@Article{info:doi/10.2196/72998, author="Zhang, Manlin and Zhao, Tianyu", title="Citation Accuracy Challenges Posed by Large Language Models", journal="JMIR Med Educ", year="2025", month="Apr", day="2", volume="11", pages="e72998", keywords="chatGPT", keywords="medical education", keywords="Saudi Arabia", keywords="perceptions", keywords="knowledge", keywords="medical students", keywords="faculty", keywords="chatbot", keywords="qualitative study", keywords="artificial intelligence", keywords="AI", keywords="AI-based tools", keywords="universities", keywords="thematic analysis", keywords="learning", keywords="satisfaction", keywords="LLM", keywords="large language model", doi="10.2196/72998", url="https://mededu.jmir.org/2025/1/e72998" } @Article{info:doi/10.2196/73698, author="Temsah, Mohamad-Hani and Al-Eyadhy, Ayman and Jamal, Amr and Alhasan, Khalid and Malki, H. Khalid", title="Authors' Reply: Citation Accuracy Challenges Posed by Large Language Models", journal="JMIR Med Educ", year="2025", month="Apr", day="2", volume="11", pages="e73698", keywords="ChatGPT", keywords="Gemini", keywords="DeepSeek", keywords="medical education", keywords="AI", keywords="artificial intelligence", keywords="Saudi Arabia", keywords="perceptions", keywords="medical students", keywords="faculty", keywords="LLM", keywords="chatbot", keywords="qualitative study", keywords="thematic analysis", keywords="satisfaction", keywords="RAG retrieval-augmented generation", doi="10.2196/73698", url="https://mededu.jmir.org/2025/1/e73698" } @Article{info:doi/10.2196/65779, author="Muthukumar, Radhakrishnan and Thepwongsa, Isaraporn and Sripa, Poompong and Jindawong, Bangonsri and Jenwitheesuk, Kamonwan and Virasiri, Surapol", title="Preclinical Medical Students' Perspectives and Experiences With Structured Web-Based English for Medical Purposes Courses: Cross-Sectional Study", journal="JMIR Med Educ", year="2025", month="Mar", day="27", volume="11", pages="e65779", keywords="English for medical purposes", keywords="online course", keywords="online learning", keywords="online education", keywords="medical students", keywords="medical school", keywords="online", keywords="online learners", keywords="perspectives", keywords="English", keywords="English language", keywords="medical research", keywords="educational method", keywords="lesson", keywords="course", keywords="instructional designs", keywords="English for medical professional", keywords="EMP", keywords="barriers", keywords="web-based", abstract="Background: English for medical purposes (EMP) is essential for medical students as it serves as a foundational language for medical communication and education. However, students often undervalue its importance within the medical curriculum. Given their demanding schedules and workload, educational methods for EMP must align with their needs. Structured web-based learning offers flexibility and convenience, yet limited research has explored its exclusive application for EMP in undergraduate medical education. Objective: This study aimed to evaluate medical students' perspectives on structured web-based EMP courses and assess their impact on medical English proficiency using objective and subjective measures. Methods: Structured web-based EMP courses were developed based on evidence-based guidelines, addressing barriers to web-based learning during development and implementation. A cross-sectional study was conducted with 535 medical students who completed these courses. Data were collected via questionnaires, the learning management system, and the Khon Kaen University Medical English Test (KKUMET), which assessed proficiency in listening, reading, writing, and speaking. Data were analyzed using descriptive statistics. Results: Of the 535 students, 452 (84.5\%) completed the survey. Participants reported confidence in reading (mean 4.11, SD 0.87), vocabulary (mean 4.04, SD 0.84), and listening skills (mean 4, SD 0.89), but lower confidence in writing skills (mean 3.46, SD 1.07). The KKUMET results showed statistically significant improvements in all 4 language skills after course completion (P<.001). The top-rated benefits of the courses were convenience (mean 4.77, SD 0.59), sufficient instruction (mean 4.5, SD 0.85), and clear content (mean 4.41, SD 0.80). Conclusions: Structured web-based EMP courses are relevant and well received by medical students. These courses significantly improve students' medical English proficiency, as evidenced by both subjective feedback and objective measures. Medical educators should consider integrating structured web-based EMP programs to better support students' language proficiency in medical contexts. ", doi="10.2196/65779", url="https://mededu.jmir.org/2025/1/e65779" } @Article{info:doi/10.2196/57821, author="Govender, Samantha and Cochrane, Elizabeth Maria and Mogale, Mabina and Gordon, Reno and Tshephe, Tjodwapi", title="Establishing a Digital Health Care Ecosystem in a Health Sciences University in South Africa: Protocol for a Mixed Methods Study", journal="JMIR Res Protoc", year="2025", month="Mar", day="25", volume="14", pages="e57821", keywords="health sciences", keywords="digital ecosystem", keywords="curriculum", keywords="community engagement", keywords="tertiary education institutions", abstract="Background: Comprehensive and formalized digital health care ecosystems in health sciences tertiary education in South Africa do not currently exist, but they have the potential to influence teaching and learning, research, and community engagement. Objective: A total of 3 key objectives underpin the study, that is, determining the health care curriculum needs and required content for the development of a formalized digital health ecosystem, determining the level of readiness of staff and students to participate in a digital health care ecosystem, and determining whether community engagement and strategic partnerships can contribute to the sustainability of a digital health care ecosystem. Methods: A multipronged approach will be used to address the objectives, with a mixed methods design being undertaken. The qualitative phases will be phenomenological in nature, and triangulation of information along with thematic analysis will be conducted on the collected data. Quantitative data will be collected prospectively and cross-sectionally and analyzed using descriptive analysis. Sampling will include subject experts for the Delphi technique, staff and students at the University, clinical training and education partners, and community leaders. This study has received ethical approval from the Sefako Makgatho Health Sciences University Research and Ethics Committee (SMUREC/H/260/2023:PG). Results: Data collection for the first phase will begin in January 2024 and conclude in December 2024. Phase 2 and 3 of the study will be conducted concurrently, with data collection starting in January 2025 and concluding in December 2026. Conclusions: The establishment of a digital health care ecosystem has the potential to benefit staff, students, and communities through stakeholder collaboration, educational opportunities, research projects, and improved service delivery. International Registered Report Identifier (IRRID): DERR1-10.2196/57821 ", doi="10.2196/57821", url="https://www.researchprotocols.org/2025/1/e57821" } @Article{info:doi/10.2196/60075, author="Karunaratne, Dilroshini and Whittock, Jessica and Moore, Amber and Dasigan, Krishna and Chevolleau, Jasmine and Bartholomew, Brent and Kelly, Nikki and Cohen, E. Charlotte", title="Exploring the Use of an Augmented Reality Device Learning Tool for Multidisciplinary Staff Training on Domestic Abuse and Sexual Violence: Postintervention Qualitative Evaluation", journal="JMIR Form Res", year="2025", month="Mar", day="19", volume="9", pages="e60075", keywords="augmented reality", keywords="virtual reality", keywords="medical technology", keywords="domestic abuse", keywords="sexual violence", keywords="medical education", keywords="training", keywords="domestic violence", keywords="violence", keywords="assault", keywords="victim", keywords="survivor-centered", keywords="staff", keywords="community stakeholders", keywords="social care", keywords="innovation", abstract="Background: Legislative policies published by National Health Service, England and the UK Government focus on prioritizing the creation of a stronger system. These frameworks emphasize on the improvement of health care staff's ability to identify and refer domestic abuse (DA) survivors as key areas for supporting workforce development. Health care staff are often the first professional contact of survivors of DA, and insufficient staff training is a key barrier to survivors being identified and directed to support. The Microsoft HoloLens2 is a mixed-reality headset that allows virtual objects (holograms) to be integrated into the real world. Mixed-reality headsets are being increasingly used within medical education and have the advantage of independent operation, reducing the staffing requirements for teaching. The HoloLens2 can be used to project HoloPatients (HPs), which resemble clinically unwell patients, into the classroom. Two of these HPs have been specifically designed to portray survivors of DA and sexual violence (SV). Objective: This study explored potential uses of the HP in DA and SV training as a potential survivor-centered educational initiative that could be used as an adjunct to existing training for health care professionals and community sector workers. Methods: Frontline staff and community stakeholders from the national health service, DA, and law enforcement sectors were invited on 3 separate occasions (n=14, 12, 22) to a HoloLens2 demonstration that displayed 9 HPs. The patient voice was to be outlined by personalized scripts, co-created alongside sector charities, ensuring survivor engagement and participation. Participants were given the opportunity to wear the headset and familiarize themselves with the technology during the sessions. A post-intervention evaluation research model was used to explore the feasibility and functionality of the HP as an educational tool. Results: Thematic analysis described the HP as a ``realistic,'' ``adjustable'' tool that ``creates a safe learning environment.'' Participants suggested it could be useful in ``pre-exposure preparation'' by ``improving communication'' and allowing different approaches to be trialed in a safe environment. The use of survivor scripts was described as a useful tool to ``bring the survivor into the learning space'' in a safe way. Participants identified the HP as a suitable tool for workers inside and outside health care, including social sectors such as law enforcement (32\%). Conclusions: The HP acts as a low-risk, adaptable tool for trainees to develop skills in a safe environment. This study demonstrates that professionals perceived the HoloLens as an innovative means to amplify the lived experience voice. Further research will evaluate this additional impact on trainees' confidence and responses to survivors disclosing DA and SV within different disciplines to drive improved outcomes. Trial Registration: Permission to conduct this study granted by the Research Innovation and Quality Improvement Team at Chelsea and Westminster NHS Foundation Trust ", doi="10.2196/60075", url="https://formative.jmir.org/2025/1/e60075" } @Article{info:doi/10.2196/65859, author="Turvey, Jake and Raggatt, Michelle and Wright, C. Cassandra J. and Davis, C. Angela and Temple-Smith, J. Meredith and Lim, C. Megan S.", title="A Digital Pornography Education Prototype Co-Designed With Young People: Formative Evaluation", journal="JMIR Form Res", year="2025", month="Mar", day="4", volume="9", pages="e65859", keywords="pornography", keywords="education", keywords="website", keywords="prototyping", keywords="evaluation", keywords="sexual health", keywords="sexual wellbeing", keywords="pornography literacy", keywords="young people", keywords="youth", keywords="adolescents", keywords="The Gist", keywords="sexual education", keywords="Australia", keywords="efficacy", keywords="digital health", keywords="co-design", abstract="Background: Interventions to help young people make sense of sex and relationships in the context of widely available pornography are becoming increasingly supported in school settings. However, young people who experience disruptions to their education often have less access to such programs. Digital platforms may offer a more accessible method to deliver tailored sexual health and pornography literacy to young people who are disengaged from mainstream schooling, or who experience other types of structural disadvantage. Objective: This study aimed to describe the formative evaluation of ``The Gist'' a co-designed online sexual health education and pornography literacy prototype designed to meet the sexual health information needs of structurally marginalized young people in Australia. Methods: We conducted iterative workshops with 33 young people aged between 15 and 24 years recruited from an alternative education school in Melbourne, Australia. Through interactive activities, participants evaluated the overall prototype design, including its usability, desirability, inclusiveness, and potential for impact. Results: Participants reported The Gist to be easy to use (17/20, 85\%) and safe (19/23, 83\%), with ``hot'' branding (25/30, 83\%). However, perceived content relevance was dependent on the participants' existing level of sexual health knowledge and experience, with only 31\% (7/23) agreeing that ``The Gist feels like it was made for me.'' The interactive learning activities such as the debunked (myth-busting) and quiz features were among the most used and well-liked on The Gist platform. Low unprompted engagement with the prototype outside of facilitated workshop settings also confirmed previous researcher postulations that The Gist as a standalone digital platform is unlikely to meet the needs of this population group. Further design refinements are needed to improve user experience, including more interactive activities and visual information in place of heavily text-based features. Conclusions: This study provides important insights into the design and sexual health information needs of structurally marginalized young people. Further research is needed to assess the overall efficacy of The Gist prototype, as well as its ability to positively influence young people's sexual attitudes, beliefs, and behaviors. Future iterations should consider hybrid or face-to-face delivery models to better capture student engagement. ", doi="10.2196/65859", url="https://formative.jmir.org/2025/1/e65859" } @Article{info:doi/10.2196/63312, author="Borg, Alexander and Georg, Carina and Jobs, Benjamin and Huss, Viking and Waldenlind, Kristin and Ruiz, Mini and Edelbring, Samuel and Skantze, Gabriel and Parodis, Ioannis", title="Virtual Patient Simulations Using Social Robotics Combined With Large Language Models for Clinical Reasoning Training in Medical Education: Mixed Methods Study", journal="J Med Internet Res", year="2025", month="Mar", day="3", volume="27", pages="e63312", keywords="virtual patients", keywords="clinical reasoning", keywords="large language models", keywords="social robotics", keywords="medical education", keywords="sustainable learning", keywords="medical students", abstract="Background: Virtual patients (VPs) are computer-based simulations of clinical scenarios used in health professions education to address various learning outcomes, including clinical reasoning (CR). CR is a crucial skill for health care practitioners, and its inadequacy can compromise patient safety. Recent advancements in large language models (LLMs) and social robots have introduced new possibilities for enhancing VP interactivity and realism. However, their application in VP simulations has been limited, and no studies have investigated the effectiveness of combining LLMs with social robots for CR training. Objective: The aim of the study is to explore the potential added value of a social robotic VP platform combined with an LLM compared to a conventional computer-based VP modality for CR training of medical students. Methods: A Swedish explorative proof-of-concept study was conducted between May and July 2023, combining quantitative and qualitative methodology. In total, 15 medical students from Karolinska Institutet and an international exchange program completed a VP case in a social robotic platform and a computer-based semilinear platform. Students' self-perceived VP experience focusing on CR training was assessed using a previously developed index, and paired 2-tailed t test was used to compare mean scores (scales from 1 to 5) between the platforms. Moreover, in-depth interviews were conducted with 8 medical students. Results: The social robotic platform was perceived as more authentic (mean 4.5, SD 0.7 vs mean 3.9, SD 0.5; odds ratio [OR] 2.9, 95\% CI 0.0-1.0; P=.04) and provided a beneficial overall learning effect (mean 4.4, SD 0.6 versus mean 4.1, SD 0.6; OR 3.7, 95\% CI 0.1-0.5; P=.01) compared with the computer-based platform. Qualitative analysis revealed 4 themes, wherein students experienced the social robot as superior to the computer-based platform in training CR, communication, and emotional skills. Limitations related to technical and user-related aspects were identified, and suggestions for improvements included enhanced facial expressions and VP cases simulating multiple personalities. Conclusions: A social robotic platform enhanced by an LLM may provide an authentic and engaging learning experience for medical students in the context of VP simulations for training CR. Beyond its limitations, several aspects of potential improvement were identified for the social robotic platform, lending promise for this technology as a means toward the attainment of learning outcomes within medical education curricula. ", doi="10.2196/63312", url="https://www.jmir.org/2025/1/e63312", url="http://www.ncbi.nlm.nih.gov/pubmed/40053778" } @Article{info:doi/10.2196/63400, author="Abouammoh, Noura and Alhasan, Khalid and Aljamaan, Fadi and Raina, Rupesh and Malki, H. Khalid and Altamimi, Ibraheem and Muaygil, Ruaim and Wahabi, Hayfaa and Jamal, Amr and Alhaboob, Ali and Assiri, Assad Rasha and Al-Tawfiq, A. Jaffar and Al-Eyadhy, Ayman and Soliman, Mona and Temsah, Mohamad-Hani", title="Perceptions and Earliest Experiences of Medical Students and Faculty With ChatGPT in Medical Education: Qualitative Study", journal="JMIR Med Educ", year="2025", month="Feb", day="20", volume="11", pages="e63400", keywords="ChatGPT", keywords="medical education", keywords="Saudi Arabia", keywords="perceptions", keywords="knowledge", keywords="medical students", keywords="faculty", keywords="chatbot", keywords="qualitative study", keywords="artificial intelligence", keywords="AI", keywords="AI-based tools", keywords="universities", keywords="thematic analysis", keywords="learning", keywords="satisfaction", abstract="Background: With the rapid development of artificial intelligence technologies, there is a growing interest in the potential use of artificial intelligence--based tools like ChatGPT in medical education. However, there is limited research on the initial perceptions and experiences of faculty and students with ChatGPT, particularly in Saudi Arabia. Objective: This study aimed to explore the earliest knowledge, perceived benefits, concerns, and limitations of using ChatGPT in medical education among faculty and students at a leading Saudi Arabian university. Methods: A qualitative exploratory study was conducted in April 2023, involving focused meetings with medical faculty and students with varying levels of ChatGPT experience. A thematic analysis was used to identify key themes and subthemes emerging from the discussions. Results: Participants demonstrated good knowledge of ChatGPT and its functions. The main themes were perceptions of ChatGPT use, potential benefits, and concerns about ChatGPT in research and medical education. The perceived benefits included collecting and summarizing information and saving time and effort. However, concerns and limitations centered around the potential lack of critical thinking in the information provided, the ambiguity of references, limitations of access, trust in the output of ChatGPT, and ethical concerns. Conclusions: This study provides valuable insights into the perceptions and experiences of medical faculty and students regarding the use of newly introduced large language models like ChatGPT in medical education. While the benefits of ChatGPT were recognized, participants also expressed concerns and limitations requiring further studies for effective integration into medical education, exploring the impact of ChatGPT on learning outcomes, student and faculty satisfaction, and the development of critical thinking skills. ", doi="10.2196/63400", url="https://mededu.jmir.org/2025/1/e63400", url="http://www.ncbi.nlm.nih.gov/pubmed/39977012" } @Article{info:doi/10.2196/58744, author="Stenseth, Vistven Hege and Steindal, A. Simen and Solberg, Trygg Marianne and {\O}lnes, Alexandra Mia and S{\o}rensen, Lene Anne and Strandell-Laine, Camilla and Olaussen, Camilla and Farsj{\o} Aure, Caroline and Pedersen, Ingunn and Zlamal, Jaroslav and Gue Martini, Jussara and Bresolin, Paula and Linnerud, Wang Silje Christin and Nes, Gon{\c{c}}alves Andr{\'e}a Aparecida", title="Simulation-Based Learning Supported by Technology to Enhance Critical Thinking in Nursing Students: Scoping Review", journal="J Med Internet Res", year="2025", month="Feb", day="18", volume="27", pages="e58744", keywords="critical thinking", keywords="simulation-based learning", keywords="technologically supported simulation-based learning", keywords="nursing education", keywords="nursing students", keywords="review", abstract="Background: Critical thinking is a crucial skill in the nursing profession and must be fostered through nursing education. Simulation-based learning (SBL) with technological modalities is a pedagogical approach to enhance critical thinking skills for nursing students. The use of technology in SBL to achieve critical thinking skills is diverse. No previous scoping review has systematically mapped studies on SBL supported by technology to enhance critical thinking in nursing students. Objective: This scoping review aimed to systematically map research on the use of SBL supported by technology to enhance critical thinking in nursing students. Methods: This scoping review was conducted according to the framework by Arksey and O'Malley and was reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A systematic, comprehensive literature search was performed in the LILACS, ERIC, MEDLINE, Embase, PsycINFO, and Web of Science databases in 2021 and repeated in 2023 and 2024. Pairs of authors independently assessed titles, abstracts, and full-text papers and extracted data from the included studies. The data underwent summative and thematic analysis and were categorized according to the findings. Results: In total, 4 main categories of technology applied in SBL were identified: computer-based simulations, human-patient simulators, virtual reality or immersive virtual reality, and others. The findings revealed a shift across time in the technology used for SBL to enhance critical thinking, from human patient simulators to computer-based simulations. A dominant part of the included studies published after 2018 (21/44, 48\%) incorporated a combination of asynchronous and synchronous learning activities. The theoretical foundation of the studies revealed a range of scientific theories and conceptual frameworks and models. Enablers of or barriers to the enhancement of critical thinking skills in nursing students were identified within the following themes: affinity for and availability of technology, realism, accessibility, engagement and motivation, validation, return on investment, and enhanced critical thinking through SBL using technology. Conclusions: There has been a noticeable shift in the technology and use of technology in SBL. Descriptions of the applied technology and pedagogical considerations are pivotal for comparing or synthesizing research results. There has been a trend toward a blended educational approach combining synchronous and asynchronous learning activities. User technological proficiency and the perceived quality of the technology are imperative in the development of critical thinking. Realism, engagement, and motivation play pivotal roles in the enhancement of critical thinking in technologically supported SBL. The establishment of robust theoretical foundations of research and standardized research practices will strengthen the evidence obtained from the research conducted. ", doi="10.2196/58744", url="https://www.jmir.org/2025/1/e58744" } @Article{info:doi/10.2196/63708, author="Davoody, Nadia and Stathakarou, Natalia and Swain, Cara and Bonacina, Stefano", title="Exploring the Impact of the COVID-19 Pandemic on Learning Experience, Mental Health, Adaptability, and Resilience Among Health Informatics Master's Students: Focus Group Study", journal="JMIR Med Educ", year="2025", month="Feb", day="10", volume="11", pages="e63708", keywords="COVID-19 pandemic", keywords="eHealth", keywords="blended learning", keywords="health informatics", keywords="higher education adaptation", abstract="Background: The shift to online education due to the COVID-19 pandemic posed significant challenges and opportunities for students, affecting their academic performance, mental well-being, and engagement. Objective: This study aimed to explore the overall learning experience among health informatics master's students at Karolinska Institutet, Sweden, and the strategies they used to overcome learning challenges posed by the COVID-19 pandemic. Methods: Through 3 structured focus groups, this study explored health informatics master's students' experiences of shifting learning environments for classes that started in 2019, 2020, and 2021. All focus group sessions were recorded and transcribed verbatim. Inductive content analysis was used to analyze the data. Results: The results highlight the benefits of increased autonomy and flexibility and identify challenges such as technical difficulties, diminished social interactions, and psychological impacts. This study underscores the importance of effective online educational strategies, technological preparedness, and support systems to enhance student learning experiences during emergencies. The findings of this study highlight implications for educators, students, and higher education institutions to embrace adaptation and foster innovation. Implications for educators, students, and higher education institutions include the need for educators to stay current with the latest educational technologies and design teaching strategies and pedagogical approaches suited to both online and in-person settings to effectively foster student engagement. Students must be informed about the technological requirements for online learning and adequately prepared to meet them. Institutions play a critical role in ensuring equitable access to technology, guiding and supporting educators in adopting innovative tools and methods, and offering mental health resources to assist students in overcoming the challenges of evolving educational environments. Conclusions: This research contributes to understanding the complexities of transitioning to online learning in urgent circumstances and offers insights for better preparing educational institutions for future pandemics. ", doi="10.2196/63708", url="https://mededu.jmir.org/2025/1/e63708" } @Article{info:doi/10.2196/63449, author="Hsu, Wan-Chen", title="eHealth Literacy and Cyberchondria Severity Among Undergraduate Students: Mixed Methods Study", journal="JMIR Form Res", year="2025", month="Feb", day="3", volume="9", pages="e63449", keywords="eHealth literacy", keywords="undergraduate student", keywords="cyberchondria", keywords="compucondria", keywords="web-based health information", keywords="health information seeking", keywords="college students", abstract="Background: With the development of the internet, health care websites have become increasingly important by enabling easy access to health information, thereby influencing the attitudes and behaviors of individuals toward health issues. However, few studies have addressed public access to health information and self-diagnosis. Objective: This study investigated the background factors and status of cyberchondria severity among college students by conducting a nationwide sample survey using the Cyberchondria Severity Scale. Further, we explored the perspective of eHealth literacy of those with scores higher than 1 SD from the mean by analyzing their recent experiences using web-based health information. Methods: A nationally representative sample of college students was surveyed, and 802 valid responses were obtained (male: 435/802, 54.2\%; female: 367/802, 45.8\%; mean age 20.3, SD 1.4 years). The Cyberchondria Severity Scale was used, which consisted of 4 dimensions (increased anxiety, obsessive-compulsive hypochondria, perceived controllability, and web-based physician-patient interaction). Additionally, we recruited 9 volunteers who scored more than 1 SD above the mean for in-depth interviews on their web-based health information--seeking behaviors. Results: Significant differences were found across the 4 dimensions of cyberchondria severity (F3,2403=256.26; P<.001), with perceived controllability scoring the highest (mean 2.75, SD 0.87) and obsessive-compulsive hypochondria scoring the lowest (mean 2.19, SD 0.77). Positive correlations were observed between perceived controllability, web-based physician-patient interactions, increased anxiety, and obsessive-compulsive hypochondria (r=0.46-0.75, P<.001). Regression analysis indicated that health concern significantly predicted perceived controllability ($\beta$ coefficient=0.12; P<.05) and web-based physician-patient interaction ($\beta$ coefficient=0.16; P<.001). Interview data revealed that students often experienced heightened anxiety (8/9, 89\%) and stress (7/9, 78\%) after exposure to web-based health information, highlighting the need for improved health literacy and reliable information sources. Conclusions: The study identified both benefits and risks in college students' use of web-based health information, emphasizing the importance of critical consciousness and eHealth literacy. Future research should examine how college students move from self-awareness to actionable change and the development of critical health literacy, which are essential for effective digital health engagement. ", doi="10.2196/63449", url="https://formative.jmir.org/2025/1/e63449" } @Article{info:doi/10.2196/54167, author="Levites Strekalova, A. Yulia and Liu-Galvin, Rachel and Border, Samuel and Midence, Sara and Khan, Mishal and VanZanten, Maya and Tomaszewski, John and Jain, Sanjay and Sarder, Pinaki", title="Summer Research Internship Curriculum to Promote Self-Efficacy, Researcher Identity, and Peer-to-Peer Learning: Retrospective Cohort Study", journal="JMIR Form Res", year="2025", month="Feb", day="3", volume="9", pages="e54167", keywords="artificial intelligence", keywords="biomedical research", keywords="curriculum", keywords="training programs", keywords="workforce", abstract="Background: Common barriers to students' persistence in research include experiencing feelings of exclusion and a lack of belonging, difficulties developing a robust researcher identity, perceptions of racial and social stigma directed toward them, and perceived gaps in research skills, which are particularly pronounced among trainees from groups traditionally underrepresented in research. To address these known barriers, summer research programs have been shown to increase the participation and retention of undergraduate students in research. However, previous programs have focused predominantly on technical knowledge and skills, without integrating an academic enrichment curriculum that promotes professional development by improving students' academic and research communication skills. Objective: This retrospective pre-then-post study aimed to evaluate changes in self-reported ratings of research abilities among a cohort of undergraduate students who participated in a summer research program. Methods: The Human BioMolecular Atlas Program (HuBMAP) piloted the implementation of a web-based academic enrichment curriculum for the Summer 2023 Research Internship cohort, which was comprised of students from groups underrepresented in biomedical artificial intelligence research. HuBMAP, a 400-member research consortium funded by the Common Fund at the National Institutes of Health, offered a 10-week summer research internship that included an academic enrichment curriculum delivered synchronously via the web to all students across multiple sites. The curriculum is intended to support intern self-efficacy, researcher identity development, and peer-to-peer learning. At the end of the internship, students were invited to participate in a web-based survey in which they were asked to rate their academic and research abilities before the internship and as a result of the internship using a modified Entering Research Learning Assessment instrument. Wilcoxon matched-pairs signed rank test was performed to assess the difference in the mean scores per respondent before and after participating in the internship. Results: A total of 14 of the 22 undergraduate students who participated in the internship responded to the survey. The results of the retrospective pre-then-post survey indicated that there was a significant increase in students' self-rated research abilities, evidenced by a significant improvement in the mean scores of the respondents when comparing reported skills self-assessment before and after the internship (improvement: median 1.09, IQR 0.88-1.65; W=52.5, P<.001). After participating in the HuBMAP web-based academic enrichment curriculum, students' self-reported research abilities, including their confidence, their communication and collaboration skills, their self-efficacy in research, and their abilities to set research career goals, increased. Conclusions: Summer internship programs can incorporate an academic enrichment curriculum with small-group peer learning in addition to a laboratory-based experience to facilitate increased student engagement, self-efficacy, and a sense of belonging in the research community. Future research should investigate the impact of academic enrichment curricula and peer mentoring on the long-term retention of students in biomedical research careers, particularly retention of students underrepresented in biomedical fields. ", doi="10.2196/54167", url="https://formative.jmir.org/2025/1/e54167" } @Article{info:doi/10.2196/59552, author="Iembo, Tatiane and Crist{\'o}v{\~a}o, Gon{\c{c}}alves Helena Landim and Santos, dos Emerson Roberto and Crist{\'o}v{\~a}o, Gon{\c{c}}alves Andr{\'e} Bavaresco and Crist{\'o}v{\~a}o, Gon{\c{c}}alves Nath{\'a}lia Bavaresco and Martins, Canato C{\'i}ntia and Castro, Rodrigues Nat{\'a}lia Almeida de Arnaldo Silva and Facio J{\'u}nior, Nestor Fernando and Oliani, H{\'e}lio Ant{\^o}nio and Lima, Abreu Alba Regina de and Brienze, Sabadoto V{\^a}nia Maria and Souza, Silva Doroteia Rossi and Andr{\'e}, C{\'e}sar J{\'u}lio", title="Challenges and Strategies Adopted for Remote Teaching of Biochemistry During the COVID-19 Pandemic: Protocol for a Scoping Review", journal="JMIR Res Protoc", year="2025", month="Jan", day="31", volume="14", pages="e59552", keywords="COVID-19", keywords="biochemistry", keywords="education, distance", keywords="teaching", keywords="educational technology", keywords="review", keywords="digital learning", keywords="virtual education", keywords="teaching tools", keywords="remote learning", keywords="social support", keywords="distance learning", keywords="remote teaching", abstract="Background: In March 2020, the global landscape witnessed widespread upheavals in both socioeconomic and educational spheres due to the onset of the COVID-19 pandemic. With measures imposed to control the virus's spread, educational institutions around the world embraced digital learning, introducing challenges in the adaptation to virtual education. This shift proved especially daunting in resource-limited nations with limited digital infrastructure. Objective: This scoping review aims to explore the experiences of biochemistry educators during the COVID-19 pandemic, focusing on successful pedagogical strategies used to overcome challenges in remote teaching. The goal is to compile valuable information applicable to health-related undergraduate and postgraduate courses. Methods: This review considers studies and experiences related to the transition to remote biochemistry education during the pandemic. It encompasses a variety of pedagogical approaches, including online teaching tools, interactive methods, and alternatives to practical laboratory classes. The search spans databases such as MEDLINE, the Cochrane Database of Systematic Reviews, and Joanna Briggs Institute (JBI) Evidence Synthesis, with a focus on identifying systematic or scoping reviews; however, none were identified in the preliminary search. Results: Starting in February 2022, the scoping review protocol was scheduled for completion by July 2024. From an initial pool of 1171 results, 85 articles were selected, with duplicate verification pending for the subsequent phase of the project. The findings from this review on biochemistry teaching strategies will be communicated using a combination of descriptive narrative, graphical, and tabular formats, emphasizing diverse pedagogical approaches pertinent to the subject. Dissemination will occur through regional and national scientific conference presentations, alongside publication in a peer-reviewed journal. Conclusions: This review aims to generate innovative pedagogical approaches and pinpoint learning activities, materials, and tools that support social and collaborative learning across various subjects, including biochemistry. Moreover, it will offer perspectives from students and educators on the implemented activities, with the intention of integrating them as supplementary methods to boost student participation, and thereby, improve learning outcomes and skill development. Trial Registration: Open Science Framework VZSA7; https://osf.io/VZSA7/ International Registered Report Identifier (IRRID): DERR1-10.2196/59552 ", doi="10.2196/59552", url="https://www.researchprotocols.org/2025/1/e59552" } @Article{info:doi/10.2196/58164, author="Lambert, Jeffrey and Loades, Maria and Marshall, Noah and Higson-Sweeney, Nina and Chan, Stella and Mahmud, Arif and Pile, Victoria and Maity, Ananya and Adam, Helena and Sung, Beatrice and Luximon, Melanie and MacLennan, Keren and Berry, Clio and Chadwick, Paul", title="Investigating the Efficacy of the Web-Based Common Elements Toolbox (COMET) Single-Session Interventions in Improving UK University Student Well-Being: Randomized Controlled Trial", journal="J Med Internet Res", year="2025", month="Jan", day="31", volume="27", pages="e58164", keywords="Common Elements Toolbox", keywords="mental well-being", keywords="online interventions", keywords="single-session interventions", keywords="university students", abstract="Background: Mental health problems in university students are associated with many negative outcomes, yet there is a gap between need and timely access to help. Single-session interventions (SSIs) are designed to be scalable and accessible, delivering core evidence-based intervention components within a one-off encounter. Objective: COMET (Common Elements Toolbox) is an online self-help SSI that includes behavioral activation, cognitive restructuring, gratitude, and self-compassion. COMET has previously been evaluated in India, Kenya, and the United States with promising results. This study tests the acceptability, appropriateness, perceived utility, and efficacy of COMET among UK university students during the peripandemic period. Methods: We conducted a randomized controlled trial evaluating the efficacy of COMET compared with a control group, with 2- and 4-week follow-ups. Outcome variables were subjective well-being, depression severity, anxiety severity, positive affect, negative affect, and perceived stress. We also measured intervention satisfaction immediately after completion of COMET. All UK university students with access to the internet were eligible to participate and were informed of the study online. The data were analyzed using linear mixed models and reported in accordance with the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth) checklist. Results: Of the 831 people screened, 468 participants were randomized to a condition, 407 completed the postintervention survey, 147 returned the 2-week follow-up survey, 118 returned the 4-week follow-up survey, and 89 returned both. Of the 239 randomized, 212 completed COMET. Significant between-group differences in favor of the COMET intervention were observed at 2-week follow-ups for subjective well-being (Warwick-Edinburgh Mental Well-Being Scale; mean difference [MD] 1.39, 95\% CI 0.19-2.61; P=.03), depression severity (9-item Patient Health Questionnaire; MD --1.31, 95\% CI --2.51 to --0.12; P=.03), and perceived stress (4-item Perceived Stress Scale; MD --1.33, 95\% CI --2.10 to --0.57; P<.001). Overall, participants were satisfied with COMET, with the majority endorsing the intervention and its modules as acceptable, appropriate, and exhibiting high utility. The self-compassion module was most often reported as the participants' favorite module and the behavioral activation module was their least favorite. Qualitative analysis revealed that participants found COMET generally accessible, but too long, and experienced immediate and long-term beneficial effects. Conclusions: This study demonstrated high engagement with the COMET intervention, along with preliminary short-term efficacy. Almost all participants completed the intervention, but study attrition was high. Participant feedback indicated a high level of overall satisfaction with the intervention, with perceived accessibility, immediate benefits, and potential long-term impact being notable findings. These findings support the potential value of COMET as a mental health intervention and highlight important areas for further improvement. Trial Registration: ClinicalTrials.gov NCT05718141; https://clinicaltrials.gov/ct2/show/NCT05718141 ", doi="10.2196/58164", url="https://www.jmir.org/2025/1/e58164", url="http://www.ncbi.nlm.nih.gov/pubmed/39888663" } @Article{info:doi/10.2196/66109, author="Walzer, Stefan and Barthel, Carolin and Pazouki, Ronja and Marx, Helga and Ziegler, Sven and Koenig, Peter and Kugler, Christiane and Jobst, Stefan", title="Teaching in the Digital Age---Developing a Support Program for Nursing Education Providers: Design-Based Research", journal="JMIR Form Res", year="2025", month="Jan", day="15", volume="9", pages="e66109", keywords="digital competencies", keywords="nursing education", keywords="support program", keywords="needs assessment", keywords="design-based research", keywords="feasibility study", keywords="nursing education provider", keywords="qualitative research", keywords="nurse", keywords="health care", keywords="focus group", keywords="digital age", keywords="expert consultation", keywords="thematic content analysis", keywords="feasibility test", keywords="satisfaction", keywords="competency-based approach", keywords="workplace barrier", keywords="health care digitalization", keywords="digital technology", abstract="Background: Health care systems and the nursing profession worldwide are being transformed by technology and digitalization. Nurses acquire digital competence through their own experience in daily practice, but also from education and training; nursing education providers thus play an important role. While nursing education providers have some level of digital competence, there is a need for ongoing training and support for them to develop more advanced skills and effectively integrate technology into their teaching. Objective: This study aims to develop a needs-based support program for nursing education providers to foster digital competencies and to test this intervention. Methods: We used a design-based research approach, incorporating iterative development with expert consultation to create and evaluate a support program for nursing education providers. Focus groups were conducted online to assess needs, and thematic content analysis was used to derive key insights. The support program was then refined through expert feedback and subjected to a feasibility and satisfaction test, with participant evaluations analyzed descriptively. Results: Six main categories emerged from the focus groups, highlighting key areas, including the use of digital technology, ongoing support needs, and the current state of digitalization in nursing education. The support program was developed based on these findings, with expert validation leading to adjustments in timing, content prioritization, and platform integration. Preliminary testing showed good overall satisfaction with the support program, although participants suggested improvements in content relevance and digital platform usability. Conclusions: Although the feasibility test showed high satisfaction with the support program, low participation rates and limited perceived knowledge gain were major concerns. The results suggest that while the program was well received, further refinements, including a focus on competency-based approaches and addressing workplace barriers, are needed to increase participation and effectiveness of such interventions. The findings of this research can be used as a basis for the development of similar programs in other educational and health care contexts. ", doi="10.2196/66109", url="https://formative.jmir.org/2025/1/e66109" } @Article{info:doi/10.2196/62669, author="Rjoop, Anwar and Al-Qudah, Mohammad and Alkhasawneh, Raja and Bataineh, Nesreen and Abdaljaleel, Maram and Rjoub, A. Moayad and Alkhateeb, Mustafa and Abdelraheem, Mohammad and Al-Omari, Salem and Bani-Mari, Omar and Alkabalan, Anas and Altulaih, Saoud and Rjoub, Iyad and Alshimi, Rula", title="Awareness and Attitude Toward Artificial Intelligence Among Medical Students and Pathology Trainees: Survey Study", journal="JMIR Med Educ", year="2025", month="Jan", day="10", volume="11", pages="e62669", keywords="artificial intelligence", keywords="AI", keywords="deep learning", keywords="medical schools", keywords="pathology", keywords="Jordan", keywords="medical education", keywords="awareness", keywords="attitude", keywords="medical students", keywords="pathology trainees", keywords="national survey study", keywords="medical practice", keywords="training", keywords="web-based survey", keywords="survey", keywords="questionnaire", abstract="Background: Artificial intelligence (AI) is set to shape the future of medical practice. The perspective and understanding of medical students are critical for guiding the development of educational curricula and training. Objective: This study aims to assess and compare medical AI-related attitudes among medical students in general medicine and in one of the visually oriented fields (pathology), along with illuminating their anticipated role of AI in the rapidly evolving landscape of AI-enhanced health care. Methods: This was a cross-sectional study that used a web-based survey composed of a closed-ended questionnaire. The survey addressed medical students at all educational levels across the 5 public medical schools, along with pathology residents in 4 residency programs in Jordan. Results: A total of 394 respondents participated (328 medical students and 66 pathology residents). The majority of respondents (272/394, 69\%) were already aware of AI and deep learning in medicine, mainly relying on websites for information on AI, while only 14\% (56/394) were aware of AI through medical schools. There was a statistically significant difference in awareness among respondents who consider themselves tech experts compared with those who do not (P=.03). More than half of the respondents believed that AI could be used to diagnose diseases automatically (213/394, 54.1\% agreement), with medical students agreeing more than pathology residents (P=.04). However, more than one-third expressed fear about recent AI developments (167/394, 42.4\% agreed). Two-thirds of respondents disagreed that their medical schools had educated them about AI and its potential use (261/394, 66.2\% disagreed), while 46.2\% (182/394) expressed interest in learning about AI in medicine. In terms of pathology-specific questions, 75.4\% (297/394) agreed that AI could be used to identify pathologies in slide examinations automatically. There was a significant difference between medical students and pathology residents in their agreement (P=.001). Overall, medical students and pathology trainees had similar responses. Conclusions: AI education should be introduced into medical school curricula to improve medical students' understanding and attitudes. Students agreed that they need to learn about AI's applications, potential hazards, and legal and ethical implications. This is the first study to analyze medical students' views and awareness of AI in Jordan, as well as the first to include pathology residents' perspectives. The findings are consistent with earlier research internationally. In comparison with prior research, these attitudes are similar in low-income and industrialized countries, highlighting the need for a global strategy to introduce AI instruction to medical students everywhere in this era of rapidly expanding technology. ", doi="10.2196/62669", url="https://mededu.jmir.org/2025/1/e62669" } @Article{info:doi/10.2196/56844, author="M{\o}rk, Gry and Bonsaksen, Tore and Larsen, S{\o}nnik Ole and Kunnikoff, Martin Hans and Lie, Stangeland Silje", title="Virtual Reality Simulation in Undergraduate Health Care Education Programs: Usability Study", journal="JMIR Med Educ", year="2024", month="Nov", day="19", volume="10", pages="e56844", keywords="360{\textdegree} videos", keywords="health professions education", keywords="virtual reality", keywords="usability study", keywords="undergraduates", keywords="university", keywords="students", keywords="simulation", abstract="Background: Virtual reality (VR) is increasingly being used in higher education for clinical skills training and role-playing among health care students. Using 360{\textdegree} videos in VR headsets, followed by peer debrief and group discussions, may strengthen students' social and emotional learning. Objective: This study aimed to explore student-perceived usability of VR simulation in three health care education programs in Norway. Methods: Students from one university participated in a VR simulation program. Of these, students in social education (n=74), nursing (n=45), and occupational therapy (n=27) completed a questionnaire asking about their perceptions of the usability of the VR simulation and the related learning activities. Differences between groups of students were examined with Pearson chi-square tests and with 1-way ANOVA. Qualitative content analysis was used to analyze data from open-ended questions. Results: The nursing students were most satisfied with the usability of the VR simulation, while the occupational therapy students were least satisfied. The nursing students had more often prior experience from using VR technology (60\%), while occupational therapy students less often had prior experience (37\%). Nevertheless, high mean scores indicated that the students experienced the VR simulation and the related learning activities as very useful. The results also showed that by using realistic scenarios in VR simulation, health care students can be prepared for complex clinical situations in a safe environment. Also, group debriefing sessions are a vital part of the learning process that enhance active involvement with peers. Conclusions: VR simulation has promise and potential as a pedagogical tool in health care education, especially for training soft skills relevant for clinical practice, such as communication, decision-making, time management, and critical thinking. ", doi="10.2196/56844", url="https://mededu.jmir.org/2024/1/e56844" } @Article{info:doi/10.2196/64476, author="Bazie, Hiwot and Lemma, Bekele and Workneh, Anteneh and Estifanos, Ashebir", title="The Effect of Virtual Laboratories on the Academic Achievement of Undergraduate Chemistry Students: Quasi-Experimental Study", journal="JMIR Form Res", year="2024", month="Nov", day="15", volume="8", pages="e64476", keywords="virtual laboratory", keywords="practical chemistry", keywords="student achievement", keywords="undergraduate student", keywords="Dilla University", keywords="simulation", keywords="chemistry education", abstract="Background: Experimentation is crucial in chemistry education as it links practical experience with theoretical concepts. However, practical chemistry courses typically rely on real laboratory experiments and often face challenges such as limited resources, equipment shortages, and logistical constraints in university settings. To address these challenges, computer-based laboratories have been introduced as a potential solution, offering electronic simulations that replicate real laboratory experiences. Objective: This study examines the effect of virtual laboratories on the academic achievement of undergraduate chemistry students and evaluates their potential as a viable alternative or complement to traditional laboratory-based instruction. Methods: A quasi-experimental design was implemented to examine the cause-and-effect relationship between instructional methods and student outcomes. The study involved 60 fourth-year BSc chemistry students from Dilla University, divided into 3 groups: a real laboratory group (n=20), which performed real laboratory experiments; a virtual group (n=20), which used virtual laboratory simulations; and a lecture group (n=20), which received lecture-based instruction. Quantitative data were collected through tests administered before and after the intervention to assess academic performance. The data analysis used descriptive and inferential statistics, such as means and SDs, 1-way ANOVA, the Tukey honestly significant difference test, and independent-sample t tests (2-tailed), with a P value of .05 set for determining statistical significance. Results: Before the intervention, the results indicated no significant differences in academic achievement among the 3 groups (P=.99). However, after the intervention, notable differences were observed in student performance across the methods. The real laboratory group had the highest mean posttest score (mean 62.6, SD 10.7), followed by the virtual laboratory group (mean 55.5, SD 6.8) and the lecture-only group, which had the lowest mean score (mean 43.7, SD 11.5). ANOVA results confirmed significant differences between the groups (F2,57=18.429; P<.001). The Tukey post hoc test further revealed that the real laboratory group significantly outperformed the lecture-only group (mean difference 18.88; P<.001), while the virtual laboratory group also performed significantly better than the lecture-only group (mean difference 11.7; P=.001). However, no statistically significant difference was found between the real laboratory and virtual laboratory groups (mean difference 7.12; P=.07). In addition, gender did not significantly influence performance in the virtual laboratory group (P=.21), with no substantial difference in posttest scores between male and female students. Conclusions: These findings suggest that computer-based laboratories are a viable and effective alternative when real laboratories are unavailable, enhancing learning outcomes when compared with traditional lecture-based methods. Therefore, universities should consider integrating computer-based laboratories into their practical chemistry curricula to provide students with interactive and engaging learning experiences, especially when physical laboratories are inaccessible. ", doi="10.2196/64476", url="https://formative.jmir.org/2024/1/e64476" } @Article{info:doi/10.2196/50389, author="Pang, MengWei and Lu, WeiYu and Huang, Chuling and Lin, Meixiu and Ran, Jiangsheng and Tang, Xiaomei and Huang, YuanDing and Yang, Sheng and Song, Jinlin", title="Development of an Interprofessional Education Project in Dentistry Based on the Positive Behavior Support Theory: Pilot Curriculum Development and Validation Study", journal="JMIR Form Res", year="2024", month="Nov", day="11", volume="8", pages="e50389", keywords="innovative interprofessional education", keywords="dentistry", keywords="dental technology", keywords="positive behavior support", keywords="IPE", keywords="positive behavior", keywords="training system", keywords="dental education", keywords="", abstract="Background: Effective interprofessional education (IPE) can facilitate teamwork between dentists and dental technicians, thereby enabling the efficient provision of high-quality dental care. Objective: This study aimed to design and assess an IPE module named Project 35, which was offered to dental and dental technology students early in their undergraduate training as a precursor to a more comprehensive IPE curriculum in dentistry and dental technology. Methods: Leveraging positive behavior support (PBS) theory, Project 35 was devised as an innovation and entrepreneurship educational training framework. It used project-based learning to cultivate teamwork skills and to promote the professional development of dental and dental technology students. The pilot study was designed to present the IPE module and preliminarily assess its validity. In survey 1, which was conducted immediately after the course, the dental and dental technology students' self-reported skill acquisition and attitudes were assessed and compared. Survey 2, conducted 1 year after the course, focused on the comparative benefits of Project 35 training for dental technology students versus an untrained group. Results: A total of 66 students, including 36 dental students and 30 dental technology students who had undertaken the training, were recruited. Project 35 training improved teamwork skills for students in both disciplines comparably, and the students recognized the training as highly valuable and effective. The mean values for all items indicating skills improvement of students ranged from 4.13 (SD 0.797) to 4.63 (SD 0.495) for dental students and from 4.13 (SD 0.869) to 4.74 (SD 0.619) for dental technology students. Among the dental technology students, the trained group showed greater independent and innovative approaches and was more optimistic about the future of the profession than the nontrained group (P<.05). Conclusions: Despite the small sample size, the validity of the Project 35 training system was evident, and the success of our pilot study provides a sound basis for the future development of IPE in clinical dental and dental technology education programs. ", doi="10.2196/50389", url="https://formative.jmir.org/2024/1/e50389" } @Article{info:doi/10.2196/57132, author="Tao, Wenjuan and Yang, Jinming and Qu, Xing", title="Utilization of, Perceptions on, and Intention to Use AI Chatbots Among Medical Students in China: National Cross-Sectional Study", journal="JMIR Med Educ", year="2024", month="Oct", day="28", volume="10", pages="e57132", keywords="medical education", keywords="artificial intelligence", keywords="UTAUT model", keywords="utilization", keywords="medical students", keywords="cross-sectional study", keywords="AI chatbots", keywords="China", keywords="acceptance", keywords="electronic survey", keywords="social media", keywords="medical information", keywords="risk", keywords="training", keywords="support", abstract="Background: Artificial intelligence (AI) chatbots are poised to have a profound impact on medical education. Medical students, as early adopters of technology and future health care providers, play a crucial role in shaping the future of health care. However, little is known about the utilization of, perceptions on, and intention to use AI chatbots among medical students in China. Objective: This study aims to explore the utilization of, perceptions on, and intention to use generative AI chatbots among medical students in China, using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. By conducting a national cross-sectional survey, we sought to identify the key determinants that influence medical students' acceptance of AI chatbots, thereby providing a basis for enhancing their integration into medical education. Understanding these factors is crucial for educators, policy makers, and technology developers to design and implement effective AI-driven educational tools that align with the needs and expectations of future health care professionals. Methods: A web-based electronic survey questionnaire was developed and distributed via social media to medical students across the country. The UTAUT was used as a theoretical framework to design the questionnaire and analyze the data. The relationship between behavioral intention to use AI chatbots and UTAUT predictors was examined using multivariable regression. Results: A total of 693 participants were from 57 universities covering 21 provinces or municipalities in China. Only a minority (199/693, 28.72\%) reported using AI chatbots for studying, with ChatGPT (129/693, 18.61\%) being the most commonly used. Most of the participants used AI chatbots for quickly obtaining medical information and knowledge (631/693, 91.05\%) and increasing learning efficiency (594/693, 85.71\%). Utilization behavior, social influence, facilitating conditions, perceived risk, and personal innovativeness showed significant positive associations with the behavioral intention to use AI chatbots (all P values were <.05). Conclusions: Chinese medical students hold positive perceptions toward and high intentions to use AI chatbots, but there are gaps between intention and actual adoption. This highlights the need for strategies to improve access, training, and support and provide peer usage examples to fully harness the potential benefits of chatbot technology. ", doi="10.2196/57132", url="https://mededu.jmir.org/2024/1/e57132" } @Article{info:doi/10.2196/55149, author="Clavier, Thomas and Chevalier, Emma and Demailly, Zo{\'e} and Veber, Benoit and Messaadi, Imad-Abdelkader and Popoff, Benjamin", title="Social Media Usage for Medical Education and Smartphone Addiction Among Medical Students: National Web-Based Survey", journal="JMIR Med Educ", year="2024", month="Oct", day="22", volume="10", pages="e55149", keywords="medical student", keywords="social network", keywords="social media", keywords="smartphone addiction", keywords="medical education", keywords="mobile addiction", keywords="social networks", abstract="Background: Social media (SoMe) have taken a major place in the medical field, and younger generations are increasingly using them as their primary source to find information. Objective: This study aimed to describe the use of SoMe for medical education among French medical students and assess the prevalence of smartphone addiction in this population. Methods: A cross-sectional web-based survey was conducted among French medical students (second to sixth year of study). The questionnaire collected information on SoMe use for medical education and professional behavior. Smartphone addiction was assessed using the Smartphone Addiction Scale Short-Version (SAS-SV) score. Results: A total of 762 medical students responded to the survey. Of these, 762 (100\%) were SoMe users, spending a median of 120 (IQR 60?150) minutes per day on SoMe; 656 (86.1\%) used SoMe for medical education, with YouTube, Instagram, and Facebook being the most popular platforms. The misuse of SoMe in a professional context was also identified; 27.2\% (207/762) of students posted hospital internship content, and 10.8\% (82/762) searched for a patient's name on SoMe. Smartphone addiction was prevalent among 29.1\% (222/762) of respondents, with a significant correlation between increased SoMe use and SAS-SV score (r=0.39, 95\% CI 0.33?0.45; P<.001). Smartphone-addicted students reported a higher impact on study time (211/222, 95\% vs 344/540, 63.6\%; P<.001) and a greater tendency to share hospital internship content on social networks (78/222, 35.1\% vs 129/540, 23.8\%; P=.002). Conclusions: Our findings reveal the extensive use of SoMe for medical education among French medical students, alongside a notable prevalence of smartphone addiction. These results highlight the need for medical schools and educators to address the responsible use of SoMe and develop strategies to mitigate the risks associated with excessive use and addiction. ", doi="10.2196/55149", url="https://mededu.jmir.org/2024/1/e55149" } @Article{info:doi/10.2196/52017, author="Alnuaim, Abeer", title="The Impact and Acceptance of Gamification by Learners in a Digital Literacy Course at the Undergraduate Level: Randomized Controlled Trial", journal="JMIR Serious Games", year="2024", month="Aug", day="23", volume="12", pages="e52017", keywords="gamification", keywords="games", keywords="technology integration", keywords="information literacy", keywords="technology acceptance", abstract="Background: In recent years, the integration of technology in education has revolutionized traditional learning paradigms. Digital literacy, a crucial skill in the 21st century, has become a vital aspect of modern education, enabling students to navigate, critically assess, and effectively use digital tools. As educators strive to boost engagement and learning outcomes, gamification has appeared as an auspicious pedagogical approach. By applying game mechanics to nongame contexts, gamification seeks to create a more immersive and digital learning experience. Objective: This research paper aims to investigate the impact and acceptance of gamification by learners in a digital literacy course at the undergraduate level. Methods: In a pre-post intervention study, 168 undergraduate students were randomly assigned either to the experimental group (gamification based) or control group (conventional) learning condition. Both groups of participants learned the same topics in digital literacy. Results: Empirical findings showed that participants from the experimental group had better academic performance in digital literacy than those who were not exposed to the game-based learning environment. The participants' prior experience with gamification was not found to be a significant predictor of their acceptance of gamification in a digital literacy course. Conclusions: The study provides evidence supporting the potential benefits of gamification in enhancing digital literacy education and opens the door for further exploration and implementation of gamified learning approaches in higher education settings. ", doi="10.2196/52017", url="https://games.jmir.org/2024/1/e52017" } @Article{info:doi/10.2196/45468, author="Rahadiani, Pratiwi and Kekalih, Aria and Soemantri, Diantha and Krisnamurti, Budi Desak Gede", title="Exploring HTML5 Package Interactive Content in Supporting Learning Through Self-Paced Massive Open Online Courses on Healthy Aging: Mixed Methods Study", journal="JMIR Med Educ", year="2024", month="Aug", day="22", volume="10", pages="e45468", keywords="HTML5 package", keywords="H5P", keywords="students' perspectives", keywords="students' acceptance", keywords="massive open online courses", keywords="MOOCs", keywords="healthy aging", keywords="self-paced MOOC", keywords="student", keywords="perception", keywords="acceptance", keywords="opinion", keywords="attitude", keywords="MOOC", keywords="self-paced", keywords="self-guided", keywords="online course", keywords="online learning", keywords="geriatric", keywords="gerontology", keywords="gerontological", keywords="learning", abstract="Background: The rapidly aging population and the growth of geriatric medicine in the field of internal medicine are not supported by sufficient gerontological training in many health care disciplines. There is rising awareness about the education and training needed to adequately prepare health care professionals to address the needs of the older adult population. Massive open online courses (MOOCs) might be the best alternative method of learning delivery in this context. However, the diversity of MOOC participants poses a challenge for MOOC providers to innovate in developing learning content that suits the needs and characters of participants. Objective: The primary outcome of this study was to explore students' perceptions and acceptance of HTML5 package (H5P) interactive content in self-paced MOOCs and its association with students' characteristics and experience in using MOOCs. Methods: This study used a cross-sectional design, combining qualitative and quantitative approaches. Participants, predominantly general practitioners from various regions of Indonesia with diverse educational backgrounds and age groups, completed pretests, engaged with H5P interactive content, and participated in forum discussions and posttests. Data were retrieved from the online questionnaire attached to a selected MOOC course. Students' perceptions and acceptance of H5P interactive content were rated on a 6-point Likert scale from 1 (strongly disagree) to 6 (strongly agree). Data were analyzed using SPSS (IBM Corp) to examine demographics, computer literacy, acceptance, and perceptions of H5P interactive content. Quantitative analysis explored correlations, while qualitative analysis identified recurring themes from open-ended survey responses to determine students' perceptions. Results: In total, 184 MOOC participants agreed to participate in the study. Students demonstrated positive perceptions and a high level of acceptance of integrating H5P interactive content within the self-paced MOOC. Analysis of mean (SD) value across all responses consistently revealed favorable scores (greater than 5), ranging from 5.18 (SD 0.861) to 5.45 (SD 0.659) and 5.28 (SD 0.728) to 5.52 (SD 0.627), respectively. This finding underscores widespread satisfaction and robust acceptance of H5P interactive content. Students found the H5P interactive content more satisfying and fun, easier to understand, more effective, and more helpful in improving learning outcomes than material in the form of common documents and learning videos. There is a significant correlation between computer literacy, students' acceptance, and students' perceptions. Conclusions: Students from various backgrounds showed a high level of acceptance and positive perceptions of leveraging H5P interactive content in the self-paced MOOC. The findings suggest potential new uses of H5P interactive content in MOOCs, such as interactive videos with pop-up questions, to substitute for synchronous learning. The study underscores the significance of tailored educational strategies in supporting the professional development of health care professionals. ", doi="10.2196/45468", url="https://mededu.jmir.org/2024/1/e45468", url="http://www.ncbi.nlm.nih.gov/pubmed/39049507" } @Article{info:doi/10.2196/53777, author="Nowell, Lorelli and Dolan, Sara and Johnston, Sonja and Jacobsen, Michele and Lorenzetti, Diane and Oddone Paolucci, Elizabeth", title="Exploring Student Perspectives and Experiences of Online Opportunities for Virtual Care Skills Development: Sequential Explanatory Mixed Methods Study", journal="JMIR Nursing", year="2024", month="Aug", day="21", volume="7", pages="e53777", keywords="virtual care", keywords="online teaching and learning", keywords="mixed methods research", keywords="development", keywords="mixed method study", keywords="online", keywords="care", keywords="student", keywords="students", keywords="online learning", keywords="virtual learning", keywords="interview", keywords="experience", keywords="educational", keywords="technology", keywords="nursing", keywords="medicine", keywords="allied health", keywords="teaching", abstract="Background: Caring profession students require skills and competencies to proficiently use information technologies for providing high-quality and effective care. However, there is a gap in exploring the perceptions and experiences of students in developing virtual care skills within online environments. Objective: This study aims to better understand caring professional students' online learning experiences with developing virtual care skills and competencies. Methods: A sequential explanatory mixed methods approach, integrating both a cross-sectional survey and individual interviews, was used to better understand caring professional students' online learning experiences with developing virtual care skills and competencies. Results: A total of 93 survey and 9 interview participants were drawn from various faculties, including students from education, nursing, medicine, and allied health. These participants identified the barriers, facilitators, principles, and skills related to learning about and delivering virtual care, including teaching methods and educational technologies. Conclusions: This study contributes to the growing body of educational research on virtual care skills by offering student insights and suggestions for improved teaching and learning strategies in caring professions' programs. ", doi="10.2196/53777", url="https://nursing.jmir.org/2024/1/e53777", url="http://www.ncbi.nlm.nih.gov/pubmed/39167789" } @Article{info:doi/10.2196/53106, author="Yeo, Ji-Young and Nam, Hyeongil and Park, Jong-Il and Han, Soo-Yeon", title="Multidisciplinary Design--Based Multimodal Virtual Reality Simulation in Nursing Education: Mixed Methods Study", journal="JMIR Med Educ", year="2024", month="Jul", day="26", volume="10", pages="e53106", keywords="multidisciplinary", keywords="multimodal", keywords="nursing", keywords="simulation", keywords="virtual reality", keywords="VR", keywords="education", keywords="allied health", keywords="educational", keywords="simulations", keywords="pediatric", keywords="pediatrics", keywords="paediatric", keywords="paediatrics", keywords="feasibility", keywords="nurse", keywords="nurses", keywords="qualitative", keywords="interview", keywords="interviews", keywords="development", keywords="develop", keywords="teaching", keywords="educator", keywords="educators", keywords="user test", keywords="user testing", keywords="module", keywords="modules", keywords="usability", keywords="satisfaction", abstract="Background: The COVID-19 pandemic underscored the necessity for innovative educational methods in nursing. Our study takes a unique approach using a multidisciplinary simulation design, which offers a systematic and comprehensive strategy for developing virtual reality (VR) simulations in nursing education. Objective: The aim of this study is to develop VR simulation content for a pediatric nursing module based on a multidisciplinary simulation design and to evaluate its feasibility for nursing education. Methods: This study used a 1-group, posttest-only design. VR content for pediatric nursing practice was developed by integrating the technological characteristics of a multimodal VR system with the learning elements of traditional nursing simulation, combining various disciplines, including education, engineering, and nursing. A user test was conducted with 12 nursing graduates (preservice nurses) followed by post hoc surveys (assessing presence, VR systems, VR sickness, and simulation satisfaction) and in-depth, one-on-one interviews. Results: User tests showed mean scores of 4.01 (SD 1.43) for presence, 4.91 (SD 0.81) for the VR system, 0.64 (SD 0.35) for VR sickness, and 5.00 (SD 1.00) for simulation satisfaction. In-depth interviews revealed that the main strengths of the immersive VR simulation for pediatric pneumonia nursing were effective visualization and direct experience through hands-on manipulation; the drawback was keyword-based voice interaction. To improve VR simulation quality, participants suggested increasing the number of nursing techniques and refining them in more detail. Conclusions: This VR simulation content for a pediatric nursing practice using a multidisciplinary educational design model was confirmed to have positive educational potential. Further research is needed to confirm the specific learning effects of immersive nursing content based on multidisciplinary design models. ", doi="10.2196/53106", url="https://mededu.jmir.org/2024/1/e53106" } @Article{info:doi/10.2196/50111, author="Jafari, Mahtab", title="Can an Online Course, Life101: Mental and Physical Self-Care, Improve the Well-Being of College Students?", journal="JMIR Med Educ", year="2024", month="Jul", day="22", volume="10", pages="e50111", keywords="self-care course", keywords="stress management", keywords="student mental health", keywords="multimodal online course", keywords="mental health interventions", doi="10.2196/50111", url="https://mededu.jmir.org/2024/1/e50111" } @Article{info:doi/10.2196/58126, author="R{\"o}ssler, Lena and Herrmann, Manfred and Wiegand, Annette and Kanzow, Philipp", title="Use of Multiple-Choice Items in Summative Examinations: Questionnaire Survey Among German Undergraduate Dental Training Programs", journal="JMIR Med Educ", year="2024", month="Jun", day="27", volume="10", pages="e58126", keywords="alternate-choice", keywords="assessment", keywords="best-answer", keywords="dental", keywords="dental schools", keywords="dental training", keywords="education", keywords="educational assessment", keywords="educational measurement", keywords="examination", keywords="German", keywords="Germany", keywords="k of n", keywords="Kprim", keywords="K'", keywords="medical education", keywords="medical student", keywords="MTF", keywords="Multiple-True-False", keywords="multiple choice", keywords="multiple-select", keywords="Pick-N", keywords="scoring", keywords="scoring system", keywords="single choice", keywords="single response", keywords="test", keywords="testing", keywords="true/false", keywords="true-false", keywords="Type A", keywords="Type K", keywords="Type K'", keywords="Type R", keywords="Type X", keywords="undergraduate", keywords="undergraduate curriculum", keywords="undergraduate education", abstract="Background: Multiple-choice examinations are frequently used in German dental schools. However, details regarding the used item types and applied scoring methods are lacking. Objective: This study aims to gain insight into the current use of multiple-choice items (ie, questions) in summative examinations in German undergraduate dental training programs. Methods: A paper-based 10-item questionnaire regarding the used assessment methods, multiple-choice item types, and applied scoring methods was designed. The pilot-tested questionnaire was mailed to the deans of studies and to the heads of the Department of Operative/Restorative Dentistry at all 30 dental schools in Germany in February 2023. Statistical analysis was performed using the Fisher exact test (P<.05). Results: The response rate amounted to 90\% (27/30 dental schools). All respondent dental schools used multiple-choice examinations for summative assessments. Examinations were delivered electronically by 70\% (19/27) of the dental schools. Almost all dental schools used single-choice Type A items (24/27, 89\%), which accounted for the largest number of items in approximately half of the dental schools (13/27, 48\%). Further item types (eg, conventional multiple-select items, Multiple-True-False, and Pick-N) were only used by fewer dental schools (?67\%, up to 18 out of 27 dental schools). For the multiple-select item types, the applied scoring methods varied considerably (ie, awarding [intermediate] partial credit and requirements for partial credit). Dental schools with the possibility of electronic examinations used multiple-select items slightly more often (14/19, 74\% vs 4/8, 50\%). However, this difference was statistically not significant (P=.38). Dental schools used items either individually or as key feature problems consisting of a clinical case scenario followed by a number of items focusing on critical treatment steps (15/27, 56\%). Not a single school used alternative testing methods (eg, answer-until-correct). A formal item review process was established at about half of the dental schools (15/27, 56\%). Conclusions: Summative assessment methods among German dental schools vary widely. Especially, a large variability regarding the use and scoring of multiple-select multiple-choice items was found. ", doi="10.2196/58126", url="https://mededu.jmir.org/2024/1/e58126" } @Article{info:doi/10.2196/51915, author="Jones, Jennifer and Johnston, Sewan Jamie and Ndiaye, Yabsa Ngouille and Tokar, Anna and Singla, Saumya and Skinner, Ann Nadine and Strehlow, Matthew and Utunen, Heini", title="Health Care Workers' Motivations for Enrolling in Massive Open Online Courses During a Public Health Emergency: Descriptive Analysis", journal="JMIR Med Educ", year="2024", month="Jun", day="19", volume="10", pages="e51915", keywords="massive open online course", keywords="MOOC", keywords="online learning", keywords="online courses", keywords="online course", keywords="health care education", keywords="medical education", keywords="education", keywords="training", keywords="professional development", keywords="continuing education", keywords="COVID-19 training", keywords="infectious disease outbreak response", keywords="emergency", keywords="public health", keywords="crisis", keywords="crises", keywords="outbreak", keywords="pandemic", keywords="COVID-19", keywords="SARS-CoV-2", keywords="coronavirus", keywords="humanitarian emergency response", keywords="health care workers", keywords="nurse", keywords="nurses", keywords="practitioner", keywords="practitioners", keywords="clinician", keywords="clinicians", keywords="health care worker", keywords="medic", keywords="low-income", keywords="lower-middle income", keywords="LIC", keywords="LMIC", keywords="developing country", keywords="developing countries", keywords="developing nation", keywords="developing nations", keywords="case study", keywords="survey", keywords="surveys", keywords="descriptive analysis", keywords="descriptive analyses", keywords="motivation", keywords="motivations", keywords="lower-middle--income country", keywords="low-income country", abstract="Background: Massive open online courses (MOOCs) are increasingly used to educate health care workers during public health emergencies. In early 2020, the World Health Organization (WHO) developed a series of MOOCs for COVID-19, introducing the disease and strategies to control its outbreak, with 6 courses specifically targeting health care workers as learners. In 2020, Stanford University also launched a MOOC designed to deliver accurate and timely education on COVID-19, equipping health care workers across the globe to provide health care safely and effectively to patients with the novel infectious disease. Although the use of MOOCs for just-in-time training has expanded during the pandemic, evidence is limited regarding the factors motivating health care workers to enroll in and complete courses, particularly in low-income countries (LICs) and lower-middle--income countries (LMICs). Objective: This study seeks to gain insights on the characteristics and motivations of learners turning to MOOCs for just-in-time training, to provide evidence that can better inform MOOC design to meet the needs of health care workers. We examine data from learners in 1 Stanford University and 6 WHO COVID-19 courses to identify (1) the characteristics of health care workers completing the courses and (2) the factors motivating them to enroll. Methods: We analyze (1) course registration data of the 49,098 health care workers who completed the 7 focal courses and (2) survey responses from 6272 course completers. The survey asked respondents to rank their motivations for enrollment and share feedback about their learning experience. We use descriptive statistics to compare responses by health care profession and by World Bank country income classification. Results: Health care workers completed the focal courses from all regions of the world, with nearly one-third (14,159/49,098, 28.84\%) practicing in LICs and LMICs. Survey data revealed a diverse range of professional roles among the learners, including physicians (2171/6272, 34.61\%); nurses (1599/6272, 25.49\%); and other health care professionals such as allied health professionals, community health workers, paramedics, and pharmacists (2502/6272, 39.89\%). Across all health care professions, the primary motivation to enroll was for personal learning to improve clinical practice. Continuing education credit was also an important motivator, particularly for nonphysicians and learners in LICs and LMICs. Course cost (3423/6272, 54.58\%) and certification (4238/6272, 67.57\%) were also important to a majority of learners. Conclusions: Our results demonstrate that a diverse range of health care professionals accessed MOOCs for just-in-time training during a public health emergency. Although all health care workers were motivated to improve their clinical practice, different factors were influential across professions and locations. These factors should be considered in MOOC design to meet the needs of health care workers, particularly those in lower-resource settings where alternative avenues for training may be limited. ", doi="10.2196/51915", url="https://mededu.jmir.org/2024/1/e51915" } @Article{info:doi/10.2196/50982, author="El Morr, Christo and Tavangar, Farideh and Ahmad, Farah and Ritvo, Paul and ", title="Predicting the Effectiveness of a Mindfulness Virtual Community Intervention for University Students: Machine Learning Model", journal="Interact J Med Res", year="2024", month="May", day="13", volume="13", pages="e50982", keywords="machine learning", keywords="virtual community", keywords="virtual care", keywords="mindfulness", keywords="depression", keywords="anxiety", keywords="stress", keywords="students", keywords="online", keywords="randomized controlled trial", keywords="Canada", keywords="virtual", keywords="artificial intelligence", keywords="symptoms", keywords="behavioral therapy", keywords="sociodemographic", keywords="mindfulness video", keywords="online video", abstract="Background: Students' mental health crisis was recognized before the COVID-19 pandemic. Mindfulness virtual community (MVC), an 8-week web-based mindfulness and cognitive behavioral therapy program, has proven to be an effective web-based program to reduce symptoms of depression, anxiety, and stress. Predicting the success of MVC before a student enrolls in the program is essential to advise students accordingly. Objective: The objectives of this study were to investigate (1) whether we can predict MVC's effectiveness using sociodemographic and self-reported features and (2) whether exposure to mindfulness videos is highly predictive of the intervention's success. Methods: Machine learning models were developed to predict MVC's effectiveness, defined as success in reducing symptoms of depression, anxiety, and stress as measured using the Patient Health Questionnaire-9 (PHQ-9), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS), to at least the minimal clinically important difference. A data set representing a sample of undergraduate students (N=209) who took the MVC intervention between fall 2017 and fall 2018 was used for this secondary analysis. Random forest was used to measure the features' importance. Results: Gradient boosting achieved the best performance both in terms of area under the curve (AUC) and accuracy for predicting PHQ-9 (AUC=0.85 and accuracy=0.83) and PSS (AUC=1 and accuracy=1), and random forest had the best performance for predicting BAI (AUC=0.93 and accuracy=0.93). Exposure to online mindfulness videos was the most important predictor for the intervention's effectiveness for PHQ-9, BAI, and PSS, followed by the number of working hours per week. Conclusions: The performance of the models to predict MVC intervention effectiveness for depression, anxiety, and stress is high. These models might be helpful for professionals to advise students early enough on taking the intervention or choosing other alternatives. The students' exposure to online mindfulness videos is the most important predictor for the effectiveness of the MVC intervention. Trial Registration: ISRCTN Registry ISRCTN12249616; https://www.isrctn.com/ISRCTN12249616 ", doi="10.2196/50982", url="https://www.i-jmr.org/2024/1/e50982", url="http://www.ncbi.nlm.nih.gov/pubmed/38578872" } @Article{info:doi/10.2196/56005, author="Friche, Pauline and Moulis, Lionel and Du Thanh, Aur{\'e}lie and Dereure, Olivier and Duflos, Claire and Carbonnel, Francois", title="Training Family Medicine Residents in Dermoscopy Using an e-Learning Course: Pilot Interventional Study", journal="JMIR Form Res", year="2024", month="May", day="13", volume="8", pages="e56005", keywords="dermoscopy", keywords="dermatoscope", keywords="dermatoscopes", keywords="dermatological", keywords="skin", keywords="training", keywords="GP", keywords="family practitioner", keywords="family practitioners", keywords="family physician", keywords="family physicians", keywords="general practice", keywords="family medicine", keywords="primary health care", keywords="internship and residency", keywords="education", keywords="e-learning", keywords="eLearning", keywords="dermatology", keywords="resident", keywords="residency", keywords="intern", keywords="interns", keywords="internship", keywords="internships", abstract="Background: Skin cancers are the most common group of cancers diagnosed worldwide. Aging and sun exposure increase their risk. The decline in the number of dermatologists is pushing the issue of dermatological screening back onto family doctors. Dermoscopy is an easy-to-use tool that increases the sensitivity of melanoma diagnosis by 60\% to 90\%, but its use is limited due to lack of training. The characteristics of ``ideal'' dermoscopy training have yet to be established. We created a Moodle (Moodle HQ)-based e-learning course to train family medicine residents in dermoscopy. Objective: This study aimed to evaluate the evolution of dermoscopy knowledge among family doctors immediately and 1 and 3 months after e-learning training. Methods: We conducted a prospective interventional study between April and November 2020 to evaluate an educational program intended for family medicine residents at the University of Montpellier-N{\^i}mes, France. They were asked to complete an e-learning course consisting of 2 modules, with an assessment quiz repeated at 1 (M1) and 3 months (M3). The course was based on a 2-step algorithm, a method of dermoscopic analysis of pigmented skin lesions that is internationally accepted. The objectives of modules 1 and 2 were to differentiate melanocytic lesions from nonmelanocytic lesions and to precisely identify skin lesions by looking for dermoscopic morphological criteria specific to each lesion. Each module consisted of 15 questions with immediate feedback after each question. Results: In total, 134 residents were included, and 66.4\% (n=89) and 47\% (n=63) of trainees fully participated in the evaluation of module 1 and module 2, respectively. This study showed a significant score improvement 3 months after the training course in 92.1\% (n=82) of participants for module 1 and 87.3\% (n=55) of participants for module 2 (P<.001). The majority of the participants expressed satisfaction (n=48, 90.6\%) with the training course, and 96.3\% (n=51) planned to use a dermatoscope in their future practice. Regarding final scores, the only variable that was statistically significant was the resident's initial scores (P=.003) for module 1. No measured variable was found to be associated with retention (midtraining or final evaluation) for module 2. Residents who had completed at least 1 dermatology rotation during medical school had significantly higher initial scores in module 1 at M0 (P=.03). Residents who reported having completed at least 1 dermatology rotation during their family medicine training had a statistically significant higher score at M1 for module 1 and M3 for module 2 (P=.01 and P=.001). Conclusions: The integration of an e-learning training course in dermoscopy into the curriculum of FM residents results in a significant improvement in their diagnosis skills and meets their expectations. Developing a program combining an e-learning course and face-to-face training for residents is likely to result in more frequent and effective dermoscopy use by family doctors. ", doi="10.2196/56005", url="https://formative.jmir.org/2024/1/e56005", url="http://www.ncbi.nlm.nih.gov/pubmed/38739910" } @Article{info:doi/10.2196/54230, author="Yun, Hyun Young and Shin, Hoon Dong and Choi, Jin Hyung", title="Perspectives of Medical Students and Developers Regarding Virtual Reality, Augmented Reality, Mixed Reality, and 3D Printing Technologies: Survey Study", journal="JMIR XR Spatial Comput", year="2024", month="May", day="7", volume="1", pages="e54230", keywords="medical student", keywords="developer", keywords="virtual reality", keywords="augmented reality", keywords="mixed reality", keywords="3D printing", keywords="perspective", keywords="survey", abstract="Background: Emerging technologies, such as virtual reality (VR), augmented reality (AR), mixed reality (MR), and 3D printing (3DP), have transformative potential in education and health care. However, complete integration has not yet been achieved, and routine use is limited. There may exist gaps in the perspectives of these technologies between users and developers, and improvement may be necessary in developing such technologies. Objective: The purpose of this study was to investigate the gaps in perspectives between medical students and developers in medical education regarding satisfaction and anticipated future use of VR, AR, MR, and 3DP technologies, as well as developers' perspectives on their advantages and current challenges. Methods: This retrospective survey study was conducted during a 4-hour elective course over a period of 4 weeks. In this course, computed tomography scans of congenital heart disease patients, medical image processing software, head-mounted displays, and a virtual table were used. Student pre- and postsurveys and the developer survey included demographic and other characteristics, satisfaction, and anticipated future use of VR, AR, MR, and 3DP technologies. The advantages and current challenges of these technologies were only assessed in the developer survey. Results: The study enrolled 41 participants, including 15 first-year medical students and 26 software and content developers. Students were more satisfied than developers across AR, VR, and 3DP in terms of overall satisfaction (VR and AR: P<.001; 3DP: P=.002), esthetics (VR: all P<.001; AR: vividness, P=.006 and design, P<.001; 3DP: vividness, P=.001 and design, P=.002), and continuous use intention (VR: repetition, P=.04 and continuous use, P=.02). Particularly in VR, satisfaction with reality was higher among students than among developers (real world, P=.006). Developers anticipated future use of MR for educating medical students and residents, individual and collaborative surgical planning, and performing surgery on patients. In contrast, students anticipated future use of VR primarily for student education, 3DP for resident education and individual surgical planning, and AR for collaborative surgical planning and performing surgery on patients. Developers perceived the inherent capabilities of VR, AR, and MR technologies as strengths, with hardware performance identified as a drawback. For 3DP, the possibility of customized product manufacturing was seen as an advantage, while cost was seen as a disadvantage. Conclusions: This study elucidated the different perspectives between medical students and developers regarding 3D technologies, highlighting the discrepancy in potential applications and challenges within the medical field. These findings will guide the integration of 3D technologies in education and health care to fulfill the needs and goals of both medical students and developers. ", doi="10.2196/54230", url="https://xr.jmir.org/2024/1/e54230" } @Article{info:doi/10.2196/50297, author="Dallora, Luiza Ana and Andersson, Kazimiera Ewa and Gregory Palm, Bruna and Bohman, Doris and Bj{\"o}rling, Gunilla and Marcinowicz, Ludmi?a and Stjernberg, Louise and Anderberg, Peter", title="Nursing Students' Attitudes Toward Technology: Multicenter Cross-Sectional Study", journal="JMIR Med Educ", year="2024", month="Apr", day="29", volume="10", pages="e50297", keywords="nursing education", keywords="technophilia", keywords="eHealth", keywords="technology anxiety", keywords="technology enthusiasm", keywords="mobile phone", abstract="Background: The growing presence of digital technologies in health care requires the health workforce to have proficiency in subjects such as informatics. This has implications in the education of nursing students, as their preparedness to use these technologies in clinical situations is something that course administrators need to consider. Thus, students' attitudes toward technology could be investigated to assess their needs regarding this proficiency. Objective: This study aims to investigate attitudes (enthusiasm and anxiety) toward technology among nursing students and to identify factors associated with those attitudes. Methods: Nursing students at 2 universities in Sweden and 1 university in Poland were invited to answer a questionnaire. Data about attitudes (anxiety and enthusiasm) toward technology, eHealth literacy, electronic device skills, and frequency of using electronic devices and sociodemographic data were collected. Descriptive statistics were used to characterize the data. The Spearman rank correlation coefficient and Mann-Whitney U test were used for statistical inferences. Results: In total, 646 students answered the questionnaire---342 (52.9\%) from the Swedish sites and 304 (47.1\%) from the Polish site. It was observed that the students' technology enthusiasm (techEnthusiasm) was on the higher end of the Technophilia instrument (score range 1-5): 3.83 (SD 0.90), 3.62 (SD 0.94), and 4.04 (SD 0.78) for the whole sample, Swedish students, and Polish students, respectively. Technology anxiety (techAnxiety) was on the midrange of the Technophilia instrument: 2.48 (SD 0.96), 2.37 (SD 1), and 2.60 (SD 0.89) for the whole sample, Swedish students, and Polish students, respectively. Regarding techEnthusiasm among the nursing students, a negative correlation with age was found for the Swedish sample (P<.001; $\rho$Swedish=?0.201) who were generally older than the Polish sample, and positive correlations with the eHealth Literacy Scale score (P<.001; $\rho$all=0.265; $\rho$Swedish=0.190; $\rho$Polish=0.352) and with the perceived skill in using computer devices (P<.001; $\rho$all=0.360; $\rho$Swedish=0.341; $\rho$Polish=0.309) were found for the Swedish, Polish, and total samples. Regarding techAnxiety among the nursing students, a positive correlation with age was found in the Swedish sample (P<.001; $\rho$Swedish=0.184), and negative correlations with eHealth Literacy Scale score (P<.001; $\rho$all=?0.196; $\rho$Swedish=?0.262; $\rho$Polish=?0.133) and with the perceived skill in using computer devices (P<.001; $\rho$all=?0.209; $\rho$Swedish=?0.347; $\rho$Polish=?0.134) were found for the Swedish, Polish, and total samples and with the semester only for the Swedish sample (P<.001; $\rho$Swedish=?0.124). Gender differences were found regarding techAnxiety in the Swedish sample, with women exhibiting a higher mean score than men (2.451, SD 1.014 and 1.987, SD 0.854, respectively). Conclusions: This study highlights nursing students' techEnthusiasm and techAnxiety, emphasizing correlations with various factors. With health care's increasing reliance on technology, integrating health technology--related topics into education is crucial for future professionals to address health care challenges effectively. International Registered Report Identifier (IRRID): RR2-10.2196/14643 ", doi="10.2196/50297", url="https://mededu.jmir.org/2024/1/e50297", url="http://www.ncbi.nlm.nih.gov/pubmed/38683660" } @Article{info:doi/10.2196/56764, author="Choudhury, Avishek and Chaudhry, Zaira", title="Large Language Models and User Trust: Consequence of Self-Referential Learning Loop and the Deskilling of Health Care Professionals", journal="J Med Internet Res", year="2024", month="Apr", day="25", volume="26", pages="e56764", keywords="trust", keywords="ChatGPT", keywords="human factors", keywords="healthcare", keywords="LLMs", keywords="large language models", keywords="LLM user trust", keywords="AI accountability", keywords="artificial intelligence", keywords="AI technology", keywords="technologies", keywords="effectiveness", keywords="policy", keywords="medical student", keywords="medical students", keywords="risk factor", keywords="quality of care", keywords="healthcare professional", keywords="healthcare professionals", keywords="human element", doi="10.2196/56764", url="https://www.jmir.org/2024/1/e56764", url="http://www.ncbi.nlm.nih.gov/pubmed/38662419" } @Article{info:doi/10.2196/46507, author="Cardoso Pinto, M. Alexandra and Soussi, Daniella and Qasim, Subaan and Dunin-Borkowska, Aleksandra and Rupasinghe, Thiara and Ubhi, Nicholas and Ranasinghe, Lasith", title="The Use of Animations Depicting Cardiac Electrical Activity to Improve Confidence in Understanding of Cardiac Pathology and Electrocardiography Traces Among Final-Year Medical Students: Nonrandomized Controlled Trial", journal="JMIR Med Educ", year="2024", month="Apr", day="23", volume="10", pages="e46507", keywords="medical education", keywords="cardiology", keywords="technology", keywords="clinical skills", keywords="cardiac", keywords="cardiac electrical activity", keywords="ECG", keywords="mixed methods study", keywords="students", keywords="education", keywords="medical professionals", keywords="development", keywords="web-based tutorial", keywords="teaching", keywords="cardiovascular", keywords="learning", keywords="electrocardiography", abstract="Background: Electrocardiography (ECG) interpretation is a fundamental skill for medical students and practicing medical professionals. Recognizing ECG pathologies promptly allows for quick intervention, especially in acute settings where urgent care is needed. However, many medical students find ECG interpretation and understanding of the underlying pathology challenging, with teaching methods varying greatly. Objective: This study involved the development of novel animations demonstrating the passage of electrical activity for well-described cardiac pathologies and showcased them alongside the corresponding live ECG traces during a web-based tutorial for final-year medical students. We aimed to assess whether the animations improved medical students' confidence in visualizing cardiac electrical activity and ECG interpretation, compared to standard ECG teaching methods. Methods: Final-year medical students at Imperial College London attended a web-based tutorial demonstrating the 7 animations depicting cardiac electrical activity and the corresponding ECG trace. Another tutorial without the animations was held to act as a control. Students completed a questionnaire assessing their confidence in interpreting ECGs and visualizing cardiovascular electrical transmission before and after the tutorial. Intervention-arm participants were also invited to a web-based focus group to explore their experiences of past ECG teaching and the tutorial, particularly on aspects they found helpful and what could be further improved in the tutorial and animations. Wilcoxon signed-rank tests and Mann-Whitney U tests were used to assess the statistical significance of any changes in confidence. Focus group transcripts were analyzed using inductive thematic analysis. Results: Overall, 19 students attended the intervention arm, with 15 (79\%) completing both the pre- and posttutorial questionnaires and 15 (79\%) participating in focus groups, whereas 14 students attended the control arm, with 13 (93\%) completing both questionnaires. Median confidence in interpreting ECGs in the intervention arm increased after the tutorial (2, IQR 1.5-3.0 vs 3, IQR 3-4.5; P<.001). Improvement was seen in both confidence in reviewing or diagnosing cardiac rhythms and the visualization of cardiac electrical activity. However, there was no significant difference between the intervention and control arms, for all pathologies (all P>.05). The main themes from the thematic analysis were that ECGs are a complex topic and past ECG teaching has focused on memorizing traces; the visualizations enabled deeper understanding of cardiac pathology; and ECG learning requires repetition, and clinical links remain essential. Conclusions: This study highlights the value of providing concise explanations of the meaning and pathophysiology behind ECG traces, both visually and verbally. ECG teaching that incorporates relevant pathophysiology, alongside vignettes with discussions regarding investigations and management options, is likely more helpful to students than practices based solely on pattern recognition. Although the animations supported student learning, the key element was the tutor's explanations. These animations may be more helpful as a supplement to teaching, for instance, as open-access videos. ", doi="10.2196/46507", url="https://mededu.jmir.org/2024/1/e46507" } @Article{info:doi/10.2196/51389, author="Kr{\"o}plin, Juliane and Maier, Leonie and Lenz, Jan-Hendrik and Romeike, Bernd", title="Knowledge Transfer and Networking Upon Implementation of a Transdisciplinary Digital Health Curriculum in a Unique Digital Health Training Culture: Prospective Analysis", journal="JMIR Med Educ", year="2024", month="Apr", day="15", volume="10", pages="e51389", keywords="big data", keywords="digital didactics", keywords="digital health applications", keywords="digital leadership", keywords="digital literacy", keywords="generative artificial intelligence", keywords="mobile working", keywords="robotics", keywords="telemedicine", keywords="wearables", abstract="Background: Digital health has been taught at medical faculties for a few years. However, in general, the teaching of digital competencies in medical education and training is still underrepresented. Objective: This study aims to analyze the objective acquisition of digital competencies through the implementation of a transdisciplinary digital health curriculum as a compulsory elective subject at a German university. The main subject areas of digital leadership and management, digital learning and didactics, digital communication, robotics, and generative artificial intelligence were developed and taught in a transdisciplinary manner over a period of 1 semester. Methods: The participants evaluated the relevant content of the curriculum regarding the competencies already taught in advance during the study, using a Likert scale. The participants' increase in digital competencies were examined with a pre-post test consisting of 12 questions. Statistical analysis was performed using an unpaired 2-tailed Student t test. A P value of <.05 was considered statistically significant. Furthermore, an analysis of the acceptance of the transdisciplinary approach as well as the application of an alternative examination method (term paper instead of a test with closed and open questions) was carried out. Results: In the first year after the introduction of the compulsory elective subject, students of human medicine (n=15), dentistry (n=3), and medical biotechnology (n=2) participated in the curriculum. In total, 13 participants were women (7 men), and 61.1\% (n=11) of the participants in human medicine and dentistry were in the preclinical study stage (clinical: n=7, 38.9\%). All the aforementioned learning objectives were largely absent in all study sections (preclinical: mean 4.2; clinical: mean 4.4; P=.02). The pre-post test comparison revealed a significant increase of 106\% in knowledge (P<.001) among the participants. Conclusions: The transdisciplinary teaching of a digital health curriculum, including digital teaching methods, considers perspectives and skills from different disciplines. Our new curriculum facilitates an objective increase in knowledge regarding the complex challenges of the digital transformation of our health care system. Of the 16 student term papers arising from the course, robotics and artificial intelligence attracted the most interest, accounting for 9 of the submissions. ", doi="10.2196/51389", url="https://mededu.jmir.org/2024/1/e51389" } @Article{info:doi/10.2196/50018, author="Cho, Sohyun and Bastien, Laurianne and Petrovic, Julia and B{\"o}ke, Naz Bilun and Heath, L. Nancy", title="The Role of Mental Health Stigma in University Students' Satisfaction With Web-Based Stress Management Resources: Intervention Study", journal="JMIR Form Res", year="2024", month="Apr", day="4", volume="8", pages="e50018", keywords="help-seeking behavior", keywords="help-seeking", keywords="mental health services", keywords="mental health stigma", keywords="mental health", keywords="university students", keywords="web-based workshop", abstract="Background: University students frequently report elevated levels of stress and mental health difficulties. Thus, the need to build coping capacity on university campuses has been highlighted as critical to mitigating the negative effects of prolonged stress and distress among students. Since the COVID-19 pandemic, web-based stress management resources such as infographics and web-based workshops have been central to supporting university students' mental health and well-being. However, there is a lack of research on students' satisfaction with and uptake of these approaches. Furthermore, mental health stigma has been suggested to have not only fueled the emergence of these web-based approaches to stress management but may also influence students' help-seeking behaviors and their satisfaction with and uptake of these resources. Objective: This study explored potential differences in students' satisfaction and strategy use in response to an interactive infographic (an emerging resource delivery modality) presenting stress management strategies and a web-based workshop (a more common modality) presenting identical strategies. This study also examined the relative contribution of students' strategy use and family-based mental health stigma in predicting their sustained satisfaction with the 2 web-based stress management approaches. Methods: University students (N=113; mean age 20.93, SD 1.53 years; 100/113, 88.5\% women) completed our web-based self-report measure of family-based mental health stigma at baseline and were randomly assigned to either independently review an interactive infographic (n=60) or attend a synchronous web-based workshop (n=53). All participants reported their satisfaction with their assigned modality at postintervention (T1) and follow-up (T2) and their strategy use at T2. Results: Interestingly, a 2-way mixed ANOVA revealed no significant group {\texttimes} time interaction or main effect of group on satisfaction. However, there was a significant decrease in satisfaction from T1 to T2, despite relatively high levels of satisfaction being reported at both time points. In addition, a 1-way ANOVA revealed no significant difference in strategy use between groups. Results from a hierarchical multiple regression revealed that students' strategy use positively predicted T2 satisfaction in both groups. However, only in the web-based workshop group did family-based mental health stigma predict T2 satisfaction over and above strategy use. Conclusions: While both approaches were highly satisfactory over time, findings highlight the potential utility of interactive infographics since they are less resource-intensive than web-based workshops and students' satisfaction with them is not impacted by family-based mental health stigma. Moreover, although numerous intervention studies measure satisfaction at a single time point, this study highlights the need for tracking satisfaction over time following intervention delivery. These findings have implications for student service units in the higher education context, emphasizing the need to consider student perceptions of family-based mental health stigma and preferences regarding delivery format when designing programming aimed at bolstering students' coping capacity. ", doi="10.2196/50018", url="https://formative.jmir.org/2024/1/e50018", url="http://www.ncbi.nlm.nih.gov/pubmed/38573758" } @Article{info:doi/10.2196/51151, author="Magalh{\~a}es Araujo, Sabrina and Cruz-Correia, Ricardo", title="Incorporating ChatGPT in Medical Informatics Education: Mixed Methods Study on Student Perceptions and Experiential Integration Proposals", journal="JMIR Med Educ", year="2024", month="Mar", day="20", volume="10", pages="e51151", keywords="education", keywords="medical informatics", keywords="artificial intelligence", keywords="AI", keywords="generative language model", keywords="ChatGPT", abstract="Background: The integration of artificial intelligence (AI) technologies, such as ChatGPT, in the educational landscape has the potential to enhance the learning experience of medical informatics students and prepare them for using AI in professional settings. The incorporation of AI in classes aims to develop critical thinking by encouraging students to interact with ChatGPT and critically analyze the responses generated by the chatbot. This approach also helps students develop important skills in the field of biomedical and health informatics to enhance their interaction with AI tools. Objective: The aim of the study is to explore the perceptions of students regarding the use of ChatGPT as a learning tool in their educational context and provide professors with examples of prompts for incorporating ChatGPT into their teaching and learning activities, thereby enhancing the educational experience for students in medical informatics courses. Methods: This study used a mixed methods approach to gain insights from students regarding the use of ChatGPT in education. To accomplish this, a structured questionnaire was applied to evaluate students' familiarity with ChatGPT, gauge their perceptions of its use, and understand their attitudes toward its use in academic and learning tasks. Learning outcomes of 2 courses were analyzed to propose ChatGPT's incorporation in master's programs in medicine and medical informatics. Results: The majority of students expressed satisfaction with the use of ChatGPT in education, finding it beneficial for various purposes, including generating academic content, brainstorming ideas, and rewriting text. While some participants raised concerns about potential biases and the need for informed use, the overall perception was positive. Additionally, the study proposed integrating ChatGPT into 2 specific courses in the master's programs in medicine and medical informatics. The incorporation of ChatGPT was envisioned to enhance student learning experiences and assist in project planning, programming code generation, examination preparation, workflow exploration, and technical interview preparation, thus advancing medical informatics education. In medical teaching, it will be used as an assistant for simplifying the explanation of concepts and solving complex problems, as well as for generating clinical narratives and patient simulators. Conclusions: The study's valuable insights into medical faculty students' perspectives and integration proposals for ChatGPT serve as an informative guide for professors aiming to enhance medical informatics education. The research delves into the potential of ChatGPT, emphasizes the necessity of collaboration in academic environments, identifies subject areas with discernible benefits, and underscores its transformative role in fostering innovative and engaging learning experiences. The envisaged proposals hold promise in empowering future health care professionals to work in the rapidly evolving era of digital health care. ", doi="10.2196/51151", url="https://mededu.jmir.org/2024/1/e51151", url="http://www.ncbi.nlm.nih.gov/pubmed/38506920" } @Article{info:doi/10.2196/54500, author="Alsahali, Saud and Almutairi, Salman and Almutairi, Salem and Almofadhi, Saleh and Anaam, Mohammed and Alshammari, Mohammed and Abdulsalim, Suhaj and Almogbel, Yasser", title="Pharmacy Students' Attitudes Toward Distance Learning After the COVID-19 Pandemic: Cross-Sectional Study From Saudi Arabia", journal="JMIR Form Res", year="2024", month="Mar", day="15", volume="8", pages="e54500", keywords="distance learning", keywords="e-learning", keywords="pharmacy education", keywords="team based learning", keywords="educational experience.", abstract="Background: Electronic learning refers to the use of assistive tools in offline and distance learning environments. It allows students to access learning tools and materials anytime and anywhere. However, distance learning courses depend on several factors that affect the quality of learning, which consequently affect students' preferences in the settings and tools used to deliver educational materials. Objective: This study aimed to evaluate students' preferences for continuing distance learning after the pandemic and to assess the distance educational environment after the pandemic. It also aimed to identify the factors affecting distance learning and evaluate students' preferences regarding modes of communication with instructors. Methods: A web-based survey was used to conduct this cross-sectional study. The target participants of this study were students in the doctor of pharmacy program at Unaizah College of Pharmacy, Qassim, Saudi Arabia. All students enrolled from December 2022 to January 2023 received an invitation with a link to the web-based survey. Results: The survey was completed by 141 students (58 female students and 83 male students). The research results showed that most students (102/141, 72.3\%) did not wish to continue distance education for laboratory courses, and 60.3\% (85/141) did not wish to continue taking distance team-based learning after the pandemic. Additionally, 83.7\% (118/141) of the students indicated that distance courses were simple. More than half of the participants (79/141, 56\%) stated that having a camera on during class negatively impacted their learning, and only 29.1\% (41/141) of the students stated that nonvisual communication with their fellow students impacted their learning. A large proportion of students (83/141, 58.9\%) reported impairment of social engagement on campus, 44\% (62/141) in-person interactions during classes, and 73.7\% (104/141) were relieved that their classes were not disrupted. Conclusions: Similar to all types of education, distance learning is characterized by advantages and disadvantages, as reported by students. Students felt that the course material was intelligible, and the distance course was uncomplicated. Moreover, they expressed relief that their studies were not disrupted. However, they also reported the loss of face-to-face contact during courses as the most significant drawback of distance learning versus face-to-face learning, followed by a lack of social connection on campus. ", doi="10.2196/54500", url="https://formative.jmir.org/2024/1/e54500", url="http://www.ncbi.nlm.nih.gov/pubmed/38488833" } @Article{info:doi/10.2196/50658, author="Tangadulrat, Pasin and Sono, Supinya and Tangtrakulwanich, Boonsin", title="Using ChatGPT for Clinical Practice and Medical Education: Cross-Sectional Survey of Medical Students' and Physicians' Perceptions", journal="JMIR Med Educ", year="2023", month="Dec", day="22", volume="9", pages="e50658", keywords="ChatGPT", keywords="AI", keywords="artificial intelligence", keywords="medical education", keywords="medical students", keywords="student", keywords="students", keywords="intern", keywords="interns", keywords="resident", keywords="residents", keywords="knee osteoarthritis", keywords="survey", keywords="surveys", keywords="questionnaire", keywords="questionnaires", keywords="chatbot", keywords="chatbots", keywords="conversational agent", keywords="conversational agents", keywords="attitude", keywords="attitudes", keywords="opinion", keywords="opinions", keywords="perception", keywords="perceptions", keywords="perspective", keywords="perspectives", keywords="acceptance", abstract="Background: ChatGPT is a well-known large language model--based chatbot. It could be used in the medical field in many aspects. However, some physicians are still unfamiliar with ChatGPT and are concerned about its benefits and risks. Objective: We aim to evaluate the perception of physicians and medical students toward using ChatGPT in the medical field. Methods: A web-based questionnaire was sent to medical students, interns, residents, and attending staff with questions regarding their perception toward using ChatGPT in clinical practice and medical education. Participants were also asked to rate their perception of ChatGPT's generated response about knee osteoarthritis. Results: Participants included 124 medical students, 46 interns, 37 residents, and 32 attending staff. After reading ChatGPT's response, 132 of the 239 (55.2\%) participants had a positive rating about using ChatGPT for clinical practice. The proportion of positive answers was significantly lower in graduated physicians (48/115, 42\%) compared with medical students (84/124, 68\%; P<.001). Participants listed a lack of a patient-specific treatment plan, updated evidence, and a language barrier as ChatGPT's pitfalls. Regarding using ChatGPT for medical education, the proportion of positive responses was also significantly lower in graduate physicians (71/115, 62\%) compared to medical students (103/124, 83.1\%; P<.001). Participants were concerned that ChatGPT's response was too superficial, might lack scientific evidence, and might need expert verification. Conclusions: Medical students generally had a positive perception of using ChatGPT for guiding treatment and medical education, whereas graduated doctors were more cautious in this regard. Nonetheless, both medical students and graduated doctors positively perceived using ChatGPT for creating patient educational materials. ", doi="10.2196/50658", url="https://mededu.jmir.org/2023/1/e50658", url="http://www.ncbi.nlm.nih.gov/pubmed/38133908" } @Article{info:doi/10.2196/40264, author="Akhras, Aya and ElSaban, Mariam and Tamil?Selvan, Varshini and Alzaabi, Zain Shaika and Senok, Abiola? and Zary, Nabil and Ho, B. Samuel", title="An Inquiry-Based Distance Learning Tool for Medical Students Under Lockdown (``COVID-19 Rounds''): Cross-Sectional Study", journal="JMIR Med Educ", year="2023", month="Nov", day="6", volume="9", pages="e40264", keywords="medical education", keywords="COVID-19", keywords="technology-enhanced learning", keywords="distance learning", keywords="student engagement", keywords="5E instructional model", abstract="Background: The?COVID-19 pandemic?presented significant challenges to both?clinical practice and the?delivery of medical education. Educators and learners implemented novel techniques, including distance learning and web-based rounds, while trying to stay updated with the surge of information regarding COVID-19 epidemiology, pathogenesis, and treatment. Hence, we designed and implemented a technologically enhanced course called ``COVID-19 Rounds'' to educate students about the rapidly evolving pandemic. Objective: The objectives of this study are to describe a technologically enhanced course called ``COVID-19 Rounds'' and evaluate the following: (1) student satisfaction and program usefulness in achieving preset objectives, (2) perceived improvement in literacy regarding the pandemic, and (3) the impact of student engagement by designing infographics and initiating COVID-19--related research projects. Methods: This is a cross-sectional study measuring the impact of the implementation of the web-based ``COVID-19 Rounds'' course. This program included?web-based clinical experiences with physicians?on?actual?rounds?in COVID-19 wards in the hospital, weekly updates on evolving data and new research, and engagement in student-led projects. The study population included 47 fourth-year medical students at the Mohamed Bin Rashid University of Medicine and Health Sciences in Dubai, the United Arab Emirates, who attended the course.?We designed and administered a 47-item survey to assess student satisfaction, program usefulness, impact on knowledge, and student engagement. Data were collected at the end of program delivery via Microsoft Forms. Results: In total, 38 (81\%)?out of 47 fourth-year medical students?participated in?this study. The final course evaluation revealed an overall high satisfaction rate, with a mean rating of 3.9 (SD 0.94) on the 5-point Likert scale.?Most students were satisfied with the course format (27/38, 71\%), organization (31/38, 82\%), and the learning experience (28/38, 74\%) that the course offered.?The course was particularly appreciated for offering evidence-based talks about aspects of the pandemic (34/38, 90\%), providing weekly updates regarding emerging evidence (32/38, 84\%),?and enhancing understanding of the challenges of the pandemic (34/38, 90\%). Satisfaction with distance learning was moderate (23/37, 62\%), and a minority of students would have preferred an in-person version of the course (10/37, 27\%). Student engagement in the course was high. All students participated in small group presentations of infographics of pandemic-related topics. Perceived advantages included conciseness and visual appeal, and disadvantages included the lack of detail and the time-consuming nature of infographic design, especially for students with no prior design experience. After the course ended, 27 (57\%) students began research projects. This resulted in 6 abstracts presented at local meetings and 8 scientific papers published or submitted for publication. Conclusions: This inquiry-based adaptive approach to educating medical students about updates on COVID-19 via web-based learning was successful in achieving objectives and encouraging engagement in research. However, shortcomings of the course related to the lack of in-person teaching and clinical activities were?also highlighted. ", doi="10.2196/40264", url="https://mededu.jmir.org/2023/1/e40264", url="http://www.ncbi.nlm.nih.gov/pubmed/37856734" } @Article{info:doi/10.2196/43977, author="B{\"a}lter, Olle and Jemstedt, Andreas and Javan Abraham, Feben and Persson Osowski, Christine and Mugisha, Reuben and B{\"a}lter, Katarina", title="Effect of Personalized Email-Based Reminders on Participants' Timeliness in an Online Education Program: Randomized Controlled Trial", journal="JMIR Form Res", year="2023", month="Oct", day="13", volume="7", pages="e43977", keywords="online learning", keywords="personal reminders", keywords="timeliness", keywords="self-regulated learning", keywords="adult education", keywords="education", keywords="students", keywords="learning", keywords="email", keywords="online", keywords="tool", keywords="intervention", keywords="program", abstract="Background: Postsecondary students need to be able to handle self-regulated learning and manage schedules set by instructors. This is particularly the case with online courses, as they often come with a limited number of social reminders and less information directly from the teacher compared to courses with physical presence. This may increase procrastination and reduce timeliness of the students. Reminders may be a tool to improve the timeliness of students' study behavior, but previous research shows that the effect of reminders differs between types of reminders, whether the reminder is personalized or general, and depending on the background of the students. In the worst cases, reminders can even increase procrastination. Objective: The aim of this study was to test if personalized email reminders, as compared to general email reminders, affect the time to completion of scheduled online coursework. The personalized reminders included information on which page in the online material the participants ought to be on at the present point in time and the last page they were on during their last session. The general reminders only contained the first part of this information: where they ought to be at the present point in time. Methods: Weekly email reminders were sent to all participants enrolled in an online program, which included 39 professional learners from three East African countries. All participants in the Online Education for Leaders in Nutrition and Sustainability program, which uses a question-based learning methodology, were randomly assigned to either personalized or general reminders. The structure of the study was AB-BA, so that group A received personalized reminders for the first unit, then general reminders for the rest of the course, while group B started with general reminders and received personalized reminders only in the third (and last) unit in the course. Results: In total, 585 email reminders were distributed, of which 390 were general reminders and 195 were personalized. A Bayesian mixed-effects logistic regression was used to estimate the difference in the probability of being on time with one's studies. The probability of being on time was 14 percentage points (95\% credible interval 3\%-25\%) higher following personalized reminders compared to that following general reminders. For a course with 100 participants, this means 14 more students would be on time. Conclusions: Personalized reminders had a greater positive effect than general reminders for a group of adults working full-time while enrolled in our online educational program. Considering how small the intervention was---adding a few words with the page number the student ought to be on to a reminder---we consider this effect fairly substantial. This intervention could be repeated manually by anyone and in large courses with some basic programming. ", doi="10.2196/43977", url="https://formative.jmir.org/2023/1/e43977", url="http://www.ncbi.nlm.nih.gov/pubmed/37831487" } @Article{info:doi/10.2196/49372, author="Helle, Nikolina and Vikman, Dubland Miriam and Dahl-Michelsen, Tone and Lie, Stangeland Silje", title="Health Care and Social Work Students' Experiences With a Virtual Reality Simulation Learning Activity: Qualitative Study", journal="JMIR Med Educ", year="2023", month="Sep", day="20", volume="9", pages="e49372", keywords="virtual reality", keywords="virtual reality simulation", keywords="learning", keywords="experiences", keywords="health care and social work", keywords="higher education", keywords="health care", keywords="social work", abstract="Background: Virtual reality is used to an increasing extent in various fields and is now making inroads into health and social education. Virtual reality simulation can provide a safe and controlled environment for students to practice and master skills that are transferable to real-world situations without putting patients, clients, or themselves at risk of any harm. Virtual reality simulation using 360{\textdegree} videos represents a novel approach to simulation in health care and social work education, and this inspired our interest in exploring students' experiences with such a learning activity. Objective: The aim of this study was to explore occupational therapy, social education, nursing, and social work students' experiences with virtual reality simulation as a learning activity in an interdisciplinary subject. Methods: The data were collected through 6 semistructured focus groups with 28 students. We conducted the focus groups after the students from the 4 education programs had participated in the virtual reality simulation at 3 campuses at a specialized university in Norway. Each focus group interview was facilitated by 1 moderator and 1 facilitator, a combination of experienced researchers and novices. We followed a qualitative design using the 6-step thematic analysis described by Braun and Clarke. Results: The analysis revealed 3 overall themes for students' experiences with the virtual reality simulation. The first theme, 360{\textdegree} videos provide observations for individual learning, illustrates how learning can take place through the students' experiences with sensory inputs and observations from the 360{\textdegree} videos. Students experienced that the video enabled them to individually reflect and achieve learning from what was considered a clinically relevant video. The second theme, 360{\textdegree} videos activate emotional learning, demonstrates how the students experienced emotional engagement when watching the 360{\textdegree} videos. The degree of realism provided in the video was considered as important for the students' learning. The last theme, Debrief sessions enhance comprehensive learning, pinpoints how the students experienced learning through reflective discussions with other students after watching the 360{\textdegree} videos. Students claimed this process to be a vital part of the learning activity. Conclusions: Virtual reality simulation represents a promising learning activity to enhance the professional learning of health care and social work students. It offers opportunities for individualized learning through observations, and it also engages students emotionally in the learning process. The combination of 360{\textdegree} videos and group discussions in virtual reality appears promising to enhance professional learning outcomes and competence, which may contribute to improved health care and social work services. ", doi="10.2196/49372", url="https://mededu.jmir.org/2023/1/e49372", url="http://www.ncbi.nlm.nih.gov/pubmed/37728988" } @Article{info:doi/10.2196/47126, author="Listiyandini, Arruum Ratih and Andriani, Annisa and Kusristanti, Chandradewi and Moulds, Michelle and Mahoney, Alison and Newby, M. Jill", title="Culturally Adapting an Internet-Delivered Mindfulness Intervention for Indonesian University Students Experiencing Psychological Distress: Mixed Methods Study", journal="JMIR Form Res", year="2023", month="Aug", day="31", volume="7", pages="e47126", keywords="psychological distress", keywords="mindfulness", keywords="cultural adaptation", keywords="internet-delivered", keywords="students", keywords="Indonesia", keywords="mobile phone", abstract="Background: Psychological distress is prevalent among university students. However, the availability of evidence-based mental health treatment remains limited in many low- and middle-income countries, including Indonesia. Internet-delivered, mindfulness-based interventions that reduce distress have potential for treating university student distress at scale. Unfortunately, evidence-based, internet-delivered mindfulness treatments are not yet available in Indonesia. Cultural adaptation of established evidence-based, internet-delivered mindfulness interventions is needed. Objective: In this paper, we describe the process of culturally adapting an Australian internet-delivered mindfulness program (Introduction to Mindfulness) to be relevant and appropriate for treating Indonesian university students' psychological distress. Methods: To assist the cultural adaptation process, we used a systematic cultural adaptation framework and a mixed methods approach combining quantitative and qualitative methods. In study 1 (information gathering), we administered an internet-delivered questionnaire to Indonesian university students (n=248) to examine their preferences regarding an internet-delivered mindfulness intervention. In study 2 (preliminary design), a draft program was developed and independently reviewed by Indonesian stakeholders. Stakeholders (n=25) included local Indonesian mindfulness and mental health professionals (n=6) and university students (n=19), who were selected to maximize sample representativeness regarding personal and professional characteristics. To evaluate the initial design and cultural congruence of the internet-delivered mindfulness program in the Indonesian context, we conducted interviews and focus groups with stakeholders. Stakeholders also completed the Cultural Relevance Questionnaire. Results: In study 1, most Indonesian university students (240/248, 96.8\%) reported openness to an internet-delivered mindfulness program. Most of interested students (127/240, 52.9\%) preferred the length of the program to be 3 to 4 sessions, with 45.8\% (110/240) preferring brief lessons taking only 15 to 30 minutes to complete. They (194/240, 80.8\%) recommended that the program be accessible both through websites and mobile phones. In study 2, Indonesian stakeholders generally found the internet-delivered program to be highly culturally appropriate in terms of language, concepts, context, treatment goals, and depictions of students' emotional and behavioral experiences. However, stakeholders also recommended some specific adaptations regarding the program's delivery model (eg, combining visual and audio modalities when delivering psychoeducation), cultural components (eg, including more social and spiritual activities), program practicality (eg, including rewards to promote engagement), and design elements (eg, including additional culturally relevant illustrations). Following stakeholder feedback, a new culturally adapted Indonesian internet-delivered mindfulness program called Program Intervensi Mindfulness Daring Mahasiswa Indonesia was created. Conclusions: This study highlights the process and importance of cultural adaptation of an evidence-based mindfulness treatment and demonstrates how this may be achieved for internet-delivered psychotherapy programs. We found that a culturally adapted internet-delivered mindfulness program was relevant for Indonesian students with some adjustments to the programs' content and delivery. Future research is now needed to evaluate the clinical benefit of this program. ", doi="10.2196/47126", url="https://formative.jmir.org/2023/1/e47126", url="http://www.ncbi.nlm.nih.gov/pubmed/37651168" } @Article{info:doi/10.2196/50902, author="Toohey, Shannon and Wray, Alisa and Hunter, John and Saadat, Soheil and Boysen-Osborn, Megan and Smart, Jonathan and Wiechmann, Warren and Pressman, D. Sarah", title="Authors' Response to the Validity of Cortisol and Galvanic Skin Responses for Measuring Student Stress During Training", journal="JMIR Med Educ", year="2023", month="Aug", day="18", volume="9", pages="e50902", keywords="augmented reality", keywords="AR", keywords="salivary cortisol", keywords="galvanic skin conductance", keywords="medical simulation", keywords="medical education", doi="10.2196/50902", url="https://mededu.jmir.org/2023/1/e50902", url="http://www.ncbi.nlm.nih.gov/pubmed/37594800" } @Article{info:doi/10.2196/45340, author="Sonawane, Urvi and Kasetti, Pragna", title="How Valid Are Cortisol and Galvanic Skin Responses in Measuring Student Stress During Training? Comment on the Psychological Effects of Simulation Training", journal="JMIR Med Educ", year="2023", month="Aug", day="18", volume="9", pages="e45340", keywords="augmented reality", keywords="AR", keywords="salivary cortisol", keywords="galvanic skin conductance", keywords="medical simulation", keywords="medical education", doi="10.2196/45340", url="https://mededu.jmir.org/2023/1/e45340", url="http://www.ncbi.nlm.nih.gov/pubmed/37594784" } @Article{info:doi/10.2196/44361, author="Deutsch, E. Judith and Palmieri, L. John and Gorin, Holly and Wendell, Augustus and Wohn, Yvette Donghee and Damodaran, Harish", title="Student and Faculty Perspectives on the Usefulness and Usability of a Digital Health Educational Tool to Teach Standardized Assessment of Persons After Stroke: Mixed Methods Study", journal="JMIR Med Educ", year="2023", month="Aug", day="10", volume="9", pages="e44361", keywords="physical therapy", keywords="education", keywords="teaching tool", keywords="simulation-based learning", keywords="computer-aided instruction", keywords="standardized assessment", keywords="clinical reasoning", keywords="sensors", abstract="Background: The VSTEP Examination Suite is a collection of evidence-based standardized assessments for persons after stroke. It was developed by an interdisciplinary team in collaboration with clinician users. It consists of 5 standardized assessments: 2 performance-based tests using the Kinect camera (Microsoft Corp) to collect kinematics (5-Time Sit-to-Stand and 4-Square Test); 2 additional performance-based tests (10-Meter Walk Test and 6-Minute Walk Test); and 1 patient-reported outcome measure, the Activities-Specific Balance Confidence Scale. Objective: This study aimed to describe the development of the VSTEP Examination Suite and its evaluation as an educational tool by physical therapy students and faculty to determine its usefulness and usability. Methods: A total of 6 students from a Doctor of Physical Therapy program in the United States and 6 faculty members who teach standardized assessments in different physical therapy programs from the United States and Israel were recruited by convenience sampling to participate in the study. They interacted with the system using a talk-aloud procedure either in pairs or individually. The transcripts of the sessions were coded deductively (by 3 investigators) with a priori categories of usability and usefulness, and comments were labeled as negative or positive. The frequencies of the deductive themes of usefulness and usability were tested for differences between faculty and students using a Wilcoxon rank sum test. A second round of inductive coding was performed by 3 investigators guided by theories of technology adoption, clinical reasoning, and education. Results: The faculty members' and students' positive useful comments ranged from 83\% (10/12) to 100\%. There were no significant differences in usefulness comments between students and faculty. Regarding usability, faculty and students had the lowest frequency of positive comments for the 10-Meter Walk Test (5/10, 50\%). Students also reported a high frequency of negative comments on the 4-Square Test (9/21, 43\%). Students had a statistically significantly higher number of negative usability comments compared with faculty (W=5.7; P=.02), specifically for the 5-Time Sit-to-Stand (W=5.3; P=.02). Themes emerged related to variable knowledge about the standardized tests, value as a teaching and learning tool, technology being consistent with clinical reasoning in addition to ensuring reliability, expert-to-novice clinical reasoning (students), and usability. Conclusions: The VSTEP Examination Suite was found to be useful by both faculty and students. Reasons for perceived usefulness had some overlap, but there were also differences based on role and experience. Usability testing revealed opportunities for technology refinement. The development of the technology by interdisciplinary teams and testing with multiple types of users may increase adoption. ", doi="10.2196/44361", url="https://mededu.jmir.org/2023/1/e44361", url="http://www.ncbi.nlm.nih.gov/pubmed/37561552" } @Article{info:doi/10.2196/43333, author="Malerbi, Korn Fernando and Nakayama, Filipe Luis and Gayle Dychiao, Robyn and Zago Ribeiro, Lucas and Villanueva, Cleva and Celi, Anthony Leo and Regatieri, Vinicius Caio", title="Digital Education for the Deployment of Artificial Intelligence in Health Care", journal="J Med Internet Res", year="2023", month="Jun", day="22", volume="25", pages="e43333", keywords="artificial intelligence", keywords="digital health", keywords="health education", keywords="machine learning", keywords="digital education", keywords="digital", keywords="education", keywords="transformation", keywords="neural", keywords="network", keywords="evaluation", keywords="dataset", keywords="data", keywords="set", keywords="clinical", doi="10.2196/43333", url="https://www.jmir.org/2023/1/e43333", url="http://www.ncbi.nlm.nih.gov/pubmed/37347537" } @Article{info:doi/10.2196/43190, author="Bajra, Rika and Frazier, Winfred and Graves, Lisa and Jacobson, Katherine and Rodriguez, Andres and Theobald, Mary and Lin, Steven", title="Feasibility and Acceptability of a US National Telemedicine Curriculum for Medical Students and Residents: Multi-institutional Cross-sectional Study", journal="JMIR Med Educ", year="2023", month="May", day="8", volume="9", pages="e43190", keywords="curriculum", keywords="distance education", keywords="graduate medical education", keywords="telemedicine", keywords="undergraduate medical education", abstract="Background: Telemedicine use increased as a response to health care delivery changes necessitated by the COVID-19 pandemic. However, lack of standardized curricular content creates gaps and inconsistencies in effectively integrating telemedicine training at both the undergraduate medical education and graduate medical education levels. Objective: This study evaluated the feasibility and acceptability of a web-based national telemedicine curriculum developed by the Society of Teachers of Family Medicine for medical students and family medicine (FM) residents. Based on the Association of American Medical Colleges telehealth competencies, the asynchronous curriculum featured 5 self-paced modules; covered topics include evidence-based telehealth uses, best practices in communication and remote physical examinations, technology requirements and documentation, access and equity in telehealth delivery, and the promise and potential perils of emerging technologies. Methods: A total of 17 medical schools and 17 FM residency programs implemented the curriculum between September 1 and December 31, 2021. Participating sites represented 25 states in all 4 US census regions with balanced urban, suburban, and rural settings. A total of 1203 learners, including 844 (70\%) medical students and 359 (30\%) FM residents, participated. Outcomes were measured through self-reported 5-point Likert scale responses. Results: A total of 92\% (1101/1203) of learners completed the entire curriculum. Across the modules, 78\% (SD 3\%) of participants agreed or strongly agreed that they gained new knowledge, skills, or attitudes that will help them in their training or career; 87\% (SD 4\%) reported that the information presented was at the right level for them; 80\% (SD 2\%) reported that the structure of the modules was effective; and 78\% (SD 3\%) agreed or strongly agreed that they were satisfied. Overall experience using the national telemedicine curriculum did not differ significantly between medical students and FM residents on binary analysis. No consistent statistically significant relationships were found between participants' responses and their institution's geographic region, setting, or previous experience with a telemedicine curriculum. Conclusions: Both undergraduate medical education and graduate medical education learners, represented by diverse geographic regions and institutions, indicated that the curriculum was broadly acceptable and effective. ", doi="10.2196/43190", url="https://mededu.jmir.org/2023/1/e43190", url="http://www.ncbi.nlm.nih.gov/pubmed/37155241" } @Article{info:doi/10.2196/43415, author="Liu, Shalom David and Abu-Shaban, Kamil and Halabi, S. Safwan and Cook, Sundaram Tessa", title="Changes in Radiology Due to Artificial Intelligence That Can Attract Medical Students to the Specialty", journal="JMIR Med Educ", year="2023", month="Mar", day="20", volume="9", pages="e43415", keywords="artificial intelligence", keywords="AI", keywords="radiology", keywords="medical students", keywords="residency", keywords="medical education", keywords="students", keywords="automated", keywords="clinical informatics", keywords="patient", keywords="care", keywords="innovation", keywords="radiologist", doi="10.2196/43415", url="https://mededu.jmir.org/2023/1/e43415", url="http://www.ncbi.nlm.nih.gov/pubmed/36939823" } @Article{info:doi/10.2196/40040, author="Musa, Dahlia and Gonzalez, Laura and Penney, Heidi and Daher, Salam", title="Technology Acceptance and Authenticity in Interactive Simulation: Experimental Study", journal="JMIR Med Educ", year="2023", month="Feb", day="15", volume="9", pages="e40040", keywords="health care simulation", keywords="interactivity", keywords="remote learning", keywords="video", keywords="technology acceptance", keywords="authenticity", keywords="nursing education", keywords="active learning", keywords="passive learning", abstract="Background: Remote and virtual simulations have gained prevalence during the COVID-19 pandemic as institutions maintain social distancing measures. Because of the challenges of cost, flexibility, and feasibility in traditional mannequin simulation, many health care educators have used videos as a remote simulation modality; however, videos provide minimal interactivity. Objective: In this study, we aimed to evaluate the role of interactivity in students' simulation experiences. We analyzed students' perceptions of technology acceptance and authenticity in interactive and noninteractive simulations. Methods: Undergraduate nursing students participated in interactive and noninteractive simulations. The interactive simulation was conducted using interactive video simulation software that we developed, and the noninteractive simulation consisted of passively playing a video of the simulation. After each simulation, the students completed a 10-item technology acceptance questionnaire and 6-item authenticity questionnaire. The data were analyzed using the Wilcoxon signed-rank test. In addition, we performed an exploratory analysis to compare technology acceptance and authenticity in interactive local and remote simulations using the Mann-Whitney U test. Results: Data from 29 students were included in this study. Statistically significant differences were found between interactive and noninteractive simulations for overall technology acceptance (P<.001) and authenticity (P<.001). Analysis of the individual questionnaire items showed statistical significance for 3 out of the 10 technology acceptance items (P=.002, P=.002, and P=.004) and 5 out of the 6 authenticity items (P<.001, P<.001, P=.001, P=.003, and P=.005). The interactive simulation scored higher than the noninteractive simulation in all the statistically significant comparisons. Our exploratory analysis revealed that local simulation may promote greater perceptions of technology acceptance (P=.007) and authenticity (P=.027) than remote simulation. Conclusions: Students' perceptions of technology acceptance and authenticity were greater in interactive simulation than in noninteractive simulation. These results support the importance of interactivity in students' simulation experiences, especially in remote or virtual simulations in which students' involvement may be less active. ", doi="10.2196/40040", url="https://mededu.jmir.org/2023/1/e40040", url="http://www.ncbi.nlm.nih.gov/pubmed/36790842" } @Article{info:doi/10.2196/36447, author="Toohey, Shannon and Wray, Alisa and Hunter, John and Waldrop, Ian and Saadat, Soheil and Boysen-Osborn, Megan and Sudario, Gabriel and Smart, Jonathan and Wiechmann, Warren and Pressman, D. Sarah", title="Comparing the Psychological Effects of Manikin-Based and Augmented Reality--Based Simulation Training: Within-Subjects Crossover Study", journal="JMIR Med Educ", year="2022", month="Aug", day="1", volume="8", number="3", pages="e36447", keywords="augmented reality", keywords="AR", keywords="salivary cortisol", keywords="galvanic skin conductance", keywords="medical simulation", keywords="medical education", abstract="Background: Patient simulators are an increasingly important part of medical training. They have been shown to be effective in teaching procedural skills, medical knowledge, and clinical decision-making. Recently, virtual and augmented reality simulators are being produced, but there is no research on whether these more realistic experiences cause problematic and greater stress responses as compared to standard manikin simulators. Objective: The purpose of this research is to examine the psychological and physiological effects of augmented reality (AR) in medical simulation training as compared to traditional manikin simulations. Methods: A within-subjects experimental design was used to assess the responses of medical students (N=89) as they completed simulated (using either manikin or AR) pediatric resuscitations. Baseline measures of psychological well-being, salivary cortisol, and galvanic skin response (GSR) were taken before the simulations began. Continuous GSR assessments throughout and after the simulations were captured along with follow-up measures of emotion and cortisol. Participants also wrote freely about their experience with each simulation, and narratives were coded for emotional word use. Results: Of the total 86 medical students who participated, 37 (43\%) were male and 49 (57\%) were female, with a mean age of 25.2 (SD 2.09, range 22-30) years and 24.7 (SD 2.08, range 23-36) years, respectively. GSR was higher in the manikin group adjusted for day, sex, and medications taken by the participants (AR-manikin: --0.11, 95\% CI --0.18 to --0.03; P=.009). The difference in negative affect between simulation types was not statistically significant (AR-manikin: 0.41, 95\% CI --0.72 to 1.53; P=.48). There was no statistically significant difference between simulation types in self-reported stress (AR-manikin: 0.53, 95\% CI --2.35 to 3.42; P=.71) or simulation stress (AR-manikin: --2.17, 95\% CI --6.94 to 2.59; P=.37). The difference in percentage of positive emotion words used to describe the experience was not statistically significant between simulation types, which were adjusted for day of experiment, sex of the participants, and total number of words used (AR-manikin: --4.0, 95\% CI --0.91 to 0.10; P=.12). There was no statistically significant difference between simulation types in terms of the percentage of negative emotion words used to describe the experience (AR-manikin: --0.33, 95\% CI --1.12 to 0.46; P=.41), simulation sickness (AR-manikin: 0.17, 95\% CI --0.29 to 0.62; P=.47), or salivary cortisol (AR-manikin: 0.04, 95\% CI --0.05 to 0.13; P=.41). Finally, preexisting levels of posttraumatic stress disorder, perceived stress, and reported depression were not tied to physiological responses to AR. Conclusions: AR simulators elicited similar stress responses to currently used manikin-based simulators, and we did not find any evidence of AR simulators causing excessive stress to participants. Therefore, AR simulators are a promising tool to be used in medical training, which can provide more emotionally realistic scenarios without the risk of additional harm. ", doi="10.2196/36447", url="https://mededu.jmir.org/2022/3/e36447", url="http://www.ncbi.nlm.nih.gov/pubmed/35916706" } @Article{info:doi/10.2196/38508, author="Taramarcaz, Victor and Herren, Tara and Golay, Eric and Regard, Simon and Martin-Achard, S{\'e}bastien and Mach, Francois and Schnetzler, Nicolas and Ricci, Ga{\"e}tan and Zamberg, Ido and Larribau, Robert and Niquille, Marc and Suppan, M{\'e}lanie and Schiffer, Eduardo and Suppan, Laurent", title="A Short Intervention and an Interactive e-Learning Module to Motivate Medical and Dental Students to Enlist as First Responders: Implementation Study", journal="J Med Internet Res", year="2022", month="May", day="18", volume="24", number="5", pages="e38508", keywords="basic life support", keywords="cardiopulmonary resuscitation", keywords="first responder", keywords="undergraduate medical education", keywords="out-of-hospital cardiac arrest", keywords="medical education", keywords="e-learning", keywords="digital education", keywords="medical student", keywords="blended learning", abstract="Background: Prompt and proficient basic life support (BLS) maneuvers are essential to increasing the odds of survival after out-of-hospital cardiac arrest. However, significant time can elapse before the arrival of professional rescuers. To decrease these delays, many countries have developed first responder networks. These networks are composed of BLS-certified lay or professional rescuers who can be dispatched by emergency medical communication centers to take care of those who experience out-of-hospital cardiac arrest. Many systems are, however, limited by a relatively low number of active first responders, and first-year medical and dental students may represent an almost untapped pool of potential rescuers. On top of providing an enhanced BLS coverage to the population, this could also help medical students be better prepared to their future role as certified health care providers and address societal expectations regarding health care students. Objective: Our objective was to describe the impact of a short motivational intervention followed by a blended BLS course (e-learning and practice session) designed to motivate first-year medical and dental students to enlist as first responders. Methods: A short, web-based, motivational intervention presenting this project took place, and first-year University of Geneva, Faculty of Medicine students were provided with a link to the study platform. Those who agreed to participate were redirected to a demographic questionnaire before registering on the platform. The participants were then asked to answer a second questionnaire designed to determine their baseline knowledge prior to following an interactive e-learning module. Upon completion, a web-based booking form enabling them to register for a 1-hour practice session was displayed. These sessions were held by senior medical students who had been trained and certified as BLS instructors. The participants who attended these practice sessions were asked to answer a postcourse questionnaire before receiving the certificate enabling them to register as first responders. Results: Out of the 529 first-year students registered at University of Geneva, Faculty of Medicine on January 14, 2021, 190 (35.9\%) initially agreed to participate. Moreover, 102 (19.3\%) attended the practice sessions, and 48 (9.1\%) had completed all training and enlisted as first responders on the dedicated platform, Save a Life, at 6 months (July 14, 2021). Postcourse confidence in resuscitation skills was associated with a higher likelihood of registering as first responder (P=.03). No association was found between prior BLS knowledge and the probability of registering to a practice session (P=.59), of obtaining a course completion certificate (P=.29), or of enlisting as first responder (P=.56). Conclusions: This study shows that a motivational intervention associated with a short BLS course can convince medical students to enlist as first responders. Further studies are needed to understand the rather low proportion of medical students finally registering as first responders. International Registered Report Identifier (IRRID): RR2-10.2196/24664 ", doi="10.2196/38508", url="https://www.jmir.org/2022/5/e38508", url="http://www.ncbi.nlm.nih.gov/pubmed/35583927" } @Article{info:doi/10.2196/34042, author="Lin, Yuchen and Lemos, Martin and Neuschaefer-Rube, Christiane", title="Digital Health and Learning in Speech-Language Pathology, Phoniatrics, and Otolaryngology: Survey Study for Designing a Digital Learning Toolbox App", journal="JMIR Med Educ", year="2022", month="Apr", day="27", volume="8", number="2", pages="e34042", keywords="digital learning", keywords="mLearning", keywords="mHealth", keywords="speech-language pathology", keywords="phoniatrics", keywords="otolaryngology", keywords="communication disorders", keywords="mobile phone", abstract="Background: The digital age has introduced opportunities and challenges for clinical education and practice caused by infinite incoming information and novel technologies for health. In the interdisciplinary field of communication sciences and disorders (CSD), engagement with digital topics has emerged slower than in other health fields, and effective strategies for accessing, managing, and focusing on digital resources are greatly needed. Objective: We aimed to conceptualize and investigate preferences of stakeholders regarding a digital learning toolbox, an app containing a library of current resources for CSD. This cross-sectional survey study conducted in German-speaking countries investigated professional and student perceptions and preferences regarding such an app's features, functions, content, and associated concerns. Methods: An open web-based survey was disseminated to professionals and students in the field of CSD, including speech-language pathologists (SLPs; German: Logop{\"a}d*innen), speech-language pathology students, phoniatricians, otolaryngologists, and medical students. Insights into preferences and perceptions across professions, generations, and years of experience regarding a proposed app were investigated. Results: Of the 164 participants, an overwhelming majority (n=162, 98.8\%) indicated readiness to use such an app, and most participants (n=159, 96.9\%) perceived the proposed app to be helpful. Participants positively rated app functions that would increase utility (eg, tutorial, quality rating function, filters based on content or topic, and digital format); however, they had varied opinions regarding an app community feature. Regarding app settings, most participants rated the option to share digital resources through social media links (144/164, 87.8\%), receive and manage push notifications (130/164, 79.3\%), and report technical issues (160/164, 97.6\%) positively. However, significant variance was noted across professions (H3=8.006; P=.046) and generations (H3=9.309; P=.03) regarding a username-password function, with SLPs indicating greater perceived usefulness in comparison to speech-language pathology students (P=.045), as was demonstrated by Generation X versus Generation Z (P=.04). Participants perceived a range of clinical topics to be important; however, significant variance was observed across professions, between physicians and SLPs regarding the topic of diagnostics (H3=9.098; P=.03) and therapy (H3=21.236; P<.001). Concerns included technical challenges, data protection, quality of the included resources, and sustainability of the proposed app. Conclusions: This investigation demonstrated that professionals and students show initial readiness to engage in the co-design and use of an interdisciplinary digital learning toolbox app. Specifically, this app could support effective access, sharing, evaluation, and knowledge management in a digital age of rapid change. Formalized digital skills education in the field of CSD is just a part of the solution. It will be crucial to explore flexible, adaptive strategies collaboratively for managing digital resources and tools to optimize targeted selection and use of relevant, high-quality evidence in a world of bewildering data. ", doi="10.2196/34042", url="https://mededu.jmir.org/2022/2/e34042", url="http://www.ncbi.nlm.nih.gov/pubmed/35475980" } @Article{info:doi/10.2196/29624, author="Hamoen, C. Esther and De Jong, M. Peter G. and Van Blankenstein, M. Floris and Reinders, J. Marlies E.", title="Design and First Impressions of a Small Private Online Course in Clinical Workplace Learning: Questionnaire and Interview Study", journal="JMIR Med Educ", year="2022", month="Apr", day="7", volume="8", number="2", pages="e29624", keywords="blended learning", keywords="design-based research", keywords="web-based learning", keywords="workplace learning", keywords="medical education", keywords="clinical internship", abstract="Background: Clinical workplace learning takes place in a dynamic and complex learning environment that is designated as a site for patient care and education. Challenges in clinical training can be overcome by implementing blended learning, as it offers flexible learning programs suitable for student-centered learning, web-based collaboration, and peer learning. Objective: The aim of this study is to evaluate the Small Private Online Course (SPOC) by interns' first impressions and satisfaction measures (N=20) on using the SPOC. This study describes the design process of a SPOC from a theoretical and practical perspective and how it has been integrated into a clinical internship in internal medicine. Methods: The design of the SPOC was based on general theoretical principles that learning should be constructive, contextual, collaborative, and self-regulated, and the self-determination theory to stimulate intrinsic motivation. Interns' impressions and level of satisfaction were evaluated with a web-based questionnaire and group interview. Results: Interns thought the web-based learning environment to be a useful and accessible alternative to improve knowledge and skills. Peer learning and web-based collaboration through peer interaction was perceived as less effective, as student feedback was felt inferior to teacher feedback. The interns would prefer more flexibility within the course, which could improve self-regulated learning and autonomy. Conclusions: The evaluation shows that the SPOC is a useful and accessible addition to the clinical learning environment, providing an alternative opportunity to improve knowledge and skills. Further research is needed to improve web-based collaboration and interaction in our course. ", doi="10.2196/29624", url="https://mededu.jmir.org/2022/2/e29624", url="http://www.ncbi.nlm.nih.gov/pubmed/35389362" } @Article{info:doi/10.2196/30653, author="Li, Yaning and Ye, Hongqiang and Wu, Siyu and Zhao, Xiaohan and Liu, Yunsong and Lv, Longwei and Zhang, Ping and Zhang, Xiao and Zhou, Yongsheng", title="Mixed Reality and Haptic--Based Dental Simulator for Tooth Preparation: Research, Development, and Preliminary Evaluation", journal="JMIR Serious Games", year="2022", month="Mar", day="9", volume="10", number="1", pages="e30653", keywords="dental education", keywords="simulator", keywords="mixed reality", keywords="tooth preparation", abstract="Background: Virtual reality (VR) dental simulators are currently used in preclinical skills training. However, with the development of extended reality technologies, the use of mixed reality (MR) has shown significant advantages over VR. Objective: This study aimed to describe the research and development of a newly developed MR and haptic--based dental simulator for tooth preparation and to conduct a preliminary evaluation of its face validity. Methods: A prototype of the MR dental simulator for tooth preparation was developed by integrating a head-mounted display (HMD), special force feedback handles, a foot pedal, computer hardware, and software program. We recruited 34 participants and divided them into the Novice group (n=17) and Skilled group (n=17) based on their clinical experience. All participants prepared a maxillary right central incisor for an all-ceramic crown in the dental simulator, completed a questionnaire afterward about their simulation experience, and evaluated hardware and software aspects of the dental simulator. Results: Of the participants, 74\% (25/34) were satisfied with the overall experience of using the Unidental MR Simulator. Approximately 90\% (31/34, 91\%) agreed that it could stimulate their interest in learning, and 82\% (28/34) were willing to use it for skills training in the future. Differences between the 2 study groups in their experience with the HMD (resolution: P=.95; wearing comfort: P=.10), dental instruments (P=.95), force feedback of the tooth (P=.08), simulation of the tooth preparation process (P=.79), overall experience with the simulation (P=.47), and attitude toward the simulator (improves skills: P=.47; suitable for learning: P=.36; willing to use: P=.89; inspiring for learning: P=.63) were not significant. The Novice group was more satisfied with the simulator's ease of use (P=.04). There were significant positive correlations between the overall experience with the simulation and the HMD's resolution (P=.03) and simulation of the preparation process (P=.001). Conclusions: The newly developed Unidental MR Simulator for tooth preparation has good face validity. It can achieve a higher degree of resemblance to the real clinical treatment environment by improving the positional adjustment of the simulated patients, for a better training experience in dental skills. ", doi="10.2196/30653", url="https://games.jmir.org/2022/1/e30653", url="http://www.ncbi.nlm.nih.gov/pubmed/35262501" } @Article{info:doi/10.2196/34751, author="Schnieders, Elena and R{\"o}hr, Freda and Mbewe, Misho and Shanzi, Aubrey and Berner-Rodoreda, Astrid and Barteit, Sandra and Louis, R. Val{\'e}rie and Andreadis, Petros and Syakantu, Gardner and Neuhann, Florian", title="Real-life Evaluation of an Interactive Versus Noninteractive e-Learning Module on Chronic Obstructive Pulmonary Disease for Medical Licentiate Students in Zambia: Web-Based, Mixed Methods Randomized Controlled Trial", journal="JMIR Med Educ", year="2022", month="Feb", day="24", volume="8", number="1", pages="e34751", keywords="distance education", keywords="randomized controlled trial", keywords="personal satisfaction", keywords="knowledge", keywords="user-centered design", keywords="chronic obstructive pulmonary disease", keywords="interactive", keywords="noninteractive", keywords="low- and middle-income country", keywords="LMIC", keywords="mobile phone", abstract="Background: e-Learning for health professionals in many low- and middle-income countries (LMICs) is still in its infancy, but with the advent of COVID-19, a significant expansion of digital learning has occurred. Asynchronous e-learning can be grouped into interactive (user-influenceable content) and noninteractive (static material) e-learning. Studies conducted in high-income countries suggest that interactive e-learning is more effective than noninteractive e-learning in increasing learner satisfaction and knowledge; however, there is a gap in our understanding of whether this also holds true in LMICs. Objective: This study aims to validate the hypothesis above in a resource-constrained and real-life setting to understand e-learning quality and delivery by comparing interactive and noninteractive e-learning user satisfaction, usability, and knowledge gain in a new medical university in Zambia. Methods: We conducted a web-based, mixed methods randomized controlled trial at the Levy Mwanawasa Medical University (LMMU) in Lusaka, Zambia, between April and July 2021. We recruited medical licentiate students (second, third, and fourth study years) via email. Participants were randomized to undergo asynchronous e-learning with an interactive or noninteractive module for chronic obstructive pulmonary disease and informally blinded to their group allocation. The interactive module included interactive interfaces, quizzes, and a virtual patient, whereas the noninteractive module consisted of PowerPoint slides. Both modules covered the same content scope. The primary outcome was learner satisfaction. The secondary outcomes were usability, short- and long-term knowledge gain, and barriers to e-learning. The mixed methods study followed an explanatory sequential design in which rating conferences delivered further insights into quantitative findings, which were evaluated through web-based questionnaires. Results: Initially, 94 participants were enrolled in the study, of whom 41 (44\%; 18 intervention participants and 23 control participants) remained in the study and were analyzed. There were no significant differences in satisfaction (intervention: median 33.5, first quartile 31.3, second quartile 35; control: median 33, first quartile 30, second quartile 37.5; P=.66), usability, or knowledge gain between the intervention and control groups. Challenges in accessing both e-learning modules led to many dropouts. Qualitative data suggested that the content of the interactive module was more challenging to access because of technical difficulties and individual factors (eg, limited experience with interactive e-learning). Conclusions: We did not observe an increase in user satisfaction with interactive e-learning. However, this finding may not be generalizable to other low-resource settings because the post hoc power was low, and the e-learning system at LMMU has not yet reached its full potential. Consequently, technical and individual barriers to accessing e-learning may have affected the results, mainly because the interactive module was considered more difficult to access and use. Nevertheless, qualitative data showed high motivation and interest in e-learning. Future studies should minimize technical barriers to e-learning to further evaluate interactive e-learning in LMICs. ", doi="10.2196/34751", url="https://mededu.jmir.org/2022/1/e34751", url="http://www.ncbi.nlm.nih.gov/pubmed/35200149" } @Article{info:doi/10.2196/23845, author="Jarratt, LynnMarie and Situ, Jenny and King, D. Rachel and Montanez Ramos, Estefania and Groves, Hannah and Ormesher, Ryen and Coss{\'e}, Melissa and Raboff, Alyse and Mahajan, Avanika and Thompson, Jennifer and Ko, F. Randy and Paltrow-Krulwich, Samantha and Price, Allison and Hurwitz, May-Ling Ariel and CampBell, Timothy and Epler, T. Lauren and Nguyen, Fiona and Wolinsky, Emma and Edwards-Fligner, Morgan and Lobo, Jolene and Rivera, Danielle and Langsjoen, Jens and Sloane, Lori and Hendrix, Ingrid and Munde, O. Elly and Onyango, O. Clinton and Olewe, K. Perez and Anyona, B. Samuel and Yingling, V. Alexandra and Lauve, R. Nicolas and Kumar, Praveen and Stoicu, Shawn and Nestsiarovich, Anastasiya and Bologa, G. Cristian and Oprea, I. Tudor and Tollestrup, Kristine and Myers, B. Orrin and Anixter, Mari and Perkins, J. Douglas and Lambert, Gerard Christophe", title="A Comprehensive COVID-19 Daily News and Medical Literature Briefing to Inform Health Care and Policy in New Mexico: Implementation Study", journal="JMIR Med Educ", year="2022", month="Feb", day="23", volume="8", number="1", pages="e23845", keywords="COVID-19", keywords="pandemic", keywords="daily report", keywords="policy", keywords="epidemics", keywords="global health", keywords="SARS-CoV-2", keywords="New Mexico", keywords="medical education", abstract="Background: On March 11, 2020, the New Mexico Governor declared a public health emergency in response to the COVID-19 pandemic. The New Mexico medical advisory team contacted University of New Mexico (UNM) faculty to form a team to consolidate growing information on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its disease to facilitate New Mexico's pandemic management. Thus, faculty, physicians, staff, graduate students, and medical students created the ``UNM Global Health COVID-19 Intelligence Briefing.'' Objective: In this paper, we sought to (1) share how to create an informative briefing to guide public policy and medical practice and manage information overload with rapidly evolving scientific evidence; (2) determine the qualitative usefulness of the briefing to its readers; and (3) determine the qualitative effect this project has had on virtual medical education. Methods: Microsoft Teams was used for manual and automated capture of COVID-19 articles and composition of briefings. Multilevel triaging saved impactful articles to be reviewed, and priority was placed on randomized controlled studies, meta-analyses, systematic reviews, practice guidelines, and information on health care and policy response to COVID-19. The finalized briefing was disseminated by email, a listserv, and posted on the UNM digital repository. A survey was sent to readers to determine briefing usefulness and whether it led to policy or medical practice changes. Medical students, unable to partake in direct patient care, proposed to the School of Medicine that involvement in the briefing should count as course credit, which was approved. The maintenance of medical student involvement in the briefings as well as this publication was led by medical students. Results: An average of 456 articles were assessed daily. The briefings reached approximately 1000 people by email and listserv directly, with an unknown amount of forwarding. Digital repository tracking showed 5047 downloads across 116 countries as of July 5, 2020. The survey found 108 (95\%) of 114 participants gained relevant knowledge, 90 (79\%) believed it decreased misinformation, 27 (24\%) used the briefing as their primary source of information, and 90 (79\%) forwarded it to colleagues. Specific and impactful public policy decisions were informed based on the briefing. Medical students reported that the project allowed them to improve on their scientific literature assessment, stay current on the pandemic, and serve their community. Conclusions: The COVID-19 briefings succeeded in informing and guiding New Mexico policy and clinical practice. The project received positive feedback from the community and was shown to decrease information burden and misinformation. The virtual platforms allowed for the continuation of medical education. Variability in subject matter expertise was addressed with training, standardized article selection criteria, and collaborative editing led by faculty. ", doi="10.2196/23845", url="https://mededu.jmir.org/2022/1/e23845", url="http://www.ncbi.nlm.nih.gov/pubmed/35142625" } @Article{info:doi/10.2196/22096, author="Samarasekara, Keshinie", title="e-Learning in Medical Education in Sri Lanka: Survey of Medical Undergraduates and New Graduates", journal="JMIR Med Educ", year="2022", month="Feb", day="10", volume="8", number="1", pages="e22096", keywords="medical education", keywords="e-learning", keywords="Sri Lanka", keywords="medical students", abstract="Background: Medical education has undergone drastic changes with the advent of novel technologies that enable e-learning. Medical students are increasingly using e-learning methods, and universities have incorporated them into their curricula. Objective: This study aimed at delineating the pattern of use of e-learning methods among medical undergraduates and new graduates of the Faculty of Medicine, University of Colombo, and identifying the challenges faced by these students in using e-learning methods. Methods: A cross-sectional descriptive study was conducted in the Faculty of Medicine, University of Colombo, in April 2020, with the participation of current undergraduates and pre-intern medical graduates, using a self-administered questionnaire that collected data on sociodemographic details, pattern of use of learning methods, and challenges faced using e-learning methods. Results: There were 778 respondents, with a response rate of 65.1\% (778/1195). All the study participants used e-learning resources with varying frequencies, and all of them had at least 1 smart device with access to the internet. Electronic versions of standard textbooks (e-books), nonmedical websites, online lectures, medical websites, and medical phone apps were used by the majority. When comparing the extent of use of different learning methods, it appeared that students preferentially used traditional learning methods. The preference was influenced by the year of study and family income. The 3 most commonly used modalities for learning new study material and revising previously learned content were notes on paper material, textbooks (paper version), and e-books. The majority (98.7\% [n=768]) of participants have encountered problems using e-learning resources. The most commonly faced problems were unavailability of free-of-charge access to some e-learning methods, expenses related to internet connection, poor connectivity of mobile internet, distractions while using online resources, and lack of storage space on electronic devices. Conclusions: There is a high uptake of e-learning methods among Sri Lankan medical students. However, when comparing the extent of use of different learning methods, it appeared that students preferentially used traditional learning methods. A majority of the students have encountered problems when using e-learning methods, and most of these problems were related to poor economic status. Universities should take these factors into consideration when developing curricula in medical education. ", doi="10.2196/22096", url="https://mededu.jmir.org/2022/1/e22096", url="http://www.ncbi.nlm.nih.gov/pubmed/35142626" } @Article{info:doi/10.2196/33390, author="Teng, Minnie and Singla, Rohit and Yau, Olivia and Lamoureux, Daniel and Gupta, Aurinjoy and Hu, Zoe and Hu, Ricky and Aissiou, Amira and Eaton, Shane and Hamm, Camille and Hu, Sophie and Kelly, Dayton and MacMillan, M. Kathleen and Malik, Shamir and Mazzoli, Vienna and Teng, Yu-Wen and Laricheva, Maria and Jarus, Tal and Field, S. Thalia", title="Health Care Students' Perspectives on Artificial Intelligence: Countrywide Survey in Canada", journal="JMIR Med Educ", year="2022", month="Jan", day="31", volume="8", number="1", pages="e33390", keywords="medical education", keywords="artificial intelligence", keywords="allied health education", keywords="medical students", keywords="health care students", keywords="medical curriculum", keywords="education", abstract="Background: Artificial intelligence (AI) is no longer a futuristic concept; it is increasingly being integrated into health care. As studies on attitudes toward AI have primarily focused on physicians, there is a need to assess the perspectives of students across health care disciplines to inform future curriculum development. Objective: This study aims to explore and identify gaps in the knowledge that Canadian health care students have regarding AI, capture how health care students in different fields differ in their knowledge and perspectives on AI, and present student-identified ways that AI literacy may be incorporated into the health care curriculum. Methods: The survey was developed from a narrative literature review of topics in attitudinal surveys on AI. The final survey comprised 15 items, including multiple-choice questions, pick-group-rank questions, 11-point Likert scale items, slider scale questions, and narrative questions. We used snowball and convenience sampling methods by distributing an email with a description and a link to the web-based survey to representatives from 18 Canadian schools. Results: A total of 2167 students across 10 different health professions from 18 universities across Canada responded to the survey. Overall, 78.77\% (1707/2167) predicted that AI technology would affect their careers within the coming decade and 74.5\% (1595/2167) reported a positive outlook toward the emerging role of AI in their respective fields. Attitudes toward AI varied by discipline. Students, even those opposed to AI, identified the need to incorporate a basic understanding of AI into their curricula. Conclusions: We performed a nationwide survey of health care students across 10 different health professions in Canada. The findings would inform student-identified topics within AI and their preferred delivery formats, which would advance education across different health care professions. ", doi="10.2196/33390", url="https://mededu.jmir.org/2022/1/e33390", url="http://www.ncbi.nlm.nih.gov/pubmed/35099397" } @Article{info:doi/10.2196/31634, author="Kim, Sungha and Bayer, Ilana and Gewurtz, Rebecca and Larivi{\`e}re, Nadine and Letts, Lori", title="Comparing Web-Based and In-Person Educational Workshops for Canadian Occupational Therapists and Understanding Their Learning Experiences: Mixed Methods Study", journal="JMIR Med Educ", year="2022", month="Jan", day="4", volume="8", number="1", pages="e31634", keywords="online education", keywords="occupational therapy", keywords="occupational therapist", keywords="continuing education", abstract="Background: The Do-Live-Well (DLW) framework is an occupation-focused health promotion approach. Occupational therapists (OTs) have been interested in training opportunities regarding this framework. Traditionally, in-person continuing educational interventions are the main way that OTs obtain knowledge, but web-based learning has become popular among health care professionals. However, its effectiveness and learners' experience in web-based learning have not been well-studied in occupational therapy education. Objective: This study aims to evaluate the effectiveness of the web-based and in-person educational DLW workshops for Canadian OTs and to understand their experiences in both workshop types. Methods: An explanatory sequential mixed methods study design was used, where quantitative data were collected first, then qualitative data were used to explain the quantitative findings. A quasi-experimental design and interpretative description methodology were used in the quantitative and qualitative phases, respectively. Results: Quantitative results were as follows: a total of 43 OTs completed pre-, post-, and follow-up evaluations (in-person group: 21/43, 49\%; web-based group: 22/43, 51\%). Practice settings of the participants varied, including geriatric, hospital, long-term, mental health, pediatric, and primary settings. The primary outcome was as follows: there were no statistically significant differences in knowledge changes at the 3 time points (P=.57 to P=.99) between the groups. In the web-based group, the knowledge scores at follow-up were lower compared with the posttest results, meaning that knowledge gain was reduced over time (P=.001). The secondary outcomes were as follows: there were statistically significant differences between the groups in factors influencing DLW adoption at posttest (P=.001) and in satisfaction with the workshop (P<.001) at posttest in favor of the in-person group. Qualitative results were as follows: a total of 18 OTs (9/18, 50\% from each group) participated in an individual interview. Five themes were identified regarding learners' workshop experiences: relevance to their practices and interests may improve learning, a familiar learning environment may facilitate learning, synchronous in-person interaction is valuable in the learning process, ease of access to learning should be considered, and flexibility in web-based learning can be both beneficial and challenging. Conclusions: The quantitative results of this study reported no difference in knowledge acquisition between the in-person and web-based groups, indicating that web-based education is as effective as in-person workshops. However, participants' satisfaction with the workshop was statistically significantly higher for the in-person workshop. The qualitative findings described the participants' perceived benefits and challenges of each educational format. The participants in both the web-based and in-person workshop groups valued in-person interactions in learning, but the participants in the web-based workshop group expressed web-based learning lacked in-person-like interactions. Thus, adding synchronous in-person interactions to web-based learning may improve learners' educational experiences in web-based occupational therapy and continuing education. ", doi="10.2196/31634", url="https://mededu.jmir.org/2022/1/e31634", url="http://www.ncbi.nlm.nih.gov/pubmed/34982719" } @Article{info:doi/10.2196/30533, author="Stunden, Chelsea and Zakani, Sima and Martin, Avery and Moodley, Shreya and Jacob, John", title="Replicating Anatomical Teaching Specimens Using 3D Modeling Embedded Within a Multimodal e-Learning Course: Pre-Post Study Exploring the Impact on Medical Education During COVID-19", journal="JMIR Med Educ", year="2021", month="Nov", day="17", volume="7", number="4", pages="e30533", keywords="congenital heart disease", keywords="cardiac anatomy, pathologic anatomy", keywords="education", keywords="learning aids", keywords="3D models", abstract="Background: The COVID-19 pandemic has had significant effects on anatomy education. During the pandemic, students have had no access to cadavers, which has been the principal method of learning anatomy. We created and tested a customized congenital heart disease e-learning course for medical students that contained interactive 3D models of anonymized pediatric congenital heart defects. Objective: The aim of this study is to assess whether a multimodal e-learning course contributed to learning outcomes in a cohort of first-year undergraduate medical students studying congenital heart diseases. The secondary aim is to assess student attitudes and experiences associated with multimodal e-learning. Methods: The pre-post study design involved 290 first-year undergraduate medical students. Recruitment was conducted by course instructors. Data were collected before and after using the course. The primary outcome was knowledge acquisition (test scores). The secondary outcomes included attitudes and experiences, time to complete the modules, and browser metadata. Results: A total of 141 students were included in the final analysis. Students' knowledge significantly improved by an average of 44.6\% (63/141) when using the course (SD 1.7\%; Z=?10.287; P<.001). Most students (108/122, 88.3\%) were highly motivated to learn with the course, and most (114/122, 93.5\%) reported positive experiences with the course. There was a strong correlation between attitudes and experiences, which was statistically significant (rs=0.687; P<.001; n=122). No relationships were found between the change in test scores and attitudes (P=.70) or experiences (P=.47). Students most frequently completed the e-learning course with Chrome (109/141, 77.3\%) and on Apple macOS (86/141, 61\%) or Windows 10 (52/141, 36.9\%). Most students (117/141, 83\%) had devices with high-definition screens. Most students (83/141, 58.9\%) completed the course in <3 hours. Conclusions: Multimodal e-learning could be a viable solution in improving learning outcomes and experiences for undergraduate medical students who do not have access to cadavers. Future research should focus on validating long-term learning outcomes. ", doi="10.2196/30533", url="https://mededu.jmir.org/2021/4/e30533", url="http://www.ncbi.nlm.nih.gov/pubmed/34787589" } @Article{info:doi/10.2196/33861, author="Karabacak, Mert and Ozkara, Berksu Burak and Ozcan, Zeynep", title="Adjusting to the Reign of Webinars: Viewpoint", journal="JMIR Med Educ", year="2021", month="Nov", day="12", volume="7", number="4", pages="e33861", keywords="virtual conference", keywords="student-based organization", keywords="neuroscience conference", keywords="COVID-19", keywords="medical education", keywords="webinars", keywords="web-based education", abstract="Background: With the integration of COVID-19 into our lives, the way events are organized has changed. The Cerrahpa?a Neuroscience Days held on May 8-9, 2021, was one of the conferences that was affected. The annual conference of the student-based Cerrahpa?a Neuroscience Society transitioned to the internet for the first time and had the premise of going international. Objective: With this study, we aim to both discuss how a virtual conference is organized and perceived, and where our conference stands within the literature as a completely student-organized event. Methods: The conference was planned in accordance with virtual standards and promoted to primarily medical schools. During the execution, there were no major issues. The feedback was collected via a form developed with Google Forms. Results: Out of 2195 registrations, 299 qualified to receive a certificate. The feedback forms revealed a general satisfaction; the overall quality of the event was rated an average of 4.6 out of 5, and the ratings of various Likert scale--based questions were statistically analyzed. Open-ended questions provided improvement suggestions for future events. Conclusions: The virtual Cerrahpa?a Neuroscience Days was a success in organization and received positive feedback from the participants. We aim to ground future events on this experience. ", doi="10.2196/33861", url="https://mededu.jmir.org/2021/4/e33861", url="http://www.ncbi.nlm.nih.gov/pubmed/34766916" } @Article{info:doi/10.2196/30873, author="Lin, Yuchen and Lemos, Martin and Neuschaefer-Rube, Christiane", title="Digital Health and Digital Learning Experiences Across Speech-Language Pathology, Phoniatrics, and Otolaryngology: Interdisciplinary Survey Study", journal="JMIR Med Educ", year="2021", month="Nov", day="5", volume="7", number="4", pages="e30873", keywords="digital learning", keywords="e-learning", keywords="speech-language pathology", keywords="phoniatrics", keywords="otolaryngology", keywords="communication disorders", keywords="mobile phone", abstract="Background: Advances in digital health and digital learning are transforming the lives of patients, health care providers, and health professional students. In the interdisciplinary field of communication sciences and disorders (CSD), digital uptake and incorporation of digital topics and technologies into clinical training programs has lagged behind other medical fields. There is a need to understand professional and student experiences, opinions, and needs regarding digital health and learning topics so that effective strategies for implementation can be optimized. Objective: This cross-sectional survey study aims to interdisciplinarily investigate professional and student knowledge, use, attitudes, and preferences toward digital health and learning in the German-speaking population. Methods: An open-ended, web-based survey was developed and conducted with professionals and students in CSD including phoniatricians and otolaryngologists, speech-language pathologists (German: Logop{\"a}d*innen), medical students, and speech-language pathology students. Differences in knowledge, use, attitudes, and preferences across profession, generation, and years of experience were analyzed. Results: A total of 170 participants completed the survey. Respondents demonstrated greater familiarity with digital learning as opposed to eHealth concepts. Significant differences were noted across profession (P<.001), generation (P=.001), and years of experience (P<.001), which demonstrated that students and younger participants were less familiar with digital health terminology. Professional (P<.001) and generational differences were also found (P=.04) in knowledge of digital therapy tools, though no significant differences were found for digital learning tools. Participants primarily used computers, tablets, and mobile phones; non--eHealth-specific tools (eg, word processing and videoconferencing applications); and digital formats such as videos, web courses, and apps. Many indicated a desire for more interactive platforms, such as virtual reality. Significant differences were found across generations for positive views toward digitalization (P<.001) and across profession for feelings of preparedness (P=.04). Interestingly, across profession (P=.03), generation (P=.006), and years of experience (P=.01), students and younger participants demonstrated greater support for medical certification. Commonly reported areas of concern included technical difficulties, quality and validity of digital materials, data privacy, and social presence. Respondents tended to prefer blended learning, a limited to moderate level of interactivity, and time and space--flexible learning environments (63/170, 37.1\%), with a notable proportion still preferring traditional time and space--dependent learning (49/170, 28.8\%). Conclusions: This comprehensive investigation into the current state of CSD student and professional opinions and experiences has shown that incorporation of digital topics and skills into academic and professional development curricula will be crucial for ensuring that the field is prepared for the ever-digitalizing health care environment. Deeper empirical investigation into efficacy and acceptance of digital learning and practice strategies and systematic training and practical organizational supports must be planned to ensure adaptive education and practice. ", doi="10.2196/30873", url="https://mededu.jmir.org/2021/4/e30873", url="http://www.ncbi.nlm.nih.gov/pubmed/34738911" } @Article{info:doi/10.2196/27441, author="Tackett, Sean and Green, David and Dyal, Michael and O'Keefe, Erin and Thomas, Emmanuelle Tanya and Nguyen, Tiffany and Vo, Duyen and Patel, Mausam and Murdock, J. Christopher and Wolfe, M. Erin and Shehadeh, A. Lina", title="Use of Commercially Produced Medical Education Videos in a Cardiovascular Curriculum: Multiple Cohort Study", journal="JMIR Med Educ", year="2021", month="Oct", day="7", volume="7", number="4", pages="e27441", keywords="commercial videos", keywords="flipped classroom", keywords="organ-systems courses", keywords="medical education", keywords="medical students", keywords="teaching", keywords="education", keywords="health science education", keywords="e-Learning", abstract="Background: Short instructional videos can make learning more efficient through the application of multimedia principles, and video animations can illustrate the complex concepts and dynamic processes that are common in health sciences education. Commercially produced videos are commonly used by medical students but are rarely integrated into curricula. Objective: Our goal was to examine student engagement with medical education videos incorporated into a preclinical Cardiovascular Systems course. Methods: Students who took the first-year 8-week Cardiovascular Systems course in 2019 and 2020 were included in the study. Videos from Osmosis were recommended to be watched before live sessions throughout the course. Video use was monitored through dashboards, and course credit was given for watching videos. All students were emailed electronic surveys after the final exam asking about the course's blended learning experience and use of videos. Osmosis usage data for number of video views, multiple choice questions, and flashcards were extracted from Osmosis dashboards. Results: Overall, 232/359 (64.6\%) students completed surveys, with rates by class of 81/154 (52.6\%) for MD Class of 2022, 39/50 (78\%) for MD/MPH Class of 2022, and 112/155 (72.3\%) for MD Class of 2023. Osmosis dashboard data were available for all 359 students. All students received the full credit offered for Osmosis engagement, and learning analytics demonstrated regular usage of videos and other digital platform features. Survey responses indicated that most students found Osmosis videos to be helpful for learning (204/232, 87.9\%; P=.001) and preferred Osmosis videos to the traditional lecture format (134/232, 57.8\%; P<.001). Conclusions: Commercial medical education videos may enhance curriculum with low faculty effort and improve students' learning experiences. Findings from our experience at one medical school can guide the effective use of supplemental digital resources for learning, and related evaluation and research. ", doi="10.2196/27441", url="https://mededu.jmir.org/2021/4/e27441", url="http://www.ncbi.nlm.nih.gov/pubmed/34617911" } @Article{info:doi/10.2196/26484, author="Evans, Yolanda and Hutchinson, Jeffrey and Ameenuddin, Nusheen", title="Opportunity, Challenge, or Both? Managing Adolescent Socioemotional and Mental Health During Web-Based Learning", journal="JMIR Ment Health", year="2021", month="Sep", day="15", volume="8", number="9", pages="e26484", keywords="pandemic", keywords="technology", keywords="media", keywords="bullying", keywords="mental health", keywords="distance learning", doi="10.2196/26484", url="https://mental.jmir.org/2021/9/e26484", url="http://www.ncbi.nlm.nih.gov/pubmed/34524094" } @Article{info:doi/10.2196/32105, author="Wei, Chapman and Bernstein, Sophie and Adusumilli, Nagasai and Marchitto, Mark and Chen, Frank and Rajpara, Anand", title="Assessment and Evaluation of Social Engagement in Dermatology Residency Programs on Instagram: Cross-sectional Study", journal="JMIR Dermatol", year="2021", month="Aug", day="26", volume="4", number="2", pages="e32105", keywords="Instagram", keywords="social media", keywords="dermatology residency", keywords="Instagram engagement score", keywords="residency recruitment", keywords="medical education", doi="10.2196/32105", url="https://derma.jmir.org/2021/2/e32105", url="http://www.ncbi.nlm.nih.gov/pubmed/37632856" } @Article{info:doi/10.2196/26325, author="Gopwani, R. Sumeet and Adams, Erin and Rooney, Alexandra and Tousimis, Eleni and Ramsey, Katherine and Warusha, Sohan", title="Impact of a Workflow-Integrated Web Tool on Resource Utilization and Information-Seeking Behavior in an Academic Anesthesiology Department: Longitudinal Cohort Survey Study", journal="JMIR Med Educ", year="2021", month="Jul", day="26", volume="7", number="3", pages="e26325", keywords="graduate medical education", keywords="learning technology", keywords="anesthesiology", keywords="information-seeking behavior", keywords="web tool", keywords="teaching", keywords="millennial learners", abstract="Background: Medical resident reading and information-seeking behavior is limited by time constraints as well as comfort in accessing and assessing evidence-based resources. Educational technology interventions, as the preferred method for millennial leaners, can reduce these barriers. We implemented an educational web tool, consisting of peer-reviewed articles as well as local and national protocols and policies, built into the daily workflow of a university-based anesthesiology department. We hypothesized that this web tool would increase resource utilization and overall perceptions of the educational environment. Objective: The goal of this study was to demonstrate that an educational web tool designed and built into the daily workflow of an academic anesthesia department for trainees could significantly decrease barriers to resource utilization, improve faculty-trainee teaching interactions, and improve the perceptions of the educational environment. Methods: Following Institutional Review Board approval, a longitudinal cohort survey study was conducted to assess trainee resource utilization, faculty evaluation of trainees' resource utilization, and trainee and faculty perceptions about the educational environment. The survey study was conducted in a pre-post fashion 3 months prior to web tool implementation and 3 months following implementation. Data were deidentified and analyzed unpaired using Student t tests for continuous data and chi-square tests for ordinal data. Results: Survey response rates were greater than 50\% in all groups: of the 43 trainees, we obtained 27 (63\%) preimplementation surveys and 22 (51\%) postimplementation surveys; of the 46 faculty members, we obtained 25 (54\%) preimplementation surveys and 23 (50\%) postimplementation surveys. Trainees showed a significant improvement in utilization of peer-reviewed articles (preimplementation mean 8.67, SD 6.45; postimplementation mean 18.27, SD 12.23; P=.02), national guidelines (preimplementation mean 2.3, SD 2.40; postimplementation mean 6.14, SD 5.01; P<.001), and local policies and protocols (preimplementation mean 2.23, SD 2.72; postimplementation mean 6.95, SD 6.09; P=.02). There was significant improvement in faculty-trainee educational interactions (preimplementation mean 1.67, SD 1.33; postimplementation mean 6.05, SD 8.74; P=.01). Faculty assessment of trainee resource utilization also demonstrated statistically significant improvements across all resource categories. Subgroups among trainees and faculty showed similar trends toward improvement. Conclusions: Learning technology interventions significantly decrease the barriers to resource utilization, particularly among millennial learners. Further investigation has been undertaken to assess how this may impact learning, knowledge retention, and patient outcomes. ", doi="10.2196/26325", url="https://mededu.jmir.org/2021/3/e26325", url="http://www.ncbi.nlm.nih.gov/pubmed/34309566" } @Article{info:doi/10.2196/29216, author="Zamberg, Ido and Schiffer, Eduardo and Stoermann-Chopard, Catherine", title="Novice and Advanced Learners' Satisfaction and Perceptions of an e-Learning Renal Semiology Module During the COVID-19 Pandemic: Mixed Methods Study", journal="JMIR Med Educ", year="2021", month="Jun", day="28", volume="7", number="2", pages="e29216", keywords="COVID-19", keywords="e-learning", keywords="medical education", keywords="eHealth", keywords="novice", keywords="advanced", keywords="students", keywords="undergraduate education", keywords="satisfaction", keywords="perception", keywords="renal", keywords="qualitative", keywords="prospective", keywords="case study", keywords="design", keywords="clinical skills", keywords="clinical skills education", abstract="Background: Nephrotic syndrome is a unique clinical disorder, which provides interesting teaching opportunities that connect physiological and pathological aspects to clinical practice. During the current COVID-19 outbreak, in-person teaching in our institution was not permitted, thus creating a unique challenge for clinical skills teaching. A case-based electronic learning (e-learning) activity was designed to replace the traditional in-person teaching of renal semiology. e-Learning activities have been shown to be effective for knowledge retention and increasing novice learners' performance. However, major knowledge gaps exist concerning the satisfaction of learners with e-learning activities as the sole form of teaching, specifically for undergraduate clinical skills education. Objective: Our study aimed to prospectively assess undergraduate medical students' perceptions of and satisfaction with an e-learning activity teaching renal semiology. Methods: All second-year medical students (novice learners) from the medical faculty of the University of Geneva, Switzerland, undertook the e-learning activity and were invited to participate in a nonmandatory, validated web-based survey, comprising questions answered using a 10-point Likert scale and one qualitative open-ended question. For comparison and to provide further insights, 17 fourth- to sixth-year students (advanced learners) were prospectively recruited to participate in both the e-learning activity and the evaluation. A mixed methods analysis was performed. Results: A total of 88 (63\%) out of 141 novice learners and all advanced learners responded to the evaluation survey. Advanced learners reported significantly higher satisfaction with the e-learning activity (mean 8.7, SD 1.0 vs mean 7.3, SD 1.8; P<.001), clarity of objectives (mean 9.6, SD 0.8 vs mean 7.7, SD 1.7; P<.001), and attainability of objectives (mean 9.8, SD 0.5 vs mean 7.3, SD 1.3; P<.001). Both groups showed high interest in the inclusion of the activity as part of a blended learning approach; however, there was low interest in the activity being the sole means of teaching. Conclusions: Case-based e-learning activities might be better suited for advanced learners and could increase learners' satisfaction within a blended teaching instructional design. More research on students' satisfaction with e-learning activities in the field of clinical skills education should be done. In addition, more effort should be put into finding alternative teaching tools for clinical skills education in light of the ongoing COVID-19 pandemic and future health crises. ", doi="10.2196/29216", url="https://mededu.jmir.org/2021/2/e29216", url="http://www.ncbi.nlm.nih.gov/pubmed/34048357" } @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/10.2196/23613, author="Asikainen, Henna and Katajavuori, Nina", title="Development of a Web-Based Intervention Course to Promote Students' Well-Being and Studying in Universities: Protocol for an Experimental Study Design", journal="JMIR Res Protoc", year="2021", month="Mar", day="9", volume="10", number="3", pages="e23613", keywords="approaches to learning", keywords="psychological flexibility", keywords="well-being", keywords="online intervention tool", keywords="peer support", keywords="reflection", abstract="Background: The decline in the well-being among university students well as increasing dropouts has become a serious issue in universities around the world. Thus, effective ways to support students' well-being and their ability to study are highly needed. Objective: The purpose of this study was to build an intervention course for university students, which promotes both students' well-being as well as their learning and study skills, and to describe the experimental study design that explores the effects of this intervention course. Methods: Research has shown that psychological flexibility has a great effect on the well-being as well as the study skills of students pursuing higher education. The basis of our intervention course was to promote psychological flexibility and students' study skills with the help of peer support and reflection. Results: This course was offered as a voluntary course to all the students at the University of Helsinki twice during the academic year 2020-2021. The first course was from October to December and the second course was from January to March. This course was advertised in fall 2020 through social media and by different student organizations and program leaders at different faculties of the University of Helsinki. As of October 2020, we enrolled 566 students comprising 310 students for the course in fall 2020 and 256 students for the course in spring 2021. Of the 256 students who enrolled in the second course, 170 students voluntarily participated in this study and they answered the questionnaires, including all the measures, simultaneously with the participants in the first group and thus served as the control group. The effect of this course will be measured with multiple data, including questionnaire data, reflective journals, and physiological data of well-being with a longitudinal experimental design. This research very strictly follows the ethical guidelines drawn up by the Finnish National Board on Research Integrity. We expect to publish the results of this study in fall 2021 at the latest. Conclusions: We argue that a web-based, 8-week intervention course, which promotes both student well-being and their study skills, is a good way to support students pursuing higher education, and both aspects should be considered when supporting university students. International Registered Report Identifier (IRRID): DERR1-10.2196/23613 ", doi="10.2196/23613", url="https://www.researchprotocols.org/2021/3/e23613", url="http://www.ncbi.nlm.nih.gov/pubmed/33687336" } @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/10.2196/15936, author="Synnott, Jonathan and Harkin, Mairead and Horgan, Brenda and McKeown, Andre and Hamilton, David and McAllister, Declan and Trainor, Claire and Nugent, Chris", title="The Digital Skills, Experiences and Attitudes of the Northern Ireland Social Care Workforce Toward Technology for Learning and Development: Survey Study", journal="JMIR Med Educ", year="2020", month="Sep", day="23", volume="6", number="2", pages="e15936", keywords="social work", keywords="learning", keywords="teaching methods", keywords="surveys", keywords="health care workers", keywords="mobile phone", keywords="digital divide", keywords="distance education", keywords="educational technology", abstract="Background: Continual development of the social care workforce is a key element in improving outcomes for the users of social care services. As the delivery of social care services continues to benefit from innovation in assistive technologies, it is important that the digital capabilities of the social care workforce are aligned. Policy makers have highlighted the importance of using technology to support workforce learning and development, and the need to ensure that the workforce has the necessary digital skills to fully benefit from such provisions. Objective: This study aims to identify the digital capability of the social care workforce in Northern Ireland and to explore the workforce's appetite for and barriers to using technology for learning and development. This study is designed to answer the following research questions: (1) What is the digital capability of the social care workforce in Northern Ireland? (2) What is the workforce's appetite to participate in digital learning and development? and (3) If there are barriers to the uptake of technology for learning and development, what are these barriers? Methods: A survey was created and distributed to the Northern Ireland social care workforce. This survey collected data on 127 metrics that described demographics, basic digital skills, technology confidence and access, factors that influence learning and development, experience with digital learning solutions, and perceived value and challenges of using technology for learning. Results: The survey was opened from December 13, 2018, to January 18, 2019. A total of 775 survey respondents completed the survey. The results indicated a workforce with a high level of self-reported basic digital skills and confidence. Face-to-face delivery of learning is still the most common method of accessing learning, which was used by 83.7\% (649/775) of the respondents; however, this is closely followed by digital learning, which was used by 79.0\% (612/775) of the respondents. There was a negative correlation between age and digital skills (rs=?0.262; P<.001), and a positive correlation between technology confidence and digital skills (rs=0.482; P<.001). There was also a negative correlation between age and the perceived value of technology (rs=?0.088; P=.02). The results indicated a predominantly motivated workforce in which a sizable portion is already engaged in informal digital learning. The results indicated that lower self-reported basic digital skills and confidence were associated with less interest in engaging with e-learning tools and that a portion of the workforce would benefit from additional basic digital skills training. Conclusions: These promising results provide a positive outlook for the potential of digital learning and development within the social care workforce. The findings provide clear areas of focus for the future use of technology for learning and development of the social care workforce and considerations to maximize engagement with such approaches. ", doi="10.2196/15936", url="http://mededu.jmir.org/2020/2/e15936/", url="http://www.ncbi.nlm.nih.gov/pubmed/32965233" } @Article{info:doi/10.2196/13795, author="Lai, Nanette and Khosa, Deep and Jones-Bitton, Andria and Dewey, E. Cate", title="Students' Experiences of Seeking Web-Based Animal Health Information at the Ontario Veterinary College: Exploratory Qualitative Study", journal="JMIR Med Educ", year="2019", month="Nov", day="8", volume="5", number="2", pages="e13795", keywords="veterinary education", keywords="internet", keywords="computer literacy", keywords="focus groups", keywords="perception", abstract="Background: Although searching for health information on the internet has offered clear benefits of rapid access to information for seekers such as patients, medical practitioners, and students, detrimental effects on seekers' experiences have also been documented. Health information overload is one such side effect, where an information seeker receives excessive volumes of potentially useful health-related messages that cannot be processed in a timely manner. This phenomenon has been documented among medical professionals, with consequences that include impacts on patient care. Presently, the use of the internet for health-related information, and particularly animal health information, in veterinary students has received far less research attention. Objective: The purpose of this study was to explore veterinary students' internet search experiences to understand how students perceived the nature of Web-based information and how these perceptions influence their information management. Methods: For this qualitative exploratory study, 5 separate focus groups and a single interview were conducted between June and October 2016 with a sample of 21 veterinary students in Ontario, Canada. Results: Thematic analysis of focus group transcripts demonstrated one overarching theme, The Overwhelming Nature of the Internet, depicted by two subthemes: Volume and Type of Web-based Health Information and Processing, Managing, and Evaluating Information. Conclusions: Integrating electronic health information literacy training into human health sciences students' training has shown to have positive effects on information management skills. Given a recent Association of American Veterinary Medical Colleges report that considers health literacy as a professional competency, results of this study point to a direction for future research and for institutions to contemplate integrating information literacy skills in veterinary curricula. Specifically, we propose that the information literacy skills should include knowledge about access, retrieval, evaluation, and timely application of Web-based information. ", doi="10.2196/13795", url="http://mededu.jmir.org/2019/2/e13795/", url="http://www.ncbi.nlm.nih.gov/pubmed/31702566" } @Article{info:doi/10.2196/12809, author="Zupanic, Michaela and Rebacz, Patrick and Ehlers, P. Jan", title="Media Use Among Students From Different Health Curricula: Survey Study", journal="JMIR Med Educ", year="2019", month="Aug", day="19", volume="5", number="2", pages="e12809", keywords="social media", keywords="medical education", keywords="computers", keywords="interprofessional relations", keywords="distance education", keywords="health occupations", abstract="Background: Mobile devices such as smartphones, tablets, and laptop computers enable users to search for information and communicate with others at any place and any time. Such devices are increasingly being used at universities for teaching and learning. The use of mobile devices by students depends, among others, on the individual media literacy level and the curricular framework. Objective: The objective of this study was to explore whether there were differences in media use in students from various curricula at the Faculty of Health, Witten/Herdecke University. Methods: During the 2015-16 winter term, a survey was conducted at the Faculty of Health, Witten/Herdecke University, in which a total of 705 students (out of 1091 students; response rate: 705/1091, 64.61\%) from 4 schools participated voluntarily: medicine (346/598), dentistry (171/204), psychology (142/243), and nursing science (46/46). The questionnaire developed for the study included 132 questions on 4 topics: (1) electronic and mobile devices (19 questions), (2) communication and organization of learning (45 questions), (3) apps/programs/websites/media (34 questions), and (4) media literacy (34 questions). The questionnaire was distributed and anonymously completed during in-class courses. Results: Students from all 4 schools had at least two electronic devices, with smartphones (97.4\%, 687/705) and laptops (94.8\%, 669/705) being the most common ones. Students agreed that electronic devices enabled them to effectively structure the learning process (mean 3.16, SD 0.62) and shared the opinion that university teaching should include imparting media literacy (mean 2.84, SD 0.84). Electronic device ownership was the highest among medical students (mean 2.68, SD 0.86) and medical students were the only ones to use a tutorial (36.1\%, 125/346). Dental students most widely used text messages (mean 3.41, SD 0.49) and social media (mean 2.57, SD 1.10) to organize learning. Psychology students considered mobile devices to be most ineffective (mean 2.81, SD 0.83). Nursing science students used emails (mean 3.47, SD 0.73) and desktop computers (39\%, 18/46) most widely. Conclusions: The results show that almost all students use electronic learning (e-learning) tools. At the same time, different profiles for different degree programs become apparent, which are to be attributed to not only the varying curricula and courses but also to the life circumstances of different age groups. Universities should, therefore, pay attention to the diverse user patterns and media literacy levels of students when planning courses to enable successful use of e-learning methods. ", doi="10.2196/12809", url="http://mededu.jmir.org/2019/2/e12809/", url="http://www.ncbi.nlm.nih.gov/pubmed/31429412" } @Article{info:doi/10.2196/11390, author="De Gagne, C. Jennie and Kim, S. Sang and Schoen, R. Ellen and Park, K. Hyeyoung", title="Assessing the Impact of Video-Based Assignments on Health Professions Students' Social Presence on Web: Case Study", journal="JMIR Med Educ", year="2018", month="Nov", day="26", volume="4", number="2", pages="e11390", keywords="case study", keywords="engagement", keywords="multimedia", keywords="Web-based learning", keywords="social presence", keywords="students' experience", abstract="Background: Web-based education is one of the leading learning pedagogies in health professions education. Students have access to a multitude of opinions, knowledge, and resources on Web, but communication among students in Web-based courses is complicated. Technology adds a filter that makes it difficult to decipher the emotions behind words or read nonverbal cues. This is a concern because students benefit more from Web-based classes when they have a high perception of social presence. To enhance social presence on Web, we planned to use video-based assignments (VBAs) that encourage students to interact with each other. Objective: This case study examines the impact of VBAs on health professions students and their experiences with the technology. This study aims to provide information to the growing body of literature about strategies to develop social presence on Web. Methods: A total of 88 students from various nursing programs participated in the study. While the control group comprised 36 students who submitted only written-based assignments (WBAs), the experimental group of 52 students submitted VBAs besides WBAs. No enrolled student had previously participated in the course, and there were no repeaters in either of the groups. Both groups participated in a weekly survey comprising 4 open-ended questions and 3 Likert items on a scale of 1-5 (1=strongly disagree and 5=strongly agree). The social presence questionnaire assessed by the experimental group comprised 16 items and a 5-point Likert scale in which higher scores represented higher levels of social presence. While quantitative data were analyzed using descriptive statistics, qualitative responses were analyzed using content analysis. Results: No significant differences were noted between the groups regarding the program (F1,87=0.36, P=.54). Regarding students' engagement, no statistically significant difference was observed between the 2 groups (t14=0.96, P=.35). However, the experimental group's average score for engagement was slightly higher (4.29 [SD 0.11]) than that of the control group (4.21 [SD 0.14]). Comparison of the total number of responses to the weekly engagement survey revealed 88.0\% (287/326) as either strongly agree or agree in the control group, whereas 93.1\% (525/564) in the experimental group. No statistically significant difference was observed between VBAs and WBAs weeks (t6=1.40, P=.21) in the experimental group. Most students reported a positive experience using VBAs, but technical issues were barriers to embracing this new approach to learning. Conclusions: This study reveals that social presence and engagement are positively associated with student learning and satisfaction in Web-based courses. Suggestions are offered to enhance social presence on Web that could generate better learning outcomes and students' experiences. ", doi="10.2196/11390", url="http://mededu.jmir.org/2018/2/e11390/", url="http://www.ncbi.nlm.nih.gov/pubmed/30478027" } @Article{info:doi/10.2196/mededu.9197, author="Pascoe, Michael and Monroe, Forrest and Macfarlane, Helen", title="Taking Constructivism One Step Further: Post Hoc Analysis of a Student-Created Wiki", journal="JMIR Med Educ", year="2018", month="Jun", day="14", volume="4", number="1", pages="e16", keywords="wiki", keywords="constructivist learning", keywords="medical education", keywords="analytics", abstract="Background: Wiki platform use has potential to improve student learning by improving engagement with course material. A student-created wiki was established to serve as a repository of study tools for students in a medical school curriculum. There is a scarcity of information describing student-led creation of wikis in medical education. Objective: The aim is to characterize website traffic of a student-created wiki and evaluate student perceptions of usage via a short anonymous online survey. Methods: Website analytics were used to track visitation statistics to the wiki and a survey was distributed to assess ease of use, interest in contributing to the wiki, and suggestions for improvement. Results: Site traffic data indicated high usage, with a mean of 315 (SD 241) pageviews per day from July 2011 to March 2013 and 74,317 total user sessions. The mean session duration was 1.94 (SD 1.39) minutes. Comparing Fall 2011 to Fall 2012 sessions revealed a large increase in returning visitors (from 12,397 to 20,544, 65.7\%) and sessions via mobile devices (831 to 1560, 87.7\%). The survey received 164 responses; 88.0\% (162/184) were aware of the wiki at the time of the survey. On average, respondents felt that the wiki was more useful in the preclinical years (mean 2.73, SD 1.25) than in the clinical years (mean 1.88, SD 1.12; P<.001). Perceived usefulness correlated with the percent of studying for which the respondent used electronic resources (Spearman $\rho$=.414, P<.001). Conclusions: Overall, the wiki was a highly utilized, although informal, part of the curriculum with much room for improvement and future exploration. ", doi="10.2196/mededu.9197", url="http://mededu.jmir.org/2018/1/e16/", url="http://www.ncbi.nlm.nih.gov/pubmed/29903697" } @Article{info:doi/10.2196/mededu.7361, author="Metcalf, Mary and Rossie, Karen and Stokes, Katie and Tanner, Bradley", title="The Perceptions of Medical School Students and Faculty Toward Obesity Medicine Education: Survey and Needs Analysis", journal="JMIR Med Educ", year="2017", month="Nov", day="09", volume="3", number="2", pages="e22", keywords="obesity", keywords="weight loss", keywords="medical students", keywords="medical education", keywords="curriculum", abstract="Background: Recent trends in obesity show that over two-thirds of US adults are considered at least overweight (body mass index, BMI?25 kg/m2) and of those, about one-third are categorized as obese (BMI?30 kg/m2). Physicians can address the health impacts of obesity; yet research has suggested that physicians-in-training frequently fail to recognize obesity, are not properly educated regarding treatment options, and spend relatively little clinic time treating obesity. Medical school is a unique opportunity to address this area of need so that the doctors of tomorrow are prepared to treat obesity appropriately. Objectives: The objective of this study was to determine perceptions of where clinical training for medical students on the topic of obesity and its treatment should improve and expand so that we could address the needs identified in a computerized clinical simulation. Methods: We conducted a literature review, as well as a needs analysis with medical school students (N=17) and faculty (N=12). Literature review provided an overview of the current state of the field. Students provided input on their current needs, learning preferences, and opinions. Faculty provided feedback on current training and their perceptions of future needs. Results: Most students were familiar with obesity medicine from various courses where obesity medicine was a subtopic, most frequently in Biochemistry or Nutrition, Endocrinology, and Wellness courses. Student knowledge about basic skills, such as measuring waist circumference, varied widely. About half of the students did not feel knowledgeable about recommending weight loss treatments. Most students did not feel prepared to provide interventions for patients in various categories of overweight/obesity, patients with psychosocial issues, obesity-related comorbidities, or failed weight loss attempts. However, most students did feel that it was their role as health professionals to provide these interventions. Faculty rated the following topics as most important to supplement the curriculum: patient-centered treatment of weight, bringing up the topic of weight, discussing weight and well-being, discussing the relationship between weight and comorbidities, and physician role with overweight or obese patients. Conclusions: A review of the literature as well as surveyed medical students and faculty identified a need for supplementation of the current obesity medicine curriculum in medical schools. Specific needed topics and skills were identified. ", doi="10.2196/mededu.7361", url="http://mededu.jmir.org/2017/2/e22/", url="http://www.ncbi.nlm.nih.gov/pubmed/29122740" } @Article{info:doi/10.2196/mededu.8188, author="Scaffidi, A. Michael and Khan, Rishad and Wang, Christopher and Keren, Daniela and Tsui, Cindy and Garg, Ankit and Brar, Simarjeet and Valoo, Kamesha and Bonert, Michael and de Wolff, F. Jacob and Heilman, James and Grover, C. Samir", title="Comparison of the Impact of Wikipedia, UpToDate, and a Digital Textbook on Short-Term Knowledge Acquisition Among Medical Students: Randomized Controlled Trial of Three Web-Based Resources", journal="JMIR Med Educ", year="2017", month="Oct", day="31", volume="3", number="2", pages="e20", keywords="medical education", keywords="medical students", abstract="Background: Web-based resources are commonly used by medical students to supplement curricular material. Three commonly used resources are UpToDate (Wolters Kluwer Inc), digital textbooks, and Wikipedia; there are concerns, however, regarding Wikipedia's reliability and accuracy. Objective: The aim of this study was to evaluate the impact of Wikipedia use on medical students' short-term knowledge acquisition compared with UpToDate and a digital textbook. Methods: This was a prospective, nonblinded, three-arm randomized trial. The study was conducted from April 2014 to December 2016. Preclerkship medical students were recruited from four Canadian medical schools. Convenience sampling was used to recruit participants through word of mouth, social media, and email. Participants must have been enrolled in their first or second year of medical school at a Canadian medical school. After recruitment, participants were randomized to one of the three Web-based resources: Wikipedia, UpToDate, or a digital textbook. During testing, participants first completed a multiple-choice questionnaire (MCQ) of 25 questions emulating a Canadian medical licensing examination. During the MCQ, participants took notes on topics to research. Then, participants researched topics and took written notes using their assigned resource. They completed the same MCQ again while referencing their notes. Participants also rated the importance and availability of five factors pertinent to Web-based resources. The primary outcome measure was knowledge acquisition as measured by posttest scores. The secondary outcome measures were participants' perceptions of importance and availability of each resource factor. Results: A total of 116 medical students were recruited. Analysis of variance of the MCQ scores demonstrated a significant interaction between time and group effects (P<.001, $\eta$g2=0.03), with the?Wikipedia?group scoring higher on the MCQ posttest compared with the textbook group (P<.001, d=0.86). Access to hyperlinks, search functions, and open-source editing were rated significantly higher by the?Wikipedia?group compared with the textbook group (P<.001). Additionally, the Wikipedia group rated open access editing significantly higher than the UpToDate group; expert editing and references were rated significantly higher by the UpToDate group compared with the?Wikipedia?group (P<.001). Conclusions: Medical students who used?Wikipedia?had superior short-term knowledge acquisition compared with those who used a digital textbook. Additionally, the Wikipedia group trended toward better posttest performance compared with the UpToDate group, though this difference was not significant. There were no significant differences between the UpToDate group and the digital textbook group. This study challenges the view that?Wikipedia?should be discouraged among medical students, instead suggesting a potential role in medical education. ", doi="10.2196/mededu.8188", url="http://mededu.jmir.org/2017/2/e20/", url="http://www.ncbi.nlm.nih.gov/pubmed/29089291" } @Article{info:doi/10.2196/mededu.6304, author="O'Sullivan, Elizabeth and Cutts, Emily and Kavikondala, Sushma and Salcedo, Alejandra and D'Souza, Karan and Hernandez-Torre, Martin and Anderson, Claire and Tiwari, Agnes and Ho, Kendall and Last, Jason", title="Social Media in Health Science Education: An International Survey", journal="JMIR Med Educ", year="2017", month="Jan", day="04", volume="3", number="1", pages="e1", keywords="health education", keywords="health surveys", keywords="interdisciplinary studies", keywords="learning", keywords="professionalism", keywords="self report", keywords="social media", keywords="students", keywords="surveys and questionnaires", keywords="universities", abstract="Background: Social media is an asset that higher education students can use for an array of purposes. Studies have shown the merits of social media use in educational settings; however, its adoption in health science education has been slow, and the contributing reasons remain unclear. Objective: This multidisciplinary study aimed to examine health science students' opinions on the use of social media in health science education and identify factors that may discourage its use. Methods: Data were collected from the Universitas 21 ``Use of social media in health education'' survey, distributed electronically among the health science staff and students from 8 universities in 7 countries. The 1640 student respondents were grouped as users or nonusers based on their reported frequency of social media use in their education. Results: Of the 1640 respondents, 1343 (81.89\%) use social media in their education. Only 462 of the 1320 (35.00\%) respondents have received specific social media training, and of those who have not, the majority (64.9\%, 608/936) would like the opportunity. Users and nonusers reported the same 3 factors as the top barriers to their use of social media: uncertainty on policies, concerns about professionalism, and lack of support from the department. Nonusers reported all the barriers more frequently and almost half of nonusers reported not knowing how to incorporate social media into their learning. Among users, more than one fifth (20.5\%, 50/243) of students who use social media ``almost always'' reported sharing clinical images without explicit permission. Conclusions: Our global, interdisciplinary study demonstrates that a significant number of students across all health science disciplines self-reported sharing clinical images inappropriately, and thus request the need for policies and training specific to social media use in health science education. ", doi="10.2196/mededu.6304", url="http://mededu.jmir.org/2017/1/e1/", url="http://www.ncbi.nlm.nih.gov/pubmed/28052842" } @Article{info:doi/10.2196/mededu.5392, author="Bull, Preston Tyler and Dewar, Roxanne Alexis and Malvey, M. Donna and Szalma, Leo James", title="Considerations for the Telehealth Systems of Tomorrow: An Analysis of Student Perceptions of Telehealth Technologies", journal="JMIR Med Educ", year="2016", month="Jul", day="08", volume="2", number="2", pages="e11", keywords="telehealth systems", keywords="younger adults", keywords="telehealth advantages", keywords="telehealth disadvantages", keywords="thematic analysis", abstract="Background: While much is known about factors that facilitate telehealth adoption, less is known about why adoption does or does not occur in specific populations, such as students. Objective: This study aims to examine the perceptions of telehealth systems within a large student sample. Methods: Undergraduate students (N=315) participated in a survey of the perceived advantages and disadvantages of telehealth technologies. The responses to the survey were analyzed using thematic analysis. Results: We found that students were likely to adopt telehealth systems for the following reasons: (1) the system worked efficiently, (2) the convenience of telehealth, and (3) to gain access to health services. Students also perceived several disadvantages to telehealth systems, such as issues of trust (ie, security, privacy), the impersonal nature of telehealth systems, and they were concerned about the potential for major system errors. Conclusion: By understanding the current barriers to telehealth adoption in a cohort of students, we can not only better anticipate the future needs of this group, but also incorporate such needs into the design of future telehealth systems. ", doi="10.2196/mededu.5392", url="http://mededu.jmir.org/2016/2/e11/", url="http://www.ncbi.nlm.nih.gov/pubmed/27731865" } @Article{info:doi/10.2196/mededu.5135, author="Royal, Kenneth and Hedgpeth, Mari-Wells and McWhorter, Dan", title="Students' Perceptions of and Experiences With Educational Technology: A Survey", journal="JMIR Medical Education", year="2016", month="May", day="18", volume="2", number="1", pages="e4", keywords="medical education", keywords="veterinary education", keywords="information literacy", keywords="experience", keywords="attitudes", keywords="preferences", keywords="technology", abstract="Background: It is generally assumed that incoming students in medical education programs will be better equipped for the ``digital age'' given their younger age and an educational upbringing in which technology was seemingly omnipresent. In particular, many assume that today's medical students are more likely to hold positive attitudes and increased comfortability with technology and possess greater information technology (IT) skills. Objective: The purpose of this study was to compare responses of incoming veterinary medical students to a series of IT-related questions contained in a common questionnaire over the course of a 10-year period (2005-2015) to discern whether students' attitudes have improved and uses and comfortability with technology have increased as anticipated. Methods: A survey measuring attitudes and preferences, computing experience, and technology ownership was administered each year for the past 10 years to incoming veterinary medical students at a large veterinary school in the United States. Students' responses to survey items were compared at 3 data points (2005, 2010, and 2015). Results: Today's incoming veterinary medical students tend to indicate the same desire to improve skills using spreadsheets and web page design as incoming students from 10 years ago. It seems that despite technological advances and increased exposure to such applications and skills, there remains a challenge for students to ``keep up'' with the ever evolving technology. Moreover, although students continue to report they are very comfortable with using a computer (and related devices), many use their computers as typewriters or word processors, as opposed to a means for performing more advanced computing functions. Conclusions: In general, today's medical students are not expert computer users as many assume. Despite an upbringing in a digitized world, many students still lack many basic computing skills. ", doi="10.2196/mededu.5135", url="http://mededu.jmir.org/2016/1/e4/", url="http://www.ncbi.nlm.nih.gov/pubmed/27731853" } @Article{info:doi/10.2196/mededu.5348, author="Nicklen, Peter and Keating, L. Jennifer and Maloney, Stephen", title="Exploring Student Preconceptions of Readiness for Remote-Online Case-Based Learning: A Case Study", journal="JMIR Medical Education", year="2016", month="Apr", day="28", volume="2", number="1", pages="e5", keywords="problem-based learning", keywords="professional education", keywords="teaching", keywords="distance education", abstract="Background: Case-based learning (CBL) is an educational approach where students work in small, collaborative groups to solve problems. Web-conferencing software provides a platform to present information and share concepts that are vital to CBL. Previous studies have found that participants were resistant to change associated with implementing e-learning; however, strategies to reduce this resistance have not been explored. Objective: This study was designed to explore student preconceptions and understanding of remote-online case-based learning (RO-CBL). Methods: The study took place during the Bachelor of Physiotherapy program at Monash University, Victoria, Australia, in 2013. The entire third-year cohort (n=73) was invited to participate. The primary outcome of interest was students' preconceptions of RO-CBL, collected via pre- and posttraining surveys. Results: Of the 73 students, 66 completed both surveys (attrition rate 9.6\%). Three key themes relevant to student preconceptions of RO-CBL emerged: flexibility in time and location of CBL, readiness or hesitation to change to a Web-based format, and the value of training in RO-CBL that included a demonstration and trial run. Thirty-four percent of the participants were hesitant to move to an online format. Conclusions: This study explored students' preconceptions of Web-based learning and evaluated the change in students' attitudes after training. The results suggest that educational designers should not assume that students are confident and competent in applying these technologies to professional educational activities. By identifying students' needs before implementation, training sessions can be designed to target these needs, and improve the understanding of RO-CBL and how it works in practice. This may reduce resistance to change, enhance students' satisfaction, and ultimately improve the learning experience. ", doi="10.2196/mededu.5348", url="http://mededu.jmir.org/2016/1/e5/", url="http://www.ncbi.nlm.nih.gov/pubmed/27731854" } @Article{info:doi/10.2196/mededu.5025, author="Nicklen, Peter and Keating, L. Jennifer and Maloney, Stephen", title="Student Response to Remote-Online Case-Based Learning: A Qualitative Study", journal="JMIR Medical Education", year="2016", month="Mar", day="22", volume="2", number="1", pages="e3", keywords="case-based learning", keywords="Web conferencing", keywords="remote-online case-based learning", keywords="student satisfaction", keywords="perceived depth of learning", abstract="Background: Case-based learning (CBL) typically involves face-to-face interaction in small collaborative groups with a focus on self-directed study. To our knowledge, no published studies report an evaluation of Web conferencing in CBL. Objective: The primary aim of this study was to explore student perceptions and attitudes in response to a remote-online case-based learning (RO-CBL) experience. Methods: This study took place over a 2-week period in 2013 at Monash University, Victoria, Australia. A third year cohort (n=73) of physiotherapy students was invited to participate. Students were required to participate in 2 training sessions, followed by RO-CBL across 2 sessions. The primary outcome of interest was the student feedback on the quality of the learning experience during RO-CBL participation. This was explored with a focus group and a survey. Results: Most students (68/73) completed the postintervention survey (nonparticipation rate 8\%). RO-CBL was generally well received by participants, with 59\% (40/68) of participates stating that they'd like RO-CBL to be used in the future and 78\% (53/68) of participants believing they could meet the CBL's learning objectives via RO-CBL. The 4 key themes relevant to student response to RO-CBL that emerged from the focus groups and open-ended questions on the postintervention survey were how RO-CBL compared to expectations, key benefits of RO-CBL including flexibility and time and cost savings, communication challenges in the online environment compared to face-to-face, and implications of moving to an online platform. Conclusions: Web conferencing may be a suitable medium for students to participate in CBL. Participants were satisfied with the learning activity and felt they could meet the CBL's learning objectives. Further study should evaluate Web conferencing CBL across an entire semester in regard to student satisfaction, perceived depth of learning, and learning outcomes. ", doi="10.2196/mededu.5025", url="http://mededu.jmir.org/2016/1/e3/", url="http://www.ncbi.nlm.nih.gov/pubmed/27731852" } @Article{info:doi/10.2196/mededu.4479, author="Tix, Nadine and Gie{\ss}ler, Paul and Ohnesorge-Radtke, Ursula and Spreckelsen, Cord", title="Semantic Indexing of Medical Learning Objects: Medical Students' Usage of a Semantic Network", journal="JMIR Medical Education", year="2015", month="Nov", day="11", volume="1", number="2", pages="e16", keywords="semantic net", keywords="usability evaluation", keywords="semantic indexing", keywords="learning objects", keywords="medical education", abstract="Background: The Semantically Annotated Media (SAM) project aims to provide a flexible platform for searching, browsing, and indexing medical learning objects (MLOs) based on a semantic network derived from established classification systems. Primarily, SAM supports the Aachen emedia skills lab, but SAM is ready for indexing distributed content and the Simple Knowledge Organizing System standard provides a means for easily upgrading or even exchanging SAM's semantic network. There is a lack of research addressing the usability of MLO indexes or search portals like SAM and the user behavior with such platforms. Objective: The purpose of this study was to assess the usability of SAM by investigating characteristic user behavior of medical students accessing MLOs via SAM. Methods: In this study, we chose a mixed-methods approach. Lean usability testing was combined with usability inspection by having the participants complete four typical usage scenarios before filling out a questionnaire. The questionnaire was based on the IsoMetrics usability inventory. Direct user interaction with SAM (mouse clicks and pages accessed) was logged. Results: The study analyzed the typical usage patterns and habits of students using a semantic network for accessing MLOs. Four scenarios capturing characteristics of typical tasks to be solved by using SAM yielded high ratings of usability items and showed good results concerning the consistency of indexing by different users. Long-tail phenomena emerge as they are typical for a collaborative Web 2.0 platform. Suitable but nonetheless rarely used keywords were assigned to MLOs by some users. Conclusions: It is possible to develop a Web-based tool with high usability and acceptance for indexing and retrieval of MLOs. SAM can be applied to indexing multicentered repositories of MLOs collaboratively. ", doi="10.2196/mededu.4479", url="http://mededu.jmir.org/2015/2/e16/", url="http://www.ncbi.nlm.nih.gov/pubmed/27731860" } @Article{info:doi/10.2196/mededu.4958, author="Alvarez, Graziela Ana and Sasso, Grace and Iyengar, Sriram", title="Mobile Virtual Learning Object for the Assessment of Acute Pain as a Learning Tool to Assess Acute Pain in Nursing: An Analysis of the Mental Workload", journal="JMIR Medical Education", year="2015", month="Nov", day="06", volume="1", number="2", pages="e15", keywords="nursing", keywords="nursing informatics", keywords="distance learning", keywords="computer-assisted instruction", keywords="educational technology", keywords="nursing education", keywords="acute pain", keywords="persuasive technology", keywords="mental workload", abstract="Background: The inclusion of new technologies in education has motivated the development of studies on mental workload. These technologies are now being used in the teaching and learning process. The analysis enables identification of factors intervening in this workload as well as planning of overload prevention for educational activities using these technologies. Objective: To analyze the mental workload of an educational intervention with the Mobile Virtual Learning Object for the Assessment of Acute Pain in adults and newborns, according to the NASA Task Load Index criteria. Methods: A methodological study with data collected from 5 nurses and 75 students, from November of 2013 to February of 2014. Results: The highest students' and specialists' means were in the dimensions of ``Mental demand'' (57.20 {\textpm} 22.27; 51 {\textpm} 29.45) and ``Performance'' (58.47 {\textpm} 24.19; 73 {\textpm} 28.85). The specialists' mental workload index was higher (50.20 {\textpm} 7.28) when compared with students' (47.87 {\textpm} 16.85) on a scale from 0 to 100 (P=.557). Conclusions: The instrument allowed for the assessment of mental workload after an online educational intervention with a mobile learning virtual object. An excessive overload was not identified among participants. Assessing mental workload from the use of educational technologies at the end of a task is a key to their applicability, with the aim of providing a more effective, stimulating, and long-lasting experience of the learning process. ", doi="10.2196/mededu.4958", url="http://mededu.jmir.org/2015/2/e15/", url="http://www.ncbi.nlm.nih.gov/pubmed/27731849" } @Article{info:doi/10.2196/mededu.4580, author="Torous, John and O'Connor, Ryan and Franzen, Jamie and Snow, Caitlin and Boland, Robert and Kitts, Robert", title="Creating a Pilot Educational Psychiatry Website: Opportunities, Barriers, and NextSteps", journal="JMIR Medical Education", year="2015", month="Nov", day="05", volume="1", number="2", pages="e14", keywords="Psychiatry", keywords="Internet", keywords="Online", keywords="Education", keywords="Website", abstract="Background: While medical students and residents may be utilizing websites as online learning resources, medical trainees and educators now have the opportunity to create such educational websites and digital tools on their own. However, the process and theory of building educational websites for medical education have not yet been fully explored. Objective: To understand the opportunities, barriers, and process of creating a novel medical educational website. Methods: We created a pilot psychiatric educational website to better understand the options, opportunities, challenges, and processes involved in the creation of a psychiatric educational website. We sought to integrate visual and interactive Web design elements to underscore the potential of such Web technology. Results: A pilot website (PsychOnCall) was created to demonstrate the potential of Web technology in medical and psychiatric education. Conclusions: Creating an educational website is now technically easier than ever before, and the primary challenge no longer is technology but rather the creation, validation, and maintenance of information for such websites as well as translating text-based didactics into visual and interactive tools. Medical educators can influence the design and implementation of online educational resources through creating their own websites and engaging medical students and residents in the process. ", doi="10.2196/mededu.4580", url="http://mededu.jmir.org/2015/2/e14/", url="http://www.ncbi.nlm.nih.gov/pubmed/27731837" } @Article{info:doi/10.2196/jmir.3650, author="Antoniades, Athos and Nicolaidou, Iolie and Spachos, Dimitris and Myll{\"a}ri, Jarkko and Giordano, Daniela and Dafli, Eleni and Mitsopoulou, Evangelia and Schizas, N. Christos and Pattichis, Constantinos and Nikolaidou, Maria and Bamidis, Panagiotis", title="Medical Content Searching, Retrieving, and Sharing Over the Internet: Lessons Learned From the mEducator Through a Scenario-Based Evaluation", journal="J Med Internet Res", year="2015", month="Oct", day="09", volume="17", number="10", pages="e229", keywords="searching and sharing of medical educational content", keywords="repurposing", keywords="metadata", keywords="evaluation", abstract="Background: The mEducator Best Practice Network (BPN) implemented and extended standards and reference models in e-learning to develop innovative frameworks as well as solutions that enable specialized state-of-the-art medical educational content to be discovered, retrieved, shared, and re-purposed across European Institutions, targeting medical students, doctors, educators and health care professionals. Scenario-based evaluation for usability testing, complemented with data from online questionnaires and field notes of users' performance, was designed and utilized for the evaluation of these solutions. Objective: The objective of this work is twofold: (1) to describe one instantiation of the mEducator BPN solutions (mEducator3.0 - ``MEdical Education LINnked Arena'' MELINA+) with a focus on the metadata schema used, as well as on other aspects of the system that pertain to usability and acceptance, and (2) to present evaluation results on the suitability of the proposed metadata schema for searching, retrieving, and sharing of medical content and with respect to the overall usability and acceptance of the system from the target users. Methods: A comprehensive evaluation methodology framework was developed and applied to four case studies, which were conducted in four different countries (ie, Greece, Cyprus, Bulgaria and Romania), with a total of 126 participants. In these case studies, scenarios referring to creating, sharing, and retrieving medical educational content using mEducator3.0 were used. The data were collected through two online questionnaires, consisting of 36 closed-ended questions and two open-ended questions that referred to mEducator 3.0 and through the use of field notes during scenario-based evaluations. Results: The main findings of the study showed that even though the informational needs of the mEducator target groups were addressed to a satisfactory extent and the metadata schema supported content creation, sharing, and retrieval from an end-user perspective, users faced difficulties in achieving a shared understanding of the meaning of some metadata fields and in correctly managing the intellectual property rights of repurposed content. Conclusions: The results of this evaluation impact researchers, medical professionals, and designers interested in using similar systems for educational content sharing in medical and other domains. Recommendations on how to improve the search, retrieval, identification, and obtaining of medical resources are provided, by addressing issues of content description metadata, content description procedures, and intellectual property rights for re-purposed content. ", doi="10.2196/jmir.3650", url="http://www.jmir.org/2015/10/e229/", url="http://www.ncbi.nlm.nih.gov/pubmed/26453250" } @Article{info:doi/10.2196/mededu.3866, author="Li, Yan Tse and Gao, Xiaoli and Wong, Kin and Tse, Kwan Christine Shuk and Chan, Yee Ying", title="Learning Clinical Procedures Through Internet Digital Objects: Experience of Undergraduate Students Across Clinical Faculties", journal="JMIR Medical Education", year="2015", month="Apr", day="14", volume="1", number="1", pages="e1", keywords="clinical skills", keywords="distance learning", keywords="dentistry", keywords="medicine", keywords="nursing", abstract="Background: Various digital learning objects (DLOs) are available via the World Wide Web, showing the flow of clinical procedures. It is unclear to what extent these freely accessible Internet DLOs facilitate or hamper students' acquisition of clinical competence. Objective: This study aimed to understand the experience of undergraduate students across clinical disciplines---medicine, dentistry, and nursing---in using openly accessible Internet DLOs, and to investigate the role of Internet DLOs in facilitating their clinical learning. Methods: Mid-year and final-year groups were selected from each undergraduate clinical degree program of the University of Hong Kong---Bachelor of Medicine and Bachelor of Surgery (MBBS), Bachelor of Dental Surgery (BDS), and Bachelor of Nursing (BNurs). All students were invited to complete a questionnaire on their personal and educational backgrounds, and their experiences and views on using Internet DLOs in learning clinical procedures. The questionnaire design was informed by the findings of six focus groups. Results: Among 439 respondents, 97.5\% (428/439) learned a variety of clinical procedures through Internet DLOs. Most nursing students (107/122, 87.7\%) learned preventive measures through Internet DLOs, with a lower percentage of medical students (99/215, 46.0\%) and dental students (43/96, 45\%) having learned them this way (both P<.001). Three-quarters (341/439, 77.7\%) of students accessed DLOs through public search engines, whereas 93.2\% (409/439) accessed them by watching YouTube videos. Students often shared DLOs with classmates (277/435, 63.7\%), but rarely discussed them with teachers (54/436, 12.4\%). The accuracy, usefulness, and importance of Internet DLOs were rated as 6.85 (SD 1.48), 7.27 (SD 1.53), and 7.13 (SD 1.72), respectively, out of a high score of 10. Conclusions: Self-exploration of DLOs in the unrestricted Internet environment is extremely common among current e-generation learners and was regarded by students across clinical faculties as an important supplement to their formal learning in the planned curriculum. This trend calls for a transformation of the educator's role from dispensing knowledge to guidance and support. ", doi="10.2196/mededu.3866", url="http://mededu.jmir.org/2015/1/e1/", url="http://www.ncbi.nlm.nih.gov/pubmed/27731303" }