",
keywords="higher education",
keywords="medical education",
keywords="health care professional education",
keywords="continuing education",
keywords="implementation",
keywords="technology",
keywords="scoping review",
keywords="Google Scholar",
keywords="health professional",
abstract="Background: The use of virtual reality in higher education show great potential to promote novel and innovative learning experiences. Until recently, virtual reality has mostly been used in technical higher education, but lately medical education programs have begun using virtual reality. Virtual reality for health professional education improves the knowledge and skills of health professionals compared with traditional or other digital education initiatives. However, the implementation of technology in higher education is slow because of barriers to technology use and innovative and successful practices are not shared. It is, therefore, of great interest to explore how virtual reality is implemented in higher health professional and continuing education. Objective: The aim of this scoping review is to identify studies that reported implementation of virtual reality in higher health professional education, to identify barriers and facilitators for implementation, and to highlight research gaps in this area. Methods: The scoping review will be conducted according to JBI Evidence Synthesis methodologies. CINAHL, the Academic Search Elite and Education Source electronic databases, and Google Scholar will be searched for studies published between 2017 and 2022. In addition, manual searching of key items, reference tracking, and citation tracking will be performed. Searches for white papers will also be manually conducted. All authors will independently extract data from full-text papers. We will use qualitative content analysis to abstract the findings. Results: The literature searches were conducted in January and February 2022. The review is expected to be completed by fall 2022, after which time it will be submitted for publication. Conclusions: We anticipate that, from the review, we will be able to coordinate recommendations for and present the challenges of virtual reality initiatives in health professional education programs. We will present recommendations for future research. International Registered Report Identifier (IRRID): DERR1-10.2196/37222 ",
doi="10.2196/37222",
url="https://www.researchprotocols.org/2022/7/e37222",
url="http://www.ncbi.nlm.nih.gov/pubmed/35787531"
}


@Article{info:doi/10.2196/38259,
author="Johnson, Gr{\o}dem Susanne
and Potrebny, Thomas
and Larun, Lillebeth
and Ciliska, Donna
and Olsen, Rydland Nina",
title="Usability Methods and Attributes Reported in Usability Studies of Mobile Apps for Health Care Education: Scoping Review",
journal="JMIR Med Educ",
year="2022",
month="Jun",
day="29",
volume="8",
number="2",
pages="e38259",
keywords="user-computer interface",
keywords="mobile apps",
keywords="online learning",
keywords="health education",
keywords="students",
abstract="Background: Mobile devices can provide extendable learning environments in higher education and motivate students to engage in adaptive and collaborative learning. Developers must design mobile apps that are practical, effective, and easy to use, and usability testing is essential for understanding how mobile apps meet users' needs. No previous reviews have investigated the usability of mobile apps developed for health care education. Objective: The aim of this scoping review is to identify usability methods and attributes in usability studies of mobile apps for health care education. Methods: A comprehensive search was carried out in 10 databases, reference lists, and gray literature. Studies were included if they dealt with health care students and usability of mobile apps for learning. Frequencies and percentages were used to present the nominal data, together with tables and graphical illustrations. Examples include a figure of the study selection process, an illustration of the frequency of inquiry usability evaluation and data collection methods, and an overview of the distribution of the identified usability attributes. We followed the Arksey and O'Malley framework for scoping reviews. Results: Our scoping review collated 88 articles involving 98 studies, mainly related to medical and nursing students. The studies were conducted from 22 countries and were published between 2008 and 2021. Field testing was the main usability experiment used, and the usability evaluation methods were either inquiry-based or based on user testing. Inquiry methods were predominantly used: 1-group design (46/98, 47\%), control group design (12/98, 12\%), randomized controlled trials (12/98, 12\%), mixed methods (12/98, 12\%), and qualitative methods (11/98, 11\%). User testing methods applied were all think aloud (5/98, 5\%). A total of 17 usability attributes were identified; of these, satisfaction, usefulness, ease of use, learning performance, and learnability were reported most frequently. The most frequently used data collection method was questionnaires (83/98, 85\%), but only 19\% (19/98) of studies used a psychometrically tested usability questionnaire. Other data collection methods included focus group interviews, knowledge and task performance testing, and user data collected from apps, interviews, written qualitative reflections, and observations. Most of the included studies used more than one data collection method. Conclusions: Experimental designs were the most commonly used methods for evaluating usability, and most studies used field testing. Questionnaires were frequently used for data collection, although few studies used psychometrically tested questionnaires. The usability attributes identified most often were satisfaction, usefulness, and ease of use. The results indicate that combining different usability evaluation methods, incorporating both subjective and objective usability measures, and specifying which usability attributes to test seem advantageous. The results can support the planning and conduct of future usability studies for the advancement of mobile learning apps in health care education. International Registered Report Identifier (IRRID): RR2-10.2196/19072 ",
doi="10.2196/38259",
url="https://mededu.jmir.org/2022/2/e38259",
url="http://www.ncbi.nlm.nih.gov/pubmed/35767323"
}


@Article{info:doi/10.2196/35878,
author="R{\o}ynesdal, {\O}ystein
and Magnus, H. Jeanette
and Moen, Anne",
title="Pedagogical Approaches and Learning Activities, Content, and Resources Used in the Design of Massive Open Online Courses (MOOCs) in the Health Sciences: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2022",
month="May",
day="30",
volume="11",
number="5",
pages="e35878",
keywords="MOOC",
keywords="scoping review",
keywords="collaborative learning",
keywords="PhD",
keywords="postgraduate",
keywords="education",
keywords="health sciences",
keywords="massive open online course",
abstract="Background: Developing online, widely accessible educational courses, such as Massive Open Online Courses (MOOCs), offer novel opportunities to advancing academic research and the educational system in resource-constrained countries. Despite much literature on the use of design-related features and principles of different pedagogical approaches when developing MOOCs, there are reports of inconsistency between the pedagogical approach and the learning activities, content, or resources in MOOCs. Objective: We present a protocol for a scoping review aiming to systematically identify and synthesize literature on the pedagogical approaches used, and the learning activities, content, and resources used to facilitate social interaction and collaboration among postgraduate learners in MOOCs across the health sciences. Methods: We will follow a 6-step procedure for scoping reviews to conduct a search of published and gray literature in the following databases: Medline via Ovid, ERIC, SCOPUS, Web of Science, and PsychINFO. Two reviewers will screen titles, abstracts, and relevant full texts independently to determine eligibility for inclusion. The team will extract data using a predefined charting form and synthesize results in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. Results: The scoping review is currently ongoing. As of March 2022, we have performed initial data searches and screened titles and abstracts of the studies we found but revised the search string owing to inaccurate results. We aim to start analyzing the data in June 2022 and expect to complete the scoping review by February 2023. Conclusions: With the results of this review, we hope to report on the use of pedagogical approaches and what learning activities, content, and resources foster social and collaborative learning processes, and to further elucidate how practitioners and academics can harvest our findings to bridge the gap between pedagogics and learning activities in the instructional design of MOOCs for postgraduate students in the health sciences. International Registered Report Identifier (IRRID): DERR1-10.2196/35878 ",
doi="10.2196/35878",
url="https://www.researchprotocols.org/2022/5/e35878",
url="http://www.ncbi.nlm.nih.gov/pubmed/35635750"
}


@Article{info:doi/10.2196/34687,
author="Wickramasinghe, Nilmini
and Thompson, R. Bruce
and Xiao, Junhua",
title="The Opportunities and Challenges of Digital Anatomy for Medical Sciences: Narrative Review",
journal="JMIR Med Educ",
year="2022",
month="May",
day="20",
volume="8",
number="2",
pages="e34687",
keywords="digital anatomy",
keywords="digital health",
keywords="virtual reality",
keywords="augmented reality",
keywords="medical education",
abstract="Background: Anatomy has been the cornerstone of medical education for centuries. However, given the advances in the Internet of Things, this landscape has been augmented in the past decade, shifting toward a greater focus on adopting digital technologies. Digital anatomy is emerging as a new discipline that represents an opportunity to embrace advances in digital health technologies and apply them to the domain of modern medical sciences. Notably, the use of augmented or mixed and virtual reality as well as mobile and platforms and 3D printing in modern anatomy has dramatically increased in the last 5 years. Objective: This review aims to outline the emerging area of digital anatomy and summarize opportunities and challenges for incorporating digital anatomy in medical science education and practices. Methods: Literature searches were performed using the PubMed, Embase, and MEDLINE bibliographic databases for research articles published between January 2005 and June 2021 (inclusive). Out of the 4650 articles, 651 (14\%) were advanced to full-text screening and 77 (1.7\%) were eligible for inclusion in the narrative review. We performed a Strength, Weakness, Opportunity, and Threat (SWOT) analysis to evaluate the role that digital anatomy plays in both the learning and teaching of medicine and health sciences as well as its practice. Results: Digital anatomy has not only revolutionized undergraduate anatomy education via 3D reconstruction of the human body but is shifting the paradigm of pre- and vocational training for medical professionals via digital simulation, advancing health care. Importantly, it was noted that digital anatomy not only benefits in situ real time clinical practice but also has many advantages for learning and teaching clinicians at multiple levels. Using the SWOT analysis, we described strengths and opportunities that together serve to underscore the benefits of embracing digital anatomy, in particular the areas for collaboration and medical advances. The SWOT analysis also identified a few weaknesses associated with digital anatomy, which are primarily related to the fact that the current reach and range of applications for digital anatomy are very limited owing to its nascent nature. Furthermore, threats are limited to technical aspects such as hardware and software issues. Conclusions: This review highlights the advances in digital health and Health 4.0 in key areas of digital anatomy analytics. The continuous evolution of digital technologies will increase their ability to reinforce anatomy knowledge and advance clinical practice. However, digital anatomy education should not be viewed as a simple technical conversion and needs an explicit pedagogical framework. This review will be a valuable asset for educators and researchers to incorporate digital anatomy into the learning and teaching of medical sciences and their practice. ",
doi="10.2196/34687",
url="https://mededu.jmir.org/2022/2/e34687",
url="http://www.ncbi.nlm.nih.gov/pubmed/35594064"
}


@Article{info:doi/10.2196/36948,
author="Ayivi-Vinz, Gloria
and Bakwa Kanyinga, Felly
and Bergeron, Lysa
and D{\'e}cary, Simon
and Adisso, Lionel {\'E}v{\`e}hou{\'e}nou
and Zomahoun, Vignon Herv{\'e} Tchala
and Daniel, J. Sam
and Tremblay, Martin
and Plourde, V. Karine
and Guay-B{\'e}langer, Sabrina
and L{\'e}gar{\'e}, France",
title="Use of the CPD-REACTION Questionnaire to Evaluate Continuing Professional Development Activities for Health Professionals: Systematic Review",
journal="JMIR Med Educ",
year="2022",
month="May",
day="2",
volume="8",
number="2",
pages="e36948",
keywords="CPD-REACTION",
keywords="behavior",
keywords="intention",
keywords="education medical",
keywords="continuing",
keywords="health care professionals",
keywords="questionnaire",
keywords="web-based",
keywords="continuing professional development",
abstract="Background: Continuing professional development (CPD) is essential for physicians to maintain and enhance their knowledge, competence, skills, and performance. Web-based CPD plays an essential role. However, validated theory--informed measures of their impact are lacking. The CPD-REACTION questionnaire is a validated theory--informed tool that evaluates the impact of CPD activities on clinicians' behavioral intentions. Objective: We aimed to review the use of the CPD-REACTION questionnaire, which measures the impact of CPD activities on health professionals' intentions to change clinical behavior. We examined CPD activity characteristics, ranges of intention, mean scores, score distributions, and psychometric properties. Methods: We conducted a systematic review informed by the Cochrane review methodology. We searched 8 databases from January 1, 2014, to April 20, 2021. Gray literature was identified using Google Scholar and Research Gate. Eligibility criteria included all health care professionals, any study design, and participants' completion of the CPD-REACTION questionnaire either before, after, or before and after a CPD activity. Study selection, data extraction, and study quality evaluation were independently performed by 2 reviewers. We extracted data on characteristics of studies, the CPD activity (eg, targeted clinical behavior and format), and CPD-REACTION use. We used the Mixed Methods Appraisal Tool to evaluate the methodological quality of the studies. Data extracted were analyzed using descriptive statistics and the Student t test (2-tailed) for bivariate analysis. The results are presented as a narrative synthesis reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: Overall, 65 citations were eligible and referred to 52 primary studies. The number of primary studies reporting the use of CPD-REACTION has increased continuously since 2014 from 1 to 16 publications per year (2021). It is available in English, French, Spanish, and Dutch. Most of the studies were conducted in Canada (30/52, 58\%). Furthermore, 40 different clinical behaviors were identified. The most common CPD format was e-learning (34/52, 65\%). The original version of the CPD-REACTION questionnaire was used in 31 of 52 studies, and an adapted version in 18 of 52 studies. In addition, 31\% (16/52) of the studies measured both the pre- and postintervention scores. In 22 studies, CPD providers were university-based. Most studies targeted interprofessional groups of health professionals (31/52, 60\%). Conclusions: The use of CPD-REACTION has increased rapidly and across a wide range of clinical behaviors and formats, including a web-based format. Further research should investigate the most effective way to adapt the CPD-REACTION questionnaire to a variety of clinical behaviors and contexts. Trial Registration: PROSPERO CRD42018116492; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=116492 ",
doi="10.2196/36948",
url="https://mededu.jmir.org/2022/2/e36948",
url="http://www.ncbi.nlm.nih.gov/pubmed/35318188"
}


@Article{info:doi/10.2196/29594,
author="Tudor Car, Lorainne
and Kyaw, Myint Bhone
and Teo, Andrew
and Fox, Erlikh Tatiana
and Vimalesvaran, Sunitha
and Apfelbacher, Christian
and Kemp, Sandra
and Chavannes, Niels",
title="Outcomes, Measurement Instruments, and Their Validity Evidence in Randomized Controlled Trials on Virtual, Augmented, and Mixed Reality in Undergraduate Medical Education: Systematic Mapping Review",
journal="JMIR Serious Games",
year="2022",
month="Apr",
day="13",
volume="10",
number="2",
pages="e29594",
keywords="virtual reality",
keywords="augmented reality",
keywords="mixed reality",
keywords="outcomes",
keywords="extended reality",
keywords="digital education",
keywords="randomized controlled trials",
keywords="medical education",
keywords="measurement instruments",
abstract="Background: Extended reality, which encompasses virtual reality (VR), augmented reality (AR), and mixed reality (MR), is increasingly used in medical education. Studies assessing the effectiveness of these new educational modalities should measure relevant outcomes using outcome measurement tools with validity evidence. Objective: Our aim is to determine the choice of outcomes, measurement instruments, and the use of measurement instruments with validity evidence in randomized controlled trials (RCTs) on the effectiveness of VR, AR, and MR in medical student education. Methods: We conducted a systematic mapping review. We searched 7 major bibliographic databases from January 1990 to April 2020, and 2 reviewers screened the citations and extracted data independently from the included studies. We report our findings in line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: Of the 126 retrieved RCTs, 115 (91.3\%) were on VR and 11 (8.7\%) were on AR. No RCT on MR in medical student education was found. Of the 115 studies on VR, 64 (55.6\%) were on VR simulators, 30 (26.1\%) on screen-based VR, 9 (7.8\%) on VR patient simulations, and 12 (10.4\%) on VR serious games. Most studies reported only a single outcome and immediate postintervention assessment data. Skills outcome was the most common outcome reported in studies on VR simulators (97\%), VR patient simulations (100\%), and AR (73\%). Knowledge was the most common outcome reported in studies on screen-based VR (80\%) and VR serious games (58\%). Less common outcomes included participants' attitudes, satisfaction, cognitive or mental load, learning efficacy, engagement or self-efficacy beliefs, emotional state, competency developed, and patient outcomes. At least one form of validity evidence was found in approximately half of the studies on VR simulators (55\%), VR patient simulations (56\%), VR serious games (58\%), and AR (55\%) and in a quarter of the studies on screen-based VR (27\%). Most studies used assessment methods that were implemented in a nondigital format, such as paper-based written exercises or in-person assessments where examiners observed performance (72\%). Conclusions: RCTs on VR and AR in medical education report a restricted range of outcomes, mostly skills and knowledge. The studies largely report immediate postintervention outcome data and use assessment methods that are in a nondigital format. Future RCTs should include a broader set of outcomes, report on the validity evidence of the measurement instruments used, and explore the use of assessments that are implemented digitally. ",
doi="10.2196/29594",
url="https://games.jmir.org/2022/2/e29594",
url="http://www.ncbi.nlm.nih.gov/pubmed/35416789"
}


@Article{info:doi/10.2196/32183,
author="Wang, Jiaqi Judy
and Singh, K. Rishabh
and Miselis, Hough Heather
and Stapleton, Nicole Stephanie",
title="Technology Literacy in Undergraduate Medical Education: Review and Survey of the US Medical School Innovation and Technology Programs",
journal="JMIR Med Educ",
year="2022",
month="Mar",
day="31",
volume="8",
number="1",
pages="e32183",
keywords="curricular development",
keywords="medical innovation",
keywords="medical technology",
keywords="student engagement",
abstract="Background: Modern innovations, like machine learning, genomics, and digital health, are being integrated into medical practice at a rapid pace. Physicians in training receive little exposure to the implications, drawbacks, and methodologies of upcoming technologies prior to their deployment. As a result, there is an increasing need for the incorporation of innovation and technology (I\&T) training, starting in medical school. Objective: We aimed to identify and describe curricular and extracurricular opportunities for innovation in medical technology in US undergraduate medical education to highlight challenges and develop insights for future directions of program development. Methods: A review of publicly available I\&T program information on the official websites of US allopathic medical schools was conducted in June 2020. Programs were categorized by structure and implementation. The geographic distribution of these categories across US regions was analyzed. A survey was administered to school-affiliated student organizations with a focus on I\&T and publicly available contact information. The data collected included the founding year, thematic focus, target audience, activities offered, and participant turnout rate. Results: A total of 103 I\&T opportunities at 69 distinct Liaison Committee on Medical Education--accredited medical schools were identified and characterized into the following six categories: (1) integrative 4-year curricula, (2) facilitated doctor of medicine/master of science dual degree programs in a related field, (3) interdisciplinary collaborations, (4) areas of concentration, (5) preclinical electives, and (6) student-run clubs. The presence of interdisciplinary collaboration is significantly associated with the presence of student-led initiatives (P=.001). ``Starting and running a business in healthcare'' and ``medical devices'' were the most popular thematic focuses of student-led I\&T groups, representing 87\% (13/15) and 80\% (12/15) of respondents, respectively. ``Career pathways exploration for students'' was the only type of activity that was significantly associated with a high event turnout rate of >26 students per event (P=.03). Conclusions: Existing school-led and student-driven opportunities in medical I\&T indicate growing national interest and reflect challenges in implementation. The greater visibility of opportunities, collaboration among schools, and development of a centralized network can be considered to better prepare students for the changing landscape of medical practice. ",
doi="10.2196/32183",
url="https://mededu.jmir.org/2022/1/e32183",
url="http://www.ncbi.nlm.nih.gov/pubmed/35357319"
}


@Article{info:doi/10.2196/32747,
author="Yeung, Kan Andy Wai
and Parvanov, D. Emil
and Hribersek, Mojca
and Eibensteiner, Fabian
and Klager, Elisabeth
and Kletecka-Pulker, Maria
and R{\"o}ssler, Bernhard
and Schebesta, Karl
and Willschke, Harald
and Atanasov, G. Atanas
and Schaden, Eva",
title="Digital Teaching in Medical Education: Scientific Literature Landscape Review",
journal="JMIR Med Educ",
year="2022",
month="Feb",
day="9",
volume="8",
number="1",
pages="e32747",
keywords="medical education",
keywords="digital teaching",
keywords="virtual reality",
keywords="augmented reality",
keywords="anatomy",
keywords="basic life support",
keywords="satisfaction",
keywords="bibliometric",
keywords="medicine",
keywords="life support",
keywords="online learning",
keywords="literature",
keywords="trend",
keywords="citation",
abstract="Background: Digital teaching in medical education has grown in popularity in the recent years. However, to the best of our knowledge, no bibliometric report to date has been published that analyzes this important literature set to reveal prevailing topics and trends and their impacts reflected in citation counts. Objective: We used a bibliometric approach to unveil and evaluate the scientific literature on digital teaching research in medical education, demonstrating recurring research topics, productive authors, research organizations, countries, and journals. We further aimed to discuss some of the topics and findings reported by specific highly cited works. Methods: The Web of Science electronic database was searched to identify relevant papers on digital teaching research in medical education. Basic bibliographic data were obtained by the ``Analyze'' and ``Create Citation Report'' functions of the database. Complete bibliographic data were exported to VOSviewer for further analyses. Visualization maps were generated to display the recurring author keywords and terms mentioned in the titles and abstracts of the publications. Results: The analysis was based on data from 3978 papers that were identified. The literature received worldwide contributions with the most productive countries being the United States and United Kingdom. Reviews were significantly more cited, but the citations between open access vs non--open access papers did not significantly differ. Some themes were cited more often, reflected by terms such as virtual reality, innovation, trial, effectiveness, and anatomy. Different aspects in medical education were experimented for digital teaching, such as gross anatomy education, histology, complementary medicine, medicinal chemistry, and basic life support. Some studies have shown that digital teaching could increase learning satisfaction, knowledge gain, and even cost-effectiveness. More studies were conducted on trainees than on undergraduate students. Conclusions: Digital teaching in medical education is expected to flourish in the future, especially during this era of COVID-19 pandemic. ",
doi="10.2196/32747",
url="https://mededu.jmir.org/2022/1/e32747",
url="http://www.ncbi.nlm.nih.gov/pubmed/35138260"
}


@Article{info:doi/10.2196/34860,
author="Jiang, Haowen
and Vimalesvaran, Sunitha
and Wang, King Jeremy
and Lim, Boon Kee
and Mogali, Reddy Sreenivasulu
and Car, Tudor Lorainne",
title="Virtual Reality in Medical Students' Education: Scoping Review",
journal="JMIR Med Educ",
year="2022",
month="Feb",
day="2",
volume="8",
number="1",
pages="e34860",
keywords="virtual reality",
keywords="medical education",
keywords="medical students",
keywords="virtual worlds",
keywords="digital health education",
abstract="Background: Virtual reality (VR) produces a virtual manifestation of the real world and has been shown to be useful as a digital education modality. As VR encompasses different modalities, tools, and applications, there is a need to explore how VR has been used in medical education. Objective: The objective of this scoping review is to map existing research on the use of VR in undergraduate medical education and to identify areas of future research. Methods: We performed a search of 4 bibliographic databases in December 2020. Data were extracted using a standardized data extraction form. The study was conducted according to the Joanna Briggs Institute methodology for scoping reviews and reported in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Results: Of the 114 included studies, 69 (60.5\%) reported the use of commercially available surgical VR simulators. Other VR modalities included 3D models (15/114, 13.2\%) and virtual worlds (20/114, 17.5\%), which were mainly used for anatomy education. Most of the VR modalities included were semi-immersive (68/114, 59.6\%) and were of high interactivity (79/114, 69.3\%). There is limited evidence on the use of more novel VR modalities, such as mobile VR and virtual dissection tables (8/114, 7\%), as well as the use of VR for nonsurgical and nonpsychomotor skills training (20/114, 17.5\%) or in a group setting (16/114, 14\%). Only 2.6\% (3/114) of the studies reported the use of conceptual frameworks or theories in the design of VR. Conclusions: Despite the extensive research available on VR in medical education, there continue to be important gaps in the evidence. Future studies should explore the use of VR for the development of nonpsychomotor skills and in areas other than surgery and anatomy. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2020-046986 ",
doi="10.2196/34860",
url="https://mededu.jmir.org/2022/1/e34860",
url="http://www.ncbi.nlm.nih.gov/pubmed/35107421"
}


@Article{info:doi/10.2196/34369,
author="Nguyen, Tuan Ba
and Phung, Lam Toi
and Khuc, Hanh Thi Hong
and Nguyen, Thi Van Anh
and Blizzard, Leigh Christopher
and Palmer, Andrew
and Nguyen, Tu Huu
and Cong Quyet, Thang
and Nelson, Mark",
title="Trauma Care Training in Vietnam: Narrative Scoping Review",
journal="JMIR Med Educ",
year="2022",
month="Jan",
day="24",
volume="8",
number="1",
pages="e34369",
keywords="trauma training",
keywords="Vietnamese medical education system",
keywords="medical curricula",
keywords="short course",
abstract="Background: The model of trauma in Vietnam has changed significantly over the last decade and requires reforming medical education to deal with new circumstances. Our aim is to evaluate this transition regarding the new target by analyzing trauma and the medical training system as a whole. Objective: This study aimed to establish if medical training in the developing country of Vietnam has adapted to the new disease pattern of road trauma emerging in its economy. Methods: A review was performed of Vietnamese medical school, Ministry of Health, and Ministry of Education and Training literature on trauma education. The review process and final review paper were prepared following the guidelines on scoping reviews and using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart. Results: The current trauma training at the undergraduate level is minimal and involves less than 5\% of the total credit. At the postgraduate level, only the specialties of surgery and anesthesia have a significant and increasing trauma training component ranging from 8\% to 22\% in the content. Trauma training, which focuses on practical skills, accounts for 31\% and 32\% of the training time of orientation courses for young doctors in ``basic surgery'' and ``basic anesthesia,'' respectively. Other relevant short course trainings, such as continuing medical education, in trauma are available, but they vary in topics, facilitators, participants, and formats. Conclusions: Medical training in Vietnam has not adapted to the new emerging disease pattern of road trauma. In the interim, the implementation of short courses, such as basic trauma life support and primary trauma care, can be considered as an appropriate method to compensate for the insufficient competency-related trauma care among health care workers while waiting for the effectiveness of medical training reformation. ",
doi="10.2196/34369",
url="https://mededu.jmir.org/2022/1/e34369",
url="http://www.ncbi.nlm.nih.gov/pubmed/34967756"
}


@Article{info:doi/10.2196/31043,
author="Charow, Rebecca
and Jeyakumar, Tharshini
and Younus, Sarah
and Dolatabadi, Elham
and Salhia, Mohammad
and Al-Mouaswas, Dalia
and Anderson, Melanie
and Balakumar, Sarmini
and Clare, Megan
and Dhalla, Azra
and Gillan, Caitlin
and Haghzare, Shabnam
and Jackson, Ethan
and Lalani, Nadim
and Mattson, Jane
and Peteanu, Wanda
and Tripp, Tim
and Waldorf, Jacqueline
and Williams, Spencer
and Tavares, Walter
and Wiljer, David",
title="Artificial Intelligence Education Programs for Health Care Professionals: Scoping Review",
journal="JMIR Med Educ",
year="2021",
month="Dec",
day="13",
volume="7",
number="4",
pages="e31043",
keywords="machine learning",
keywords="deep learning",
keywords="health care providers",
keywords="education",
keywords="learning",
keywords="patient care",
abstract="Background: As the adoption of artificial intelligence (AI) in health care increases, it will become increasingly crucial to involve health care professionals (HCPs) in developing, validating, and implementing AI-enabled technologies. However, because of a lack of AI literacy, most HCPs are not adequately prepared for this revolution. This is a significant barrier to adopting and implementing AI that will affect patients. In addition, the limited existing AI education programs face barriers to development and implementation at various levels of medical education. Objective: With a view to informing future AI education programs for HCPs, this scoping review aims to provide an overview of the types of current or past AI education programs that pertains to the programs' curricular content, modes of delivery, critical implementation factors for education delivery, and outcomes used to assess the programs' effectiveness. Methods: After the creation of a search strategy and keyword searches, a 2-stage screening process was conducted by 2 independent reviewers to determine study eligibility. When consensus was not reached, the conflict was resolved by consulting a third reviewer. This process consisted of a title and abstract scan and a full-text review. The articles were included if they discussed an actual training program or educational intervention, or a potential training program or educational intervention and the desired content to be covered, focused on AI, and were designed or intended for HCPs (at any stage of their career). Results: Of the 10,094 unique citations scanned, 41 (0.41\%) studies relevant to our eligibility criteria were identified. Among the 41 included studies, 10 (24\%) described 13 unique programs and 31 (76\%) discussed recommended curricular content. The curricular content of the unique programs ranged from AI use, AI interpretation, and cultivating skills to explain results derived from AI algorithms. The curricular topics were categorized into three main domains: cognitive, psychomotor, and affective. Conclusions: This review provides an overview of the current landscape of AI in medical education and highlights the skills and competencies required by HCPs to effectively use AI in enhancing the quality of care and optimizing patient outcomes. Future education efforts should focus on the development of regulatory strategies, a multidisciplinary approach to curriculum redesign, a competency-based curriculum, and patient-clinician interaction. ",
doi="10.2196/31043",
url="https://mededu.jmir.org/2021/4/e31043",
url="http://www.ncbi.nlm.nih.gov/pubmed/34898458"
}


@Article{info:doi/10.2196/29707,
author="Amod, Hafaza
and Mkhize, Wellington Sipho
and Muraraneza, Claudine",
title="Analyzing Evidence on Interventions to Strengthen the Clinical Support for Midwifery Students in Clinical Placements: Protocol for a Systematic Scoping Review",
journal="JMIR Res Protoc",
year="2021",
month="Sep",
day="21",
volume="10",
number="9",
pages="e29707",
keywords="midwifery students",
keywords="registered midwives",
keywords="clinical support interventions",
keywords="midwives",
keywords="midwifery",
keywords="students",
keywords="mentorship",
keywords="clinical supervision",
keywords="collaboration",
keywords="clinician attitudes",
abstract="Background: The benefits of clinical support are evident in various mentorship, preceptorship, or clinical supervision models. Poor collaboration between lecturers and clinical staff, lack of confidence about student support, large student intakes coupled with core demands create negative attitudes toward student supervision, and this poses a huge challenge to midwifery students who are expected to become competent in the process. Objective: This study aims to identify and analyze interventions, strategies, and/or mechanisms in order to strengthen the clinical support for midwifery students in clinical practice areas from a global perspective. Methods: This review will follow the Arksey and O'Malley framework (2005). The search strategy will include primary studies searched for in electronic databases such as EBSCOhost (CINAHL, MEDLINE, and Health Source: Nursing/Academic edition), PubMed, Google, and Google Scholar. Keywords such as ``midwifery students,'' ``midwifery education,'' and ``clinical support'' will be used to search for related articles. The search will include articles from the cited by search, as well as citations from the reference list of included articles. All title-screened articles will be exported to an EndNote library, and duplicate studies will be removed. Two independent reviewers will concurrently carry out the abstract and full-text article screening according to the eligibility criteria. Extracted data will highlight the aims, geographical setting, and level of training; intervention outcomes; and the most relevant and most significant findings. This review will also include a mixed methods quality appraisal check. A narrative summary of data extracted will be analyzed using content analysis. Results: Interventions to strengthen the clinical support for midwifery students in practice will be extracted from this review, and data will be analyzed and extracted to develop a comprehensive guide or framework for clinical mentorship. As of August 2021, the electronic search, the data extraction, and the analysis have been completed. The results paper is expected to be published within the next 6 months. Conclusions: It is expected that this review will contribute to midwifery education by identifying quality evidence on clinical support interventions available to midwifery students globally, as well as best practice methods, procedures, or interventions that can be used to develop a midwifery mentorship training program. International Registered Report Identifier (IRRID): DERR1-10.2196/29707 ",
doi="10.2196/29707",
url="https://www.researchprotocols.org/2021/9/e29707",
url="http://www.ncbi.nlm.nih.gov/pubmed/34546180"
}


@Article{info:doi/10.2196/27239,
author="Amosun, Seyi
and Kimmie-Dhansay, Faheema
and Geerts, Greta
and Basson, Reneda",
title="Career Development of Academic Staff in Faculties of Dentistry by Means of Mentorship Programs: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2021",
month="Jul",
day="21",
volume="10",
number="7",
pages="e27239",
keywords="scoping review protocol",
keywords="academic staff development",
keywords="mentorship",
keywords="capacity development",
keywords="dental education",
keywords="dentistry",
keywords="dental educators",
abstract="Background: Globally, the demands on dental educators continue to diversify and expand. Due to their importance and value, mentoring programs have been acknowledged as a means of recruiting, developing, and retaining academics in dental education. Objective: This protocol is for a scoping review that aims to identify the goals of mentoring programs for academic staff in dental faculties and determine how these programs were structured, delivered, and evaluated. Methods: The review will be performed in accordance with the Joanna Briggs Institute's methodology for scoping reviews, which covers both qualitative and quantitative scientific literature as well as grey literature written in English and published between 2000 and 2020. The databases will include PubMed, Ovid, the Educational Resources Information Center database, Science Direct, Scopus, Google Scholar, Trove, Web of Science, Openthesis.org, and the website of the American Dental Education Association. A manual search will also be conducted by using the reference lists of included studies to identify additional articles. Working independently, the authors will participate iteratively in literature screening, paper selection, and data extraction. Disagreements between the reviewers will be resolved by discussion until a consensus is reached or after consultation with the research team. Key information that is relevant to the review questions will be extracted from the selected articles and imported into a Microsoft Excel file. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) will be used to guide the reporting of this protocol. Results: The search for appropriate literature has commenced, and we aim to present the results before the end of the 2021 academic year. Conclusions: The development of formal mentorship programs for academics in dental education will enhance the retention of academic staff. International Registered Report Identifier (IRRID): PRR1-10.2196/27239 ",
doi="10.2196/27239",
url="https://www.researchprotocols.org/2021/7/e27239",
url="http://www.ncbi.nlm.nih.gov/pubmed/34287219"
}


@Article{info:doi/10.2196/28275,
author="Tudor Car, Lorainne
and Kyaw, Myint Bhone
and Nannan Panday, S. Rishi
and van der Kleij, Rianne
and Chavannes, Niels
and Majeed, Azeem
and Car, Josip",
title="Digital Health Training Programs for Medical Students: Scoping Review",
journal="JMIR Med Educ",
year="2021",
month="Jul",
day="21",
volume="7",
number="3",
pages="e28275",
keywords="digital health",
keywords="education",
keywords="eHealth",
keywords="medical students",
keywords="scoping review",
keywords="electronic health records",
keywords="computer literacy",
abstract="Background: Medical schools worldwide are accelerating the introduction of digital health courses into their curricula. The COVID-19 pandemic has contributed to this swift and widespread transition to digital health and education. However, the need for digital health competencies goes beyond the COVID-19 pandemic because they are becoming essential for the delivery of effective, efficient, and safe care. Objective: This review aims to collate and analyze studies evaluating digital health education for medical students to inform the development of future courses and identify areas where curricula may need to be strengthened. Methods: We carried out a scoping review by following the guidance of the Joanna Briggs Institute, and the results were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. We searched 6 major bibliographic databases and gray literature sources for articles published between January 2000 and November 2019. Two authors independently screened the retrieved citations and extracted the data from the included studies. Discrepancies were resolved by consensus discussions between the authors. The findings were analyzed using thematic analysis and presented narratively. Results: A total of 34 studies focusing on different digital courses were included in this review. Most of the studies (22/34, 65\%) were published between 2010 and 2019 and originated in the United States (20/34, 59\%). The reported digital health courses were mostly elective (20/34, 59\%), were integrated into the existing curriculum (24/34, 71\%), and focused mainly on medical informatics (17/34, 50\%). Most of the courses targeted medical students from the first to third year (17/34, 50\%), and the duration of the courses ranged from 1 hour to 3 academic years. Most of the studies (22/34, 65\%) reported the use of blended education. A few of the studies (6/34, 18\%) delivered courses entirely digitally by using online modules, offline learning, massive open online courses, and virtual patient simulations. The reported courses used various assessment approaches such as paper-based assessments, in-person observations, and online assessments. Most of the studies (30/34, 88\%) evaluated courses mostly by using an uncontrolled before-and-after design and generally reported improvements in students' learning outcomes. Conclusions: Digital health courses reported in literature are mostly elective, focus on a single area of digital health, and lack robust evaluation. They have diverse delivery, development, and assessment approaches. There is an urgent need for high-quality studies that evaluate digital health education. ",
doi="10.2196/28275",
url="https://mededu.jmir.org/2021/3/e28275",
url="http://www.ncbi.nlm.nih.gov/pubmed/34287206"
}


@Article{info:doi/10.2196/29080,
author="Barteit, Sandra
and Lanfermann, Lucia
and B{\"a}rnighausen, Till
and Neuhann, Florian
and Beiersmann, Claudia",
title="Augmented, Mixed, and Virtual Reality-Based Head-Mounted Devices for Medical Education: Systematic Review",
journal="JMIR Serious Games",
year="2021",
month="Jul",
day="8",
volume="9",
number="3",
pages="e29080",
keywords="virtual reality",
keywords="augmented reality",
keywords="global health",
keywords="income-limited countries",
keywords="medical education",
abstract="Background: Augmented reality (AR), mixed reality (MR), and virtual reality (VR), realized as head-mounted devices (HMDs), may open up new ways of teaching medical content for low-resource settings. The advantages are that HMDs enable repeated practice without adverse effects on the patient in various medical disciplines; may introduce new ways to learn complex medical content; and may alleviate financial, ethical, and supervisory constraints on the use of traditional medical learning materials, like cadavers and other skills lab equipment. Objective: We examine the effectiveness of AR, MR, and VR HMDs for medical education, whereby we aim to incorporate a global health perspective comprising low- and middle-income countries (LMICs). Methods: We conducted a systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) and Cochrane guidelines. Seven medical databases (PubMed, Cochrane Library, Web of Science, Science Direct, PsycINFO, Education Resources Information Centre, and Google Scholar) were searched for peer-reviewed publications from January 1, 2014, to May 31, 2019. An extensive search was carried out to examine relevant literature guided by three concepts of extended reality (XR), which comprises the concepts of AR, MR, and VR, and the concepts of medicine and education. It included health professionals who took part in an HMD intervention that was compared to another teaching or learning method and evaluated with regard to its effectiveness. Quality and risk of bias were assessed with the Medical Education Research Study Quality Instrument, the Newcastle-Ottawa Scale-Education, and A Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies of Interventions. We extracted relevant data and aggregated the data according to the main outcomes of this review (knowledge, skills, and XR HMD). Results: A total of 27 studies comprising 956 study participants were included. The participants included all types of health care professionals, especially medical students (n=573, 59.9\%) and residents (n=289, 30.2\%). AR and VR implemented with HMDs were most often used for training in the fields of surgery (n=13, 48\%) and anatomy (n=4, 15\%). A range of study designs were used, and quantitative methods were clearly dominant (n=21, 78\%). Training with AR- and VR-based HMDs was perceived as salient, motivating, and engaging. In the majority of studies (n=17, 63\%), HMD-based interventions were found to be effective. A small number of included studies (n=4, 15\%) indicated that HMDs were effective for certain aspects of medical skills and knowledge learning and training, while other studies suggested that HMDs were only viable as an additional teaching tool (n=4, 15\%). Only 2 (7\%) studies found no effectiveness in the use of HMDs. Conclusions: The majority of included studies suggested that XR-based HMDs have beneficial effects for medical education, whereby only a minority of studies were from LMICs. Nevertheless, as most studies showed at least noninferior results when compared to conventional teaching and training, the results of this review suggest applicability and potential effectiveness in LMICs. Overall, users demonstrated greater enthusiasm and enjoyment in learning with XR-based HMDs. It has to be noted that many HMD-based interventions were small-scale and conducted as short-term pilots. To generate relevant evidence in the future, it is key to rigorously evaluate XR-based HMDs with AR and VR implementations, particularly in LMICs, to better understand the strengths and shortcomings of HMDs for medical education. ",
doi="10.2196/29080",
url="https://games.jmir.org/2021/3/e29080",
url="http://www.ncbi.nlm.nih.gov/pubmed/34255668"
}


@Article{info:doi/10.2196/29335,
author="Wilcha, Robyn-Jenia",
title="Author's Reply to: Virtual vs Online: Insight From Medical Students. Comment on ``Effectiveness of Virtual Medical Teaching During the COVID-19 Crisis: Systematic Review''",
journal="JMIR Med Educ",
year="2021",
month="May",
day="14",
volume="7",
number="2",
pages="e29335",
keywords="virtual teaching",
keywords="medical student",
keywords="medical education",
keywords="COVID-19",
keywords="review",
keywords="search term",
keywords="virus",
keywords="pandemic",
keywords="quarantine",
doi="10.2196/29335",
url="https://mededu.jmir.org/2021/2/e29335",
url="http://www.ncbi.nlm.nih.gov/pubmed/33852412"
}


@Article{info:doi/10.2196/27020,
author="Kaini, Shahil
and Motie, Zahrah Lucinda",
title="Virtual vs Online: Insight From Medical Students. Comment on ``Effectiveness of Virtual Medical Teaching During the COVID-19 Crisis: Systematic Review''",
journal="JMIR Med Educ",
year="2021",
month="May",
day="14",
volume="7",
number="2",
pages="e27020",
keywords="virtual teaching",
keywords="medical student",
keywords="medical education",
keywords="COVID-19",
keywords="review",
keywords="search term",
keywords="virus",
keywords="pandemic",
keywords="quarantine",
doi="10.2196/27020",
url="https://mededu.jmir.org/2021/2/e27020",
url="http://www.ncbi.nlm.nih.gov/pubmed/33988518"
}


@Article{info:doi/10.2196/25377,
author="Gladman, Tehmina
and Tylee, Grace
and Gallagher, Steve
and Mair, Jonathan
and Grainger, Rebecca",
title="Measuring the Quality of Clinical Skills Mobile Apps for Student Learning: Systematic Search, Analysis, and Comparison of Two Measurement Scales",
journal="JMIR Mhealth Uhealth",
year="2021",
month="Apr",
day="23",
volume="9",
number="4",
pages="e25377",
keywords="mobile apps",
keywords="MARS",
keywords="MARuL",
keywords="medical education",
keywords="app review",
keywords="mobile phone",
abstract="Background: Mobile apps are widely used in health professions, which increases the need for simple methods to determine the quality of apps. In particular, teachers need the ability to curate high-quality mobile apps for student learning. Objective: This study aims to systematically search for and evaluate the quality of clinical skills mobile apps as learning tools. The quality of apps meeting the specified criteria was evaluated using two measures---the widely used Mobile App Rating Scale (MARS), which measures general app quality, and the Mobile App Rubric for Learning (MARuL), a recently developed instrument that measures the value of apps for student learning---to assess whether MARuL is more effective than MARS in identifying high-quality apps for learning. Methods: Two mobile app stores were systematically searched using clinical skills terms commonly found in medical education and apps meeting the criteria identified using an approach based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 9 apps were identified during the screening process. The apps were rated independently by 2 reviewers using MARS and MARuL. Results: The intraclass correlation coefficients (ICCs) for the 2 raters using MARS and MARuL were the same (MARS ICC [two-way]=0.68; P<.001 and MARuL ICC [two-way]=0.68; P<.001). Of the 9 apps, Geeky Medics-OSCE revision (MARS Android=3.74; MARS iOS=3.68; MARuL Android=75; and MARuL iOS=73) and OSCE PASS: Medical Revision (MARS Android=3.79; MARS iOS=3.71; MARuL Android=69; and MARuL iOS=73) scored highly on both measures of app quality and for both Android and iOS. Both measures also showed agreement for the lowest rated app, Patient Education Institute (MARS Android=2.21; MARS iOS=2.11; MARuL Android=18; and MARuL iOS=21.5), which had the lowest scores in all categories except information (MARS) and professional (MARuL) in both operating systems. MARS and MARuL were both able to differentiate between the highest and lowest quality apps; however, MARuL was better able to differentiate apps based on teaching and learning quality. Conclusions: This systematic search and rating of clinical skills apps for learning found that the quality of apps was highly variable. However, 2 apps---Geeky Medics-OSCE revision and OSCE PASS: Medical Revision---rated highly for both versions and with both quality measures. MARS and MARuL showed similar abilities to differentiate the quality of the 9 apps. However, MARuL's incorporation of teaching and learning elements as part of a multidimensional measure of quality may make it more appropriate for use with apps focused on teaching and learning, whereas MARS's more general rating of quality may be more appropriate for health apps targeting a general health audience. Ratings of the 9 apps by both measures also highlighted the variable quality of clinical skills mobile apps for learning. ",
doi="10.2196/25377",
url="https://mhealth.jmir.org/2021/4/e25377",
url="http://www.ncbi.nlm.nih.gov/pubmed/33890859"
}


@Article{info:doi/10.2196/13681,
author="Meinert, Edward
and Eerens, Jessie
and Banks, Christina
and Maloney, Stephen
and Rivers, George
and Ilic, Dragan
and Walsh, Kieran
and Majeed, Azeem
and Car, Josip",
title="Exploring the Cost of eLearning in Health Professions Education: Scoping Review",
journal="JMIR Med Educ",
year="2021",
month="Mar",
day="11",
volume="7",
number="1",
pages="e13681",
keywords="education",
keywords="distance education",
keywords="professional education",
keywords="online education",
keywords="online learning",
keywords="costs and cost analysis",
keywords="economics",
abstract="Background: Existing research on the costs associated with the design and deployment of eLearning in health professions education is limited. The relative costs of these learning platforms to those of face-to-face learning are also not well understood. The lack of predefined costing models used for eLearning cost data capture has made it difficult to complete cost evaluation. Objective: The key aim of this scoping review was to explore the state of evidence concerning cost capture within eLearning in health professions education. The review explores the available data to define cost calculations related to eLearning. Methods: The scoping review was performed using a search strategy with Medical Subject Heading terms and related keywords centered on eLearning and cost calculation with a population scope of health professionals in all countries. The search was limited to articles published in English. No restriction was placed on literature publication date. Results: In total, 7344 articles were returned from the original search of the literature. Of these, 232 were relevant to associated keywords or abstract references following screening. Full-text review resulted in 168 studies being excluded. Of these, 61 studies were excluded because they were unrelated to eLearning and focused on general education. In addition, 103 studies were excluded because of lack of detailed information regarding costs; these studies referred to cost in ways either indicating cost favorability or unfavorability, but without data to support findings. Finally, 4 studies were excluded because of limited cost data that were insufficient for analysis. In total, 42 studies provided data and analysis of the impact of cost and value in health professions education. The most common data source was total cost of training (n=29). Other sources included cost per learner, referring to the cost for individual students (n=13). The population most frequently cited was medical students (n=15), although 12 articles focused on multiple populations. A further 22 studies provide details of costing approaches for the production and delivery of eLearning. These studies offer insight into the ways eLearning has been budgeted and project-managed through implementation. Conclusions: Although cost is a recognized factor in studies detailing eLearning design and implementation, the way cost is captured is inconsistent. Despite a perception that eLearning is more cost-effective than face-to-face instruction, there is not yet sufficient evidence to assert this conclusively. A rigorous, repeatable data capture method is needed, in addition to a means to leverage existing economic evaluation methods that can then test eLearning cost-effectiveness and how to implement eLearning with cost benefits and advantages over traditional instruction. ",
doi="10.2196/13681",
url="https://mededu.jmir.org/2021/1/e13681",
url="http://www.ncbi.nlm.nih.gov/pubmed/33704073"
}


@Article{info:doi/10.2196/24093,
author="Olgers, Joan Tycho
and bij de Weg, Akke Anne
and ter Maaten, Cornelis Jan",
title="Serious Games for Improving Technical Skills in Medicine: Scoping Review",
journal="JMIR Serious Games",
year="2021",
month="Jan",
day="25",
volume="9",
number="1",
pages="e24093",
keywords="serious games",
keywords="technical skills",
keywords="ultrasound skills",
keywords="validity of serious games",
abstract="Background: Serious games are being used to train specific technical skills in medicine, and most research has been done for surgical skills. It is not known if these games improve technical skills in real life as most games have not been completely validated. Objective: This scoping review aimed to evaluate the current use of serious games for improving technical skills in medicine and to determine their current validation state using a validation framework specifically designed for serious games. Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A multidatabase search strategy was adopted, after which a total of 17 publications were included in this review. Results: These 17 publications described five different serious games for improving technical skills. We discuss these games in detail and report about their current validation status. Only one game was almost fully validated. We also discuss the different frameworks that can be used for validation of serious games. Conclusions: Serious games are not extensively used for improving technical skills in medicine, although they may represent an attractive alternative way of learning. The validation of these games is mostly incomplete. Additionally, several frameworks for validation exist, but it is unknown which one is the best. This review may assist game developers or educators in validating serious games. ",
doi="10.2196/24093",
url="http://games.jmir.org/2021/1/e24093/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33492234"
}


@Article{info:doi/10.2196/25126,
author="Zlamal, Jaroslav
and Gjevjon, Roth Edith
and Fossum, Mariann
and Solberg, Trygg Marianne
and Steindal, Alexander Simen
and Strandell-Laine, Camilla
and Larsen, Hamilton Marie
and Pettersen, Solvang Fredrik
and Nes, Gon{\c{c}}alves Andr{\'e}a Aparecida",
title="Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: Protocol for a Mixed Methods Systematic Review",
journal="JMIR Res Protoc",
year="2021",
month="Jan",
day="19",
volume="10",
number="1",
pages="e25126",
keywords="critical thinking",
keywords="technology",
keywords="guidance models",
keywords="nursing education",
keywords="clinical practice",
abstract="Background: Critical thinking is an essential skill that nursing students need to develop. Technological tools have opened new avenues for technology-supported guidance models, but the challenges and facilitators of such guidance models, as well as how they stimulate the development of critical thinking, remain unclear. Objective: We developed a protocol for a mixed methods systematic review to investigate the use of technology-supported guidance models that stimulate the development of critical thinking in nursing education clinical practice. Methods: A convergent integrated design following the Joanna Briggs Institute Manual for Evidence Synthesis will be employed. A pair of authors will select the articles by screening titles and abstracts, and the methodological quality of the articles included in the review will be assessed by a pair of authors according to checklists for specific study designs. The data will be extracted using the standardized Joanna Briggs Institute mixed methods data extraction form and following a convergent integrated approach. The thematic synthesis for data transformation will be used. Results: Development of a comprehensive systematic search strategy was completed in October 2020. The database searches were performed on October 21, 2020. As of January 2021, analysis and synthesis is ongoing. Completion of this review is expected by January 2021. Conclusions: By combining evidence from studies with varied methodological approaches, the results should provide broad insight into the use of technology-supported guidance models for clinical practice in nursing education with a focus on the development of nursing students' critical thinking. The results of this mixed methods systematic review can also be used to develop or improve current technology-supported guidance models for clinical practice in nursing education. International Registered Report Identifier (IRRID): PRR1-10.2196/25126 ",
doi="10.2196/25126",
url="http://www.researchprotocols.org/2021/1/e25126/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33464214"
}


@Article{info:doi/10.2196/17765,
author="Isangula, Kahabi
and Edwards, Grace
and Mwansisya, Tumbwene
and Mbekenga, Columba
and Pallangyo, Eunice
and Sarki, Ahmed
and Ndirangu-Mugo, Eunice",
title="Open and Distance Learning Programs for Nursing and Midwifery Education in East Africa: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2021",
month="Jan",
day="11",
volume="10",
number="1",
pages="e17765",
keywords="open and distance",
keywords="learning",
keywords="health care",
keywords="nurses",
keywords="midwifery",
keywords="health",
keywords="East Africa",
abstract="Background: In the face of growing modernity and the coronavirus disease 2019 (COVID-19) pandemic, open and distance learning (ODL) is considered to play an important role in increasing access to education worldwide. There is a robust evidence base demonstrating its cost effectiveness in comparison with conventional class-based teaching; however, the transition to this new paradigm of learning for nursing and midwifery courses has been difficult in low-income countries. While there are notable efforts to increase internet and education access to health care professionals, not much is known about ODL for nurses and midwives in East African countries. Objective: The objective of this scoping review is to understand whether ODL programs for nursing and midwifery education exist, the drivers of their adoption, their implementation, the topics/courses covered, their acceptability, and their impacts in East African countries. Methods: The scoping review methodology employs the framework developed by Arksey and O'Malley. Using an exploratory approach, a two-stage screening process consisting of a title and abstract scan and a full-text review will be used to determine the eligibility of articles. To be included, articles must report on an existing ODL initiative for nurses and midwives in Uganda, Tanzania, and Kenya. All articles will be independently assessed for eligibility by pairs of reviewers, and all eligible articles will be abstracted and charted in duplicate using a standardized form. Results: Details of ODL for nursing and midwifery education initiatives and study outcomes will be summarized in a table. The extracted data will undergo exploratory descriptive analysis, and the results will be classified into learner and clinical outcomes. Conclusions: Evidence on ODL for nursing and midwifery education will inform the ongoing development and restructuring of health care professional education in East Africa amidst the COVID-19 pandemic. International Registered Report Identifier (IRRID): PRR1-10.2196/17765 ",
doi="10.2196/17765",
url="http://www.researchprotocols.org/2021/1/e17765/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33427679"
}


@Article{info:doi/10.2196/20963,
author="Wilcha, Robyn-Jenia",
title="Effectiveness of Virtual Medical Teaching During the COVID-19 Crisis: Systematic Review",
journal="JMIR Med Educ",
year="2020",
month="Nov",
day="18",
volume="6",
number="2",
pages="e20963",
keywords="virtual teaching",
keywords="medical student",
keywords="medical education",
keywords="COVID-19",
keywords="review",
keywords="virus",
keywords="pandemic",
keywords="quarantine",
abstract="Background: In December 2019, COVID-19 emerged and rapidly spread worldwide. Transmission of SARS-CoV-2, the virus that causes COVID-19, is high; as a result, countries worldwide have imposed rigorous public health measures, such as quarantine. This has involved the suspension of medical school classes globally. Medical school attachments are vital to aid the progression of students' confidence and competencies as future physicians. Since the outbreak of COVID-19, medical schools have sought ways to replace medical placements with virtual clinical teaching. Objective: The objective of this study was to review the advantages and disadvantages of virtual medical teaching for medical students during the COVID-19 pandemic based on the current emerging literature. Methods: A brief qualitative review based on the application and effectiveness of virtual teaching during the COVID-19 pandemic was conducted by referencing keywords, including medical student virtual teaching COVID-19, virtual undergraduate medical education, and virtual medical education COVID-19, in the electronic databases of PubMed and Google Scholar. A total of 201 articles were found, of which 34 were included in the study. Manual searches of the reference lists of the included articles yielded 5 additional articles. The findings were tabulated and assessed under the following headings: summary of virtual teaching offered, strengths of virtual teaching, and weaknesses of virtual teaching. Results: The strengths of virtual teaching included the variety of web-based resources available. New interactive forms of virtual teaching are being developed to enable students to interact with patients from their homes. Open-access teaching with medical experts has enabled students to remain abreast of the latest medical advancements and to reclaim knowledge lost by the suspension of university classes and clinical attachments. Peer mentoring has been proven to be a valuable tool for medical students with aims of increasing knowledge and providing psychological support. Weaknesses of virtual teaching included technical challenges, confidentiality issues, reduced student engagement, and loss of assessments. The mental well-being of students was found to be negatively affected during the pandemic. Inequalities of virtual teaching services worldwide were also noted to cause differences in medical education. Conclusions: In the unprecedented times of the COVID-19 pandemic, medical schools have a duty to provide ongoing education to medical students. The continuation of teaching is crucial to enable the graduation of future physicians into society. The evidence suggests that virtual teaching is effective, and institutions are working to further develop these resources to improve student engagement and interactivity. Moving forward, medical faculties must adopt a more holistic approach to student education and consider the mental impact of COVID-19 on students as well as improve the security and technology of virtual platforms. ",
doi="10.2196/20963",
url="http://mededu.jmir.org/2020/2/e20963/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33106227"
}


@Article{info:doi/10.2196/20027,
author="Echelard, Jean-Fran{\c{c}}ois
and M{\'e}thot, Fran{\c{c}}ois
and Nguyen, Hue-Anh
and Pomey, Marie-Pascale",
title="Medical Student Training in eHealth: Scoping Review",
journal="JMIR Med Educ",
year="2020",
month="Sep",
day="11",
volume="6",
number="2",
pages="e20027",
keywords="medical education",
keywords="eHealth",
keywords="digital health",
keywords="mHealth",
keywords="health apps",
keywords="telehealth",
keywords="artificial intelligence",
keywords="electronic health records",
keywords="programming",
keywords="internet of things",
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. ",
doi="10.2196/20027",
url="https://mededu.jmir.org/2020/2/e20027",
url="http://www.ncbi.nlm.nih.gov/pubmed/32915154"
}


@Article{info:doi/10.2196/19285,
author="Sapci, Hasan A.
and Sapci, Aylin H.",
title="Artificial Intelligence Education and Tools for Medical and Health Informatics Students: Systematic Review",
journal="JMIR Med Educ",
year="2020",
month="Jun",
day="30",
volume="6",
number="1",
pages="e19285",
keywords="artificial intelligence",
keywords="education",
keywords="machine learning",
keywords="deep learning",
keywords="medical education",
keywords="health informatics",
keywords="systematic review",
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. ",
doi="10.2196/19285",
url="http://mededu.jmir.org/2020/1/e19285/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32602844"
}


@Article{info:doi/10.2196/13997,
author="De Gagne, Chang Jennie
and Park, Kate Hyeyoung
and Hall, Katherine
and Woodward, Amanda
and Yamane, Sandra
and Kim, Suk Sang",
title="Microlearning in Health Professions Education: Scoping Review",
journal="JMIR Med Educ",
year="2019",
month="Jul",
day="23",
volume="5",
number="2",
pages="e13997",
keywords="online learning",
keywords="health occupations students",
keywords="mobile applications",
keywords="active learning",
keywords="distance learning",
keywords="Web 2.0",
abstract="Background: Microlearning, the acquisition of knowledge or skills in the form of small units, is endorsed by health professions educators as a means of facilitating student learning, training, and continuing education, but it is difficult to define in terms of its features and outcomes. Objective: This review aimed to conduct a systematic search of the literature on microlearning in health professions education to identify key concepts, characterize microlearning as an educational strategy, and evaluate pedagogical outcomes experienced by health professions students. Methods: A scoping review was performed using the bibliographic databases PubMed (MEDLINE), CINAHL, Education Resources Information Center, EMBASE, PsycINFO, Education Full Text (HW Wilson), and ProQuest Dissertations and Theses Global. A combination of keywords and subject headings related to microlearning, electronic learning, or just-in-time learning combined with health professions education was used. No date limits were placed on the search, but inclusion was limited to materials published in English. Pedagogical outcomes were evaluated according to the 4-level Kirkpatrick model. Results: A total of 3096 references were retrieved, of which 17 articles were selected after applying the inclusion and exclusion criteria. Articles that met the criteria were published between 2011 and 2018, and their authors were from a range of countries, including the United States, China, India, Australia, Canada, Iran, Netherlands, Taiwan, and the United Kingdom. The 17 studies reviewed included various health-related disciplines, such as medicine, nursing, pharmacy, dentistry, and allied health. Although microlearning appeared in a variety of subject areas, different technologies, such as podcast, short messaging service, microblogging, and social networking service, were also used. On the basis of Buchem and Hamelmann's 10 microlearning concepts, each study satisfied at least 40\% of the characteristics, whereas all studies featured concepts of maximum time spent less than 15 min as well as content aggregation. According to our assessment of each article using the Kirkpatrick model, 94\% (16/17) assessed student reactions to the microlearning (level 1), 82\% (14/17) evaluated knowledge or skill acquisition (level 2), 29\% (5/17) measured the effect of the microlearning on student behavior (level 3), and no studies were found at the highest level. Conclusions: Microlearning as an educational strategy has demonstrated a positive effect on the knowledge and confidence of health professions students in performing procedures, retaining knowledge, studying, and engaging in collaborative learning. However, downsides to microlearning include pedagogical discomfort, technology inequalities, and privacy concerns. Future research should look at higher-level outcomes, including benefits to patients or practice changes. The findings of this scoping review will inform education researchers, faculty, and academic administrators on the application of microlearning, pinpoint gaps in the literature, and help identify opportunities for instructional designers and subject matter experts to improve course content in didactic and clinical settings. ",
doi="10.2196/13997",
url="http://mededu.jmir.org/2019/2/e13997/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31339105"
}


@Article{info:doi/10.2196/13128,
author="de Leeuw, Robert
and de Soet, Anneloes
and van der Horst, Sabine
and Walsh, Kieran
and Westerman, Michiel
and Scheele, Fedde",
title="How We Evaluate Postgraduate Medical E-Learning: Systematic Review",
journal="JMIR Med Educ",
year="2019",
month="Apr",
day="05",
volume="5",
number="1",
pages="e13128",
keywords="distance education",
keywords="learning",
keywords="professional education",
abstract="Background: Electronic learning (e-learning) in postgraduate medical education has seen a rapid evolution; however, we tend to evaluate it only on its primary outcome or learning aim, whereas its effectiveness also depends on its instructional design. We believe it is important to have an overview of all the methods currently used to evaluate e-learning design so that the preferred method may be identified and the next steps needed to continue to evaluate postgraduate medical e-learning may be outlined. Objective: This study aimed to identify and compare the outcomes and methods used to evaluate postgraduate medical e-learning. Methods: We performed a systematic literature review using the Web of Science, PubMed, Education Resources Information Center, and Cumulative Index of Nursing and Allied Health Literature databases. Studies that used postgraduates as participants and evaluated any form of e-learning were included. Studies without any evaluation outcome (eg, just a description of e-learning) were excluded. Results: The initial search identified 5973 articles, of which we used 418 for our analysis. The types of studies were trials, prospective cohorts, case reports, and reviews. The primary outcomes of the included studies were knowledge, skills, and attitude. A total of 12 instruments were used to evaluate a specific primary outcome, such as laparoscopic skills or stress related to training. The secondary outcomes mainly evaluated satisfaction, motivation, efficiency, and usefulness. We found 13 e-learning design methods across 19 studies (4\% 19/418). The methods evaluated usability, motivational characteristics, and the use of learning styles or were based on instructional design theories, such as Gagne's instructional design, the Heidelberg inventory, Kern's curriculum development steps, and a scale based on the cognitive load theory. Finally, 2 instruments attempted to evaluate several aspects of a design, based on the experience of creating e-learning. Conclusions: Evaluating the effect of e-learning design is complicated. Given the diversity of e-learning methods, there are many ways to carry out such an evaluation, and probably, many ways to do so correctly. However, the current literature shows us that we have yet to reach any form of consensus about which indicators to evaluate. There is a great need for an evaluation tool that is properly constructed, validated, and tested. This could be a more homogeneous way to compare the effects of e-learning and for the authors of e-learning to continue to improve their product. ",
doi="10.2196/13128",
url="http://mededu.jmir.org/2019/1/e13128/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30950805"
}


@Article{info:doi/10.2196/12998,
author="Wahabi, Abdelmageed Hayfaa
and Esmaeil, Ahmed Samia
and Bahkali, Hassan Khawater
and Titi, Abdelraheim Maher
and Amer, Sami Yasser
and Fayed, Ahmed Amel
and Jamal, Amr
and Zakaria, Nasriah
and Siddiqui, Rehana Amna
and Semwal, Monika
and Car, Tudor Lorainne
and Posadzki, Paul
and Car, Josip",
title="Medical Doctors' Offline Computer-Assisted Digital Education: Systematic Review by the Digital Health Education Collaboration",
journal="J Med Internet Res",
year="2019",
month="Mar",
day="01",
volume="21",
number="3",
pages="e12998",
keywords="systematic review",
keywords="medical education, digital education",
abstract="Background: The widening gap between innovations in the medical field and the dissemination of such information to doctors may affect the quality of care. Offline computer-based digital education (OCDE) may be a potential solution to overcoming the geographical, financial, and temporal obstacles faced by doctors. Objective: The objectives of this systematic review were to evaluate the effectiveness of OCDE compared with face-to-face learning, no intervention, or other types of digital learning for improving medical doctors' knowledge, cognitive skills, and patient-related outcomes. Secondary objectives were to assess the cost-effectiveness (CE) of OCDE and any adverse effects. Methods: We searched major bibliographic databases from 1990 to August 2017 to identify relevant articles and followed the Cochrane methodology for systematic reviews of intervention. Results: Overall, 27 randomized controlled trials (RCTs), 1 cluster RCT (cRCT), and 1 quasi-RCT were included in this review. The total number of participants was 1690 in addition to the cRCT, which included 24 practices. Due to the heterogeneity of the participants, interventions, and outcomes, meta-analysis was not feasible, and the results were presented as narrative summary. Compared with face-to-face learning, the effect of OCDE on knowledge gain is uncertain (ratio of the means [RM] range 0.95-1.17; 8 studies, 495 participants; very low grade of evidence). From the same comparison, the effect of OCDE on cognitive skill gain is uncertain (RM range 0.1-0.9; 8 studies, 375 participants; very low grade of evidence). OCDE may have little or no effect on patients' outcome compared with face-to-face education (2 studies, 62 participants; low grade of evidence). Compared with no intervention, OCDE may improve knowledge gain (RM range 1.36-0.98; 4 studies, 401 participants; low grade of evidence). From the same comparison, the effect of OCDE on cognitive skill gain is uncertain (RM range 1.1-1.15; 4 trials, 495 participants; very low grade of evidence). One cRCT, involving 24 practices, investigated patients' outcome in this comparison and showed no difference between the 2 groups with low-grade evidence. Compared with text-based learning, the effect of OCDE on cognitive skills gain is uncertain (RM range 0.91-1.46; 3 trials with 4 interventions; 68 participants; very low-grade evidence). No study in this comparison investigated knowledge gain or patients' outcomes. One study assessed the CE and showed that OCDE was cost-effective when compared with face-to-face learning if the cost is less than or equal to Can \$200. No trial evaluated the adverse effect of OCDE. Conclusions: The effect of OCDE compared with other methods of education on medical doctors' knowledge and cognitive skill gain is uncertain. OCDE may improve doctors' knowledge compared with no intervention but its effect on doctors' cognitive skills is uncertain. OCDE may have little or no effect in improving patients' outcome. ",
doi="10.2196/12998",
url="https://www.jmir.org/2019/3/e12998/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30821689"
}


@Article{info:doi/10.2196/12945,
author="Tudor Car, Lorainne
and Kyaw, Myint Bhone
and Dunleavy, Gerard
and Smart, A. Neil
and Semwal, Monika
and Rotgans, I. Jerome
and Low-Beer, Naomi
and Campbell, James",
title="Digital Problem-Based Learning in Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration",
journal="J Med Internet Res",
year="2019",
month="Feb",
day="28",
volume="21",
number="2",
pages="e12945",
keywords="randomized controlled trials",
keywords="effectiveness",
keywords="systematic review",
keywords="problem-based learning",
keywords="medical education",
abstract="Background: The use of digital education in problem-based learning, or digital problem-based learning (DPBL), is increasingly employed in health professions education. DPBL includes purely digitally delivered as well as blended problem-based learning, wherein digital and face-to-face learning are combined. Objective: The aim of this review is to evaluate the effectiveness of DPBL in improving health professionals' knowledge, skills, attitudes, and satisfaction. Methods: We used the gold-standard Cochrane methods to conduct a systematic review of randomized controlled trials (RCTs). We included studies that compared the effectiveness of DPBL with traditional learning methods or other forms of digital education in improving health professionals' knowledge, skills, attitudes, and satisfaction. Two authors independently screened studies, extracted data, and assessed the risk of bias. We contacted study authors for additional information, if necessary. We used the random-effects model in the meta-analyses. Results: Nine RCTs involving 890 preregistration health professionals were included. Digital technology was mostly employed for presentation of problems. In three studies, PBL was delivered fully online. Digital technology modalities spanned online learning, offline learning, virtual reality, and virtual patients. The control groups consisted of traditional PBL and traditional learning. The pooled analysis of seven studies comparing the effect of DPBL and traditional PBL reported little or no difference in postintervention knowledge outcomes (standardized mean difference [SMD] 0.19, 95\% CI 0.00-0.38). The pooled analysis of three studies comparing the effect of DPBL to traditional learning on postintervention knowledge outcomes favored DPBL (SMD 0.67, 95\% CI 0.14-1.19). For skill development, the pooled analysis of two studies comparing DPBL to traditional PBL favored DPBL (SMD 0.30, 95\% CI 0.07-0.54). Findings on attitudes and satisfaction outcomes were mixed. The included studies mostly had an unclear risk of bias. Conclusions: Our findings suggest that DPBL is as effective as traditional PBL and more effective than traditional learning in improving knowledge. DPBL may be more effective than traditional learning or traditional PBL in improving skills. Further studies should evaluate the use of digital technology for the delivery of other PBL components as well as PBL overall. ",
doi="10.2196/12945",
url="https://www.jmir.org/2019/2/e12945/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30816846"
}


@Article{info:doi/10.2196/jmir.9085,
author="Nicoll, Pam
and MacRury, Sandra
and van Woerden, C. Hugo
and Smyth, Keith",
title="Evaluation of Technology-Enhanced Learning Programs for Health Care Professionals: Systematic Review",
journal="J Med Internet Res",
year="2018",
month="Apr",
day="11",
volume="20",
number="4",
pages="e131",
keywords="technology-enhanced learning",
keywords="evaluation",
keywords="e-learning",
keywords="blended learning",
keywords="digital learning",
keywords="program evaluation",
keywords="effectiveness",
abstract="Background: Technology-enhanced learning (TEL) programs are increasingly seen as the way in which education for health care professionals can be transformed, giving access to effective ongoing learning and training even where time or geographical barriers exist. Given the increasing emphasis on this mode of educational support for health care practitioners, it is vital that we can effectively evaluate and measure impact to ensure that TEL programs are effective and fit for purpose. This paper examines the current evidence base for the first time, in relation to the evaluation of TEL programs for health care professionals. Objective: We conducted a systematic review of the current literature relating to the evaluation of TEL programs for health care professionals and critically appraised the quality of the studies. Methods: This review employed specific search criteria to identify research studies that included evaluation of TEL for health care professionals. The databases searched included Medline Ovid, Cumulative Index of Nursing and Allied Health Literature Plus Advanced, Applied Social Sciences Index and Abstracts, ZETOC, Institute of Electrical and Electronics Engineers Explore Digital Library, Allied and Complementary Medicine, and Education Resources Information Center between January 2006 and January 2017. An additional hand search for relevant articles from reference lists was undertaken. Each of the studies identified was critically appraised for quality using the Crowe Critical Appraisal Tool. This approach produced a percentage total score for each study across specified categories. A proportion of the studies were independently assessed by an additional two reviewers. Results: The review identified 21 studies that met the inclusion criteria. The studies included scored totals across eight categories within a range of 37\%-95\% and an average score of 68\%. Studies that measured TEL using learner satisfaction surveys, or combined pretest and posttest knowledge score testing with learner satisfaction surveys, were found to be the most common types of TEL evaluations evident in the literature. The studies reviewed had low scores across reporting on ethical matters, design, and data collection categories. Conclusions: There continues to be a need to develop effective and standard TEL evaluation tools, and good quality studies that describe effective evaluation of TEL education for health care professionals. Studies often fail to provide sufficient detail to support transferability or direct future TEL health care education programs. ",
doi="10.2196/jmir.9085",
url="http://www.jmir.org/2018/4/e131/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29643049"
}


@Article{info:doi/10.2196/mededu.6288,
author="De Angelis, Gino
and Davies, Barbara
and King, Judy
and McEwan, Jessica
and Cavallo, Sabrina
and Loew, Laurianne
and Wells, A. George
and Brosseau, Lucie",
title="Information and Communication Technologies for the Dissemination of Clinical Practice Guidelines to Health Professionals: A Systematic Review",
journal="JMIR Med Educ",
year="2016",
month="Nov",
day="30",
volume="2",
number="2",
pages="e16",
keywords="health information technologies",
keywords="electronic mail",
keywords="email",
keywords="Web 2.0",
keywords="practice guidelines",
keywords="health professions",
keywords="information dissemination",
abstract="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. ",
doi="10.2196/mededu.6288",
url="http://mededu.jmir.org/2016/2/e16/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27903488"
}


@Article{info:doi/10.2196/jmir.5461,
author="Taveira-Gomes, Tiago
and Ferreira, Patr{\'i}cia
and Taveira-Gomes, Isabel
and Severo, Milton
and Ferreira, Am{\'e}lia Maria",
title="What Are We Looking for in Computer-Based Learning Interventions in Medical Education? A Systematic Review",
journal="J Med Internet Res",
year="2016",
month="Aug",
day="01",
volume="18",
number="8",
pages="e204",
keywords="medical education",
keywords="internet-based learning",
keywords="computer-based learning",
keywords="e-learning",
keywords="b-learning",
keywords="systematic review",
abstract="Background: Computer-based learning (CBL) has been widely used in medical education, and reports regarding its usage and effectiveness have ranged broadly. Most work has been done on the effectiveness of CBL approaches versus traditional methods, and little has been done on the comparative effects of CBL versus CBL methodologies. These findings urged other authors to recommend such studies in hopes of improving knowledge about which CBL methods work best in which settings. Objective: In this systematic review, we aimed to characterize recent studies of the development of software platforms and interventions in medical education, search for common points among studies, and assess whether recommendations for CBL research are being taken into consideration. Methods: We conducted a systematic review of the literature published from 2003 through 2013. We included studies written in English, specifically in medical education, regarding either the development of instructional software or interventions using instructional software, during training or practice, that reported learner attitudes, satisfaction, knowledge, skills, or software usage. We conducted 2 latent class analyses to group articles according to platform features and intervention characteristics. In addition, we analyzed references and citations for abstracted articles. Results: We analyzed 251 articles. The number of publications rose over time, and they encompassed most medical disciplines, learning settings, and training levels, totaling 25 different platforms specifically for medical education. We uncovered 4 latent classes for educational software, characteristically making use of multimedia (115/251, 45.8\%), text (64/251, 25.5\%), Web conferencing (54/251, 21.5\%), and instructional design principles (18/251, 7.2\%). We found 3 classes for intervention outcomes: knowledge and attitudes (175/212, 82.6\%), knowledge, attitudes, and skills (11.8\%), and online activity (12/212, 5.7\%). About a quarter of the articles (58/227, 25.6\%) did not hold references or citations in common with other articles. The number of common references and citations increased in articles reporting instructional design principles (P=.03), articles measuring online activities (P=.01), and articles citing a review by Cook and colleagues on CBL (P=.04). There was an association between number of citations and studies comparing CBL versus CBL, independent of publication date (P=.02). Conclusions: Studies in this field vary highly, and a high number of software systems are being developed. It seems that past recommendations regarding CBL interventions are being taken into consideration. A move into a more student-centered model, a focus on implementing reusable software platforms for specific learning contexts, and the analysis of online activity to track and predict outcomes are relevant areas for future research in this field. ",
doi="10.2196/jmir.5461",
url="http://www.jmir.org/2016/8/e204/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27480053"
}


@Article{info:doi/10.2196/mededu.5515,
author="Hamann, Claus
and Martelon, MaryKate",
title="Branding Asklepios and the Traditional and Variant Serpent Symbol Display Among Health Professional Schools in the United States, Puerto Rico, and Canada: A Cross-Sectional Survey",
journal="JMIR Medical Education",
year="2016",
month="May",
day="25",
volume="2",
number="1",
pages="e6",
keywords="caduceus",
keywords="emblems",
keywords="insigne",
keywords="insignia",
keywords="history of medicine",
keywords="history",
keywords="humanities",
keywords="Asklepios",
keywords="Asclepius",
keywords="medical symbol",
abstract="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. ",
doi="10.2196/mededu.5515",
url="http://mededu.jmir.org/2016/1/e6/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27731851"
}


@Article{info:doi/10.2196/jmir.4807,
author="Liu, Qian
and Peng, Weijun
and Zhang, Fan
and Hu, Rong
and Li, Yingxue
and Yan, Weirong",
title="The Effectiveness of Blended Learning in Health Professions: Systematic Review and Meta-Analysis",
journal="J Med Internet Res",
year="2016",
month="Jan",
day="04",
volume="18",
number="1",
pages="e2",
keywords="blended learning",
keywords="effectiveness",
keywords="knowledge",
keywords="health professions",
keywords="meta-analysis",
abstract="Background: Blended learning, defined as the combination of traditional face-to-face learning and asynchronous or synchronous e-learning, has grown rapidly and is now widely used in education. Concerns about the effectiveness of blended learning have led to an increasing number of studies on this topic. However, there has yet to be a quantitative synthesis evaluating the effectiveness of blended learning on knowledge acquisition in health professions. Objective: We aimed to assess the effectiveness of blended learning for health professional learners compared with no intervention and with nonblended learning. We also aimed to explore factors that could explain differences in learning effects across study designs, participants, country socioeconomic status, intervention durations, randomization, and quality score for each of these questions. Methods: We conducted a search of citations in Medline, CINAHL, Science Direct, Ovid Embase, Web of Science, CENTRAL, and ERIC through September 2014. Studies in any language that compared blended learning with no intervention or nonblended learning among health professional learners and assessed knowledge acquisition were included. Two reviewers independently evaluated study quality and abstracted information including characteristics of learners and intervention (study design, exercises, interactivity, peer discussion, and outcome assessment). Results: We identified 56 eligible articles. Heterogeneity across studies was large (I2 ?93.3) in all analyses. For studies comparing knowledge gained from blended learning versus no intervention, the pooled effect size was 1.40 (95\% CI 1.04-1.77; P<.001; n=20 interventions) with no significant publication bias, and exclusion of any single study did not change the overall result. For studies comparing blended learning with nonblended learning (pure e-learning or pure traditional face-to-face learning), the pooled effect size was 0.81 (95\% CI 0.57-1.05; P<.001; n=56 interventions), and exclusion of any single study did not change the overall result. Although significant publication bias was found, the trim and fill method showed that the effect size changed to 0.26 (95\% CI -0.01 to 0.54) after adjustment. In the subgroup analyses, pre-posttest study design, presence of exercises, and objective outcome assessment yielded larger effect sizes. Conclusions: Blended learning appears to have a consistent positive effect in comparison with no intervention, and to be more effective than or at least as effective as nonblended instruction for knowledge acquisition in health professions. Due to the large heterogeneity, the conclusion should be treated with caution. ",
doi="10.2196/jmir.4807",
url="http://www.jmir.org/2016/1/e2/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26729058"
}