@Article{info:doi/10.2196/67244, author="Bolgova, Olena and Shypilova, Inna and Mavrych, Volodymyr", title="Large Language Models in Biochemistry Education: Comparative Evaluation of Performance", journal="JMIR Med Educ", year="2025", month="Apr", day="10", volume="11", pages="e67244", keywords="ChatGPT", keywords="Claude", keywords="Gemini", keywords="Copilot", keywords="biochemistry", keywords="LLM", keywords="medical education", keywords="artificial intelligence", keywords="NLP", keywords="natural language processing", keywords="machine learning", keywords="large language model", keywords="AI", keywords="ML", keywords="comprehensive analysis", keywords="medical students", keywords="GPT-4", keywords="questionnaire", keywords="medical course", keywords="bioenergetics", abstract="Background: Recent advancements in artificial intelligence (AI), particularly in large language models (LLMs), have started a new era of innovation across various fields, with medicine at the forefront of this technological revolution. Many studies indicated that at the current level of development, LLMs can pass different board exams. However, the ability to answer specific subject-related questions requires validation. Objective: The objective of this study was to conduct a comprehensive analysis comparing the performance of advanced LLM chatbots---Claude (Anthropic), GPT-4 (OpenAI), Gemini (Google), and Copilot (Microsoft)---against the academic results of medical students in the medical biochemistry course. Methods: We used 200 USMLE (United States Medical Licensing Examination)--style multiple-choice questions (MCQs) selected from the course exam database. They encompassed various complexity levels and were distributed across 23 distinctive topics. The questions with tables and images were not included in the study. The results of 5 successive attempts by Claude 3.5 Sonnet, GPT-4?1106, Gemini 1.5 Flash, and Copilot to answer this questionnaire set were evaluated based on accuracy in August 2024. Statistica 13.5.0.17 (TIBCO Software Inc) was used to analyze the data's basic statistics. Considering the binary nature of the data, the chi-square test was used to compare results among the different chatbots, with a statistical significance level of P<.05. Results: On average, the selected chatbots correctly answered 81.1\% (SD 12.8\%) of the questions, surpassing the students' performance by 8.3\% (P=.02). In this study, Claude showed the best performance in biochemistry MCQs, correctly answering 92.5\% (185/200) of questions, followed by GPT-4 (170/200, 85\%), Gemini (157/200, 78.5\%), and Copilot (128/200, 64\%). The chatbots demonstrated the best results in the following 4 topics: eicosanoids (mean 100\%, SD 0\%), bioenergetics and electron transport chain (mean 96.4\%, SD 7.2\%), hexose monophosphate pathway (mean 91.7\%, SD 16.7\%), and ketone bodies (mean 93.8\%, SD 12.5\%). The Pearson chi-square test indicated a statistically significant association between the answers of all 4 chatbots (P<.001 to P<.04). Conclusions: Our study suggests that different AI models may have unique strengths in specific medical fields, which could be leveraged for targeted support in biochemistry courses. This performance highlights the potential of AI in medical education and assessment. ", doi="10.2196/67244", url="https://mededu.jmir.org/2025/1/e67244" } @Article{info:doi/10.2196/67883, author="Wei, Bin and Yao, Lili and Hu, Xin and Hu, Yuxiang and Rao, Jie and Ji, Yu and Dong, Zhuoer and Duan, Yichong and Wu, Xiaorong", title="Evaluating the Effectiveness of Large Language Models in Providing Patient Education for Chinese Patients With Ocular Myasthenia Gravis: Mixed Methods Study", journal="J Med Internet Res", year="2025", month="Apr", day="10", volume="27", pages="e67883", keywords="LLM", keywords="large language models", keywords="ocular myasthenia gravis", keywords="patient education", keywords="China", keywords="effectiveness", keywords="deep learning", keywords="artificial intelligence", keywords="health care", keywords="accuracy", keywords="applicability", keywords="neuromuscular disorder", keywords="extraocular muscles", keywords="ptosis", keywords="diplopia", keywords="ophthalmology", keywords="ChatGPT", keywords="clinical practice", keywords="digital health", abstract="Background: Ocular myasthenia gravis (OMG) is a neuromuscular disorder primarily affecting the extraocular muscles, leading to ptosis and diplopia. Effective patient education is crucial for disease management; however, in China, limited health care resources often restrict patients' access to personalized medical guidance. Large language models (LLMs) have emerged as potential tools to bridge this gap by providing instant, AI-driven health information. However, their accuracy and readability in educating patients with OMG remain uncertain. Objective: The purpose of this study was to systematically evaluate the effectiveness of multiple LLMs in the education of Chinese patients with OMG. Specifically, the validity of these models in answering patients with OMG-related questions was assessed through accuracy, completeness, readability, usefulness, and safety, and patients' ratings of their usability and readability were analyzed. Methods: The study was conducted in two phases: 130 choice ophthalmology examination questions were input into 5 different LLMs. Their performance was compared with that of undergraduates, master's students, and ophthalmology residents. In addition, 23 common patients with OMG-related patient questions were posed to 4 LLMs, and their responses were evaluated by ophthalmologists across 5 domains. In the second phase, 20 patients with OMG interacted with the 2 LLMs from the first phase, each asking 3 questions. Patients assessed the responses for satisfaction and readability, while ophthalmologists evaluated the responses again using the 5 domains. Results: ChatGPT o1-preview achieved the highest accuracy rate of 73\% on 130 ophthalmology examination questions, outperforming other LLMs and professional groups like undergraduates and master's students. For 23 common patients with OMG-related questions, ChatGPT o1-preview scored highest in correctness (4.44), completeness (4.44), helpfulness (4.47), and safety (4.6). GEMINI (Google DeepMind) provided the easiest-to-understand responses in readability assessments, while GPT-4o had the most complex responses, suitable for readers with higher education levels. In the second phase with 20 patients with OMG, ChatGPT o1-preview received higher satisfaction scores than Ernie 3.5 (Baidu; 4.40 vs 3.89, P=.002), although Ernie 3.5's responses were slightly more readable (4.31 vs 4.03, P=.01). Conclusions: LLMs such as ChatGPT o1-preview may have the potential to enhance patient education. Addressing challenges such as misinformation risk, readability issues, and ethical considerations is crucial for their effective and safe integration into clinical practice. ", doi="10.2196/67883", url="https://www.jmir.org/2025/1/e67883" } @Article{info:doi/10.2196/60790, author="Martinez, Jacob and Cordero, I. Jacquelin and Whitney, Meagan and LaRoche, L. Katie and Frietze, Gabriel and Moya, M. Eva and Gosselink, Kristin", title="Web-Based Human Papillomavirus Education and Professional Skills Intervention for Health Care Providers: Protocol for a Randomized Controlled Trial", journal="JMIR Res Protoc", year="2025", month="Apr", day="3", volume="14", pages="e60790", keywords="human papillomavirus", keywords="randomized controlled trial", keywords="HPV knowledge", keywords="HPV vaccine", keywords="health care provider", keywords="provider recommendations", keywords="communication strategies", keywords="Hispanic", abstract="Background: ?The human papillomavirus (HPV) vaccine is an effective way to prevent HPV and its associated cancers. Provider recommendation has been shown to be one of the most successful strategies for increasing the uptake of the HPV vaccine; however, more training and resources are needed to help boost health care providers' confidence and communication skills in recommending the HPV vaccine to their patients, particularly in underserved Hispanic communities where vaccination rates among all ages are lower. Objective: ?This study aims to compare HPV educational and professional skills intervention effectiveness on improving provider recommendations and patient communication strategies with health care providers serving the El Paso United States--Mexico border region. Methods: ?We will conduct a randomized, blinded, multiple posttest-only controlled behavioral trial using a parallel group design that will examine the effectiveness of a fully automated, web-based, culturally tailored HPV education and professional skills intervention containing unique reading material and video role-play, as compared to a standard Centers for Disease Control and Prevention fact sheet and video about general communication skills. Participants were recruited using a purposive sampling technique, both internet-based and in-person outreach events. Study data are being collected and managed using REDCap (Research Electronic Data Capture; Vanderbilt University) hosted at the University of Texas at El Paso. Chi-square analyses, ANOVA, and other statistical tests will be used with 2-tail $\alpha$ to reject null hypotheses at .05 to analyze the self-assessed outcome data. The Mauchly test of sphericity for each ANOVA and the Huynh-Feldt epsilon test or Greenhouse-Geisser correction to the degrees of freedom of the F-ratio will be reported for each significant effect. We may use multiple imputation procedures to handle the missing data (if applicable). This study is being conducted in the west Texas or southeast New Mexico region of the United States. Chi-square analyses will be used to assess associations between variables reported on the baseline provider knowledge, attitudes, and practice scales. We seek to examine self-assessed changes in provider attitudes and behaviors regarding HPV vaccine recommendation 1 month after receiving our unique multimedia and culturally tailored intervention. Results: ?Research and data collection for this clinical trial began in December 2023. Participant recruitment was closed by May 2024 (N=128), with final data collection expected to be completed by December 2024. Conclusions: ?This study team decided to report on the intervention protocol to help ensure transparency in the research process and facilitate the improvement of the research design. Tailored web-based educational programs for health care professionals, designed to address regional and patient population characteristics, may be a promising approach to enhancing the real-world implementation of clinical practice guidelines. Trial Registration: ClinicalTrials.gov NCT05120869; http://clinicaltrials.gov/ct2/show/NCT05120869 International Registered Report Identifier (IRRID): PRR1-10.2196/60790 ", doi="10.2196/60790", url="https://www.researchprotocols.org/2025/1/e60790" } @Article{info:doi/10.2196/55313, author="Wiet, Ryan and Casanova, P. Madeline and Moore, D. Jonathan and Deming, M. Sarah and Baker Jr, T. Russell", title="Creation of the ECHO Idaho Podcast: Tutorial and Pilot Assessment", journal="JMIR Med Educ", year="2025", month="Mar", day="21", volume="11", pages="e55313", keywords="Project ECHO", keywords="ECHO Idaho", keywords="medical education", keywords="medical training", keywords="medication teaching", keywords="medical knowledge", keywords="rural health care", keywords="rural medicine", keywords="underserved population", keywords="underserved people", keywords="substance use", keywords="substance use disorder", keywords="SUD", keywords="drug abuse", keywords="drug use", keywords="alcoholism", keywords="addiction", keywords="pain", keywords="behavioral health", keywords="podcast", keywords="webinar", abstract="Background: Project ECHO (Extension for Community Health Outcomes) is an innovative program that uses videoconferencing technology to connect health care providers with experts. The model has been successful in reaching health care providers in rural and underserved areas and positively impacting clinical practice. ECHO Idaho, a replication partner, has developed programming that has increased knowledge and confidence of health care professionals throughout the state of Idaho, United States. Although the ECHO model has a demonstrated ability to recruit, educate, and train health care providers, barriers to attending Project ECHO continuing education (CE) programs remain. The asynchronous nature of podcasts could be used as an innovative medium to help address barriers to CE access that health care professionals face. The ECHO Idaho ``Something for the Pain'' podcast was developed to increase CE accessibility to rural and frontier providers, while upscaling their knowledge of and competence to treat and assess substance use disorders, pain, and behavioral health conditions. Objective: This paper describes the creation and preliminary assessment of the ECHO Idaho ``Something for the Pain'' podcast. Methods: Podcast episodes consisted of interviews with individuals as well as didactic lectures. Audio from these recordings were edited for content and length and then professionally reviewed by subject matter experts (eg, featured episode speakers). Target audiences consisted of health care providers and community members interested in behavioral health and substance use disorders. Metrics on podcast listeners were assessed using SoundCloud's RSS feed, continuing education survey completion, and iECHO. Results: The ECHO Idaho ``Something for the Pain'' podcast's inaugural season comprised 14 episodes with 626 minutes of CE material. The podcast series received a total of 2441 listens from individuals in 14 different cities across Idaho, and 63 health care providers listened and claimed CE credits. The largest professional group was social workers (n=22; 35\%). Conclusions: We provide preliminary evidence that podcasts can be used to provide health care providers with opportunities to access CE material. Health care providers listened to and claimed CE credits from the ECHO Idaho ``Something for the Pain'' podcast. Project ECHO programs should consider creating podcasts as an additional platform for disseminating ECHO material. ", doi="10.2196/55313", url="https://mededu.jmir.org/2025/1/e55313" } @Article{info:doi/10.2196/72190, author="Jacobs, Chris", title="Examining Multimodal AI Resources in Medical Education: The Role of Immersion, Motivation, and Fidelity in AI Narrative Learning", journal="JMIR Med Educ", year="2025", month="Mar", day="18", volume="11", pages="e72190", keywords="artificial intelligence", keywords="cinematic clinical narrative", keywords="cinemeducation", keywords="medical education", keywords="narrative learning", keywords="AI", keywords="medical students", keywords="preclinical education", keywords="long-term retention", keywords="pharmacology", keywords="AI tools", keywords="GPT-4", keywords="image", keywords="applicability", keywords="CCN", doi="10.2196/72190", url="https://mededu.jmir.org/2025/1/e72190" } @Article{info:doi/10.2196/72336, author="Bland, Tyler", title="Author's Reply: Examining Multimodal AI Resources in Medical Education: The Role of Immersion, Motivation, and Fidelity in AI Narrative Learning", journal="JMIR Med Educ", year="2025", month="Mar", day="18", volume="11", pages="e72336", keywords="artificial intelligence", keywords="cinematic clinical narrative", keywords="cinemeducation", keywords="medical education", keywords="narrative learning", keywords="pharmacology", keywords="AI", keywords="medical students", keywords="preclinical education", keywords="long-term retention", keywords="AI tools", keywords="GPT-4", keywords="image", keywords="applicability", keywords="CCN", doi="10.2196/72336", url="https://mededu.jmir.org/2025/1/e72336" } @Article{info:doi/10.2196/67673, author="Little, R. Jeanette and Rivera-Nichols, Triana and Pavliscsak, H. Holly and Badawi, Omar and Gaudaen, C. James and Yeoman, R. Chevas and Hall, S. Todd and Quist, T. Ethan and Stoor-Burning, L. Ericka", title="Demonstrating Tactical Combat Casualty Care in Simulated Environments to Enable Passive, Autonomous Documentation: Protocol for a Prospective Simulation-Based Study", journal="JMIR Res Protoc", year="2025", month="Mar", day="17", volume="14", pages="e67673", keywords="tactical combat casualty care", keywords="TCCC, automation", keywords="medical documentation", keywords="DD form 1380", keywords="combat casualty care", keywords="artificial intelligence", keywords="AI", keywords="machine learning", keywords="ML", keywords="point of injury", keywords="POI", keywords="simulation", keywords="military health", keywords="passive data collection", keywords="sensors", keywords="algorithms", keywords="medical record", abstract="Background: The Telemedicine \& Advanced Technology Research Center (TATRC) commenced a new research portfolio specifically addressing Autonomous Casualty Care (AC2) in 2023. The first project within this portfolio addresses the current and historical challenges of capturing tactical combat casualty care (TCCC) data in operational settings. Objective: The initial autonomous casualty care effort, the Passive Data Collection using Autonomous Documentation research project, conducts systematic, simulated patient and casualty care scenarios, leveraging suites of passive sensor inputs to populate a data repository that will automate future combat care. Methods: To obtain the required datasets, TATRC will engage care provider participants who provided consent in one of 6 randomized simulated TCCC scenarios leveraging an institutional review board--approved office protocol (\#M-11057). These simulations will leverage mannikins (low and high fidelity) and live simulated patients (eg, human actors who provided consent). All consenting participants (eg, both the care providers and live simulated patients) will be equipped with suites of sensors that will passively collect data on care delivery actions and patient physiology. Simulated data is being collected at Fort Detrick, Maryland; Fort Sam Houston, Texas; Fort Indiantown Gap, Pennsylvania; Fort Liberty, North Carolina; and a commercial site in Greenville, North Carolina. Results: Across all research locations, TATRC will collect and annotate approximately 2500 simulation procedures tasks by March 2025. These study data will generate the first machine learning and artificial intelligence algorithms to populate Department of Defense (DD) Form 1380 fields accurately and reliably. Additional data collected past March 2025 will be used to continue to refine and mature the algorithm. Conclusions: The military health care system (MHS) lacks real-world datasets for TCCC care at the point of injury. Developing a data repository of simulated TCCC data is required as an essential step toward automating TCCC care. If TATRC's research efforts result in the ability to automate care delivery documentation, this will alleviate the cognitive burden of TCCC care providers in austere, chaotic environments. By generating a TCCC data repository through this Autonomous Documentation research project, TATRC will have opportunities to leverage this research data to create machine learning and artificial intelligence models to advance passive, automated medical documentation across the health care continuum. International Registered Report Identifier (IRRID): DERR1-10.2196/67673 ", doi="10.2196/67673", url="https://www.researchprotocols.org/2025/1/e67673" } @Article{info:doi/10.2196/64768, author="Zainal, Humairah and Xiao Hui, Xin and Thumboo, Julian and Kok Yong, Fong", title="Organizational Leaders' Views on Digital Health Competencies in Medical Education: Qualitative Semistructured Interview Study", journal="JMIR Med Educ", year="2025", month="Mar", day="7", volume="11", pages="e64768", keywords="technology", keywords="medical education", keywords="curriculum", keywords="clinical competence", keywords="digital competence", keywords="Singapore", keywords="digital health", keywords="qualitative study", keywords="medical school", keywords="risk", keywords="comprehensive framework", keywords="doctor", keywords="thematic analysis", keywords="information technology", keywords="evidence-based", keywords="undergraduate", keywords="healthcare systems", keywords="mobile phone", abstract="Background: Digital technologies (DTs) have profoundly impacted health care delivery globally and are increasingly used in clinical practice. Despite this, there is a scarcity of guidelines for implementing training in digital health competencies (DHC) in medical schools, especially for clinical practice. A lack of sustained integration of DHC risks creating knowledge gaps due to a limited understanding of how DT should be used in health care. Furthermore, few studies have explored reasons for this lag, both within and beyond the medical school curriculum. Current frameworks to address these barriers are often specific to individual countries or schools and focus primarily on curriculum design and delivery. A comprehensive framework is therefore required to ensure consistent implementation of DHC across various contexts and times. Objective: This study aims to use Singapore as a case study and examine the perspectives of doctors in organizational leadership positions to identify and analyze the barriers to DHC implementation in the undergraduate curriculum of Singapore's medical schools. It also seeks to apply the Normalization Process Theory (NPT) to address these barriers and bridge the gap between health care systems and digital health education (DHE) training. Methods: Individual semistructured interviews were conducted with doctors in executive and organizational leadership roles. Participants were recruited through purposive sampling, and the data were interpreted using qualitative thematic analysis. Results: A total of 33 doctors participated, 26 of whom are currently in organizational leadership roles and 7 of whom have previously held such positions. A total of 6 barriers were identified: bureaucratic inertia, lack of opportunities to pursue nontraditional career pathways, limited protective mechanisms for experiential learning and experimentation, lack of clear policy guidelines for clinical practice, insufficient integration between medical school education and clinical experience, and poor IT integration within the health care industry. Conclusions: These barriers are also present in other high-income countries experiencing health care digitalization, highlighting the need for a theoretical framework that broadens the generalizability of existing recommendations. Applying the NPT underscores the importance of addressing these barriers to effectively integrate DHC into the curriculum. The active involvement of multiple stakeholders and the incorporation of continuous feedback mechanisms are essential. Our proposed framework provides concrete, evidence-based, and step-by-step recommendations for implementation practice, supporting the introduction of DHC in undergraduate medical education. ", doi="10.2196/64768", url="https://mededu.jmir.org/2025/1/e64768", url="http://www.ncbi.nlm.nih.gov/pubmed/40053774" } @Article{info:doi/10.2196/57361, author="Galvin, Charlotte and Watt, Jonathan and Ghatnekar, Payal and Peres, Nicholas and Rees-Lee, Jacqueline", title="A Local Training Program to Increase Awareness of Emerging Extended Reality Technologies Among Health Care Professionals: Development Study", journal="JMIR XR Spatial Comput", year="2025", month="Feb", day="27", volume="2", pages="e57361", keywords="health care XR", keywords="extended reality in health care", keywords="XR", keywords="virtual reality in health care", keywords="VR", keywords="digital awareness training", keywords="digital deep dive", keywords="digital literacy", keywords="emerging health care technology", keywords="digital future", keywords="extended reality", keywords="virtual reality", abstract="Background: Demands on health care services can greatly outweigh capacity. Multifactorial causative factors present great challenges, forcing the National Health Service (NHS) to increase efficiency and adaptivity. Concurrently, digital advancements are excelling and long-term plans for NHS sustainability are focusing on the use of technological interventions to benefit patients. As a result, integration of extended reality (XR) technology has become an important focus of health care research. However, models of how the digital literacy of health care workforces can be developed and how frontline staff can be actively involved in the design and development of creative digital interventions are lacking. Such programs are essential to allow the development and upscaling of digital innovation within the NHS for the benefit of the patients. Such a program has been developed in the Digital Futures research lab at Torbay and South Devon NHS Foundation Trust, representing one of the first immersive digital technologies research spaces embedded within the NHS. A ``Digital Deep Dive'' training program has been developed, allowing local health care workers to recognize the possibilities of digital health care technologies and supporting them in the evolution of ideas for potential bespoke digital solutions appropriate to their own patient groups and care pathways. Objective: This paper aims to explain the development of this unique XR Deep Dive program and present the evaluation that informed future directions for its ongoing development. Methods: The Deep Dive sessions were designed according to relevant pedagogic principles, including experiential, active, and contextual learning theories. Voluntary pilot sessions were held for local clinical teams comprised of junior doctors, consultants, nurses, and allied health professionals. Self-selection sampling was used. Participants completed an anonymous postsession feedback form, which was used to conduct a service evaluation. Data were analyzed using descriptive statistics (quantitative) and thematic analysis (qualitative). Results: In total, 21 completed questionnaires were analyzed. Overall, the sessions were positively received: all participants reported increased awareness of the potential for digital health care innovation postsession and most found it useful and relevant to their clinical careers. Participants valued the sessions being grounded in a context relevant to local practice with opportunities to interact with the technology through the lens of use cases. Conclusions: We have developed a unique training initiative providing contextually relevant XR technology awareness training for health care professionals locally. Despite the growing pace of digital health care innovation, we recognized a knowledge gap in our local workforce regarding the potential of XR technologies within health care. We responded by developing a training program grounded in the concept of digital co-creation---working with staff and service users to develop bespoke solutions integrated within patient pathways. The results from this paper will help to inform future directions for developing digital awareness training in our trust and have implications for wider NHS digital literacy training. ", doi="10.2196/57361", url="https://xr.jmir.org/2025/1/e57361" } @Article{info:doi/10.2196/63364, author="Abdulai, Abdul-Fatawu and Duong, Cam and Stroulia, Eleni and Czerniak, Efrat and Chiu, Rachel and Mehta, Aashay and Koike, Ken and Norman, V. Wendy", title="A Health Professional Mentorship Platform to Improve Equitable Access to Abortion: Development, Usability, and Content Evaluation", journal="JMIR Hum Factors", year="2025", month="Feb", day="19", volume="12", pages="e63364", keywords="medication abortion", keywords="mifepristone", keywords="web-based platform", keywords="user-centered design", keywords="underserved populations", keywords="abortion", keywords="equitable", keywords="accessibility", keywords="open-access website", keywords="gender-affirming", keywords="user-centered", keywords="Canada", keywords="unwanted pregnancy", keywords="framework", abstract="Background: Access to safe abortion care is a reproductive right for all individuals across Canada. Underserved populations are overrepresented among those with unintended pregnancies and particularly those seeking abortion. Yet, few resources exist to help health care and allied helping professionals provide culturally competent and gender-affirming abortion care to such a population group. Objective: This project aimed to redesign and adapt an existing subscription-based medication abortion mentorship platform into a culturally appropriate and gender-affirming open-access website of curated health professional resources to promote equitable, accessible, high-quality abortion care, particularly for underserved populations. Methods: We drew on a user-centered design framework to redesign the web platform in 5 iterative phases. Health care and allied helping professionals were engaged in each stage of the development process including the initial design of the platform, curation of the resources, review of the content, and evaluation of the wireframes and the end product. Results: This project resulted in an open-access bilingual (English and French) web-based platform containing comprehensive information and resources on abortion care for health care providers (physicians, nurse practitioners, and pharmacists) and allied helping professionals (midwives, medical officers, community workers, and social workers). The website incorporated information on clinical, logistical, and administrative guidance, including culturally competent and gender-affirming toolkits that could equip health care professionals with the requisite knowledge to provide abortion care for underserved populations. Conclusions: This platform contains resources that can increase the competencies of health care professionals to initiate and sustain culturally and contextually appropriate abortion care for underserved groups while clarifying myths and misconceptions that often militate against initiating abortion. Our resource also has the potential to support equitable access to high-quality abortion care, particularly for those among underserved populations who may have the greatest unmet need for abortion services yet face the greatest barriers to accessing care. ", doi="10.2196/63364", url="https://humanfactors.jmir.org/2025/1/e63364" } @Article{info:doi/10.2196/60651, author="Almashmoum, Maryam and Payton, Antony and Johnstone, Emily and Cunningham, James and Ainsworth, John", title="Understanding the Views of Health Care Professionals on the Usability and Utility of Virtual Reality Multidisciplinary Team Meetings: Usability and Utility Study", journal="JMIR XR Spatial Comput", year="2025", month="Feb", day="14", volume="2", pages="e60651", keywords="knowledge sharing", keywords="multidisciplinary team meetings", keywords="artificial intelligence", keywords="heuristic evaluation", keywords="usability", keywords="virtual reality", keywords="VR", keywords="simulation", keywords="virtual environments", keywords="digital environments", abstract="Background: Multidisciplinary team (MDT) meetings are one of the facilitators that enhance knowledge sharing among health care professionals. However, organizing a face-to-face MDT meeting to discuss patient treatment plans can be time-consuming. Virtual reality software is widely used in health care nowadays to save time and protect lives. Therefore, the use of virtual reality multidisciplinary team (VRMDT) meeting software may help enhance knowledge sharing between health care professionals and make meetings more efficient. Objective: The objectives of this study were to introduce VRMDT software for enhancing knowledge sharing and to evaluate the feasibility and usability of the VRMDT for use by professionals in health care institutions. Methods: We invited participants from The University of Manchester Faculty for Biology, Medicine, and Health who had a health care background. As this was the first stage of software development, individuals who did not usually attend MDT meetings were also invited via email to participate in this study. Participants evaluated VRMDT using a Meta Quest 3 headset, and software developed using the Unity platform. The software contained an onboarding tutorial that taught the participants how to select items, load and rotate 3D Digital Imaging and Communications in Medicine files, talk to a generative artificial intelligence--supported avatar, and make notes. After the evaluation (approximately 15 min), participants received an electronic survey using the Qualtrics survey tool (Qualtrics International Inc) to score the usability and feasibility of the software by responding to the 10-item system usability scale, and 12-point heuristic evaluation questions with Neilsen severity rating. Results: A total of 12 participants, including 4 health informatics, 3 with a nursing background, 2 medical doctors, 1 radiologist, and 2 biostatisticians, participated in the study. The most common age bracket of participants was 20?30 years (6/12, 50\%). Most of the respondents had no experience with virtual reality, either in educational or entertainment settings. The VRMDT received a mean usability score of 72.7 (range between 68 and 80.3), earning an overall ``good'' rating grade. The mean score of single items in the heuristic evaluation questionnaires was less than 1 out of 4 (the overall mean was 0.6), which indicates that only minor problems were encountered when using this software. Overall, the participant's feedback was good with highlighted issues including a poor internet connection and the quality of the generative artificial intelligence response. Conclusions: VRMDT software (developed by SentiraXR) was developed with several functions aimed at helping health care professionals to discuss medical conditions efficiently. Participants found that the VRMDT is a powerful, and useful tool for enhancing knowledge sharing among professionals who are involved in MDT meetings due to its functionality and multiuser interactive environments. Additionally, there may be the possibility of using it to train junior professionals to interpret medical reports. ", doi="10.2196/60651", url="https://xr.jmir.org/2025/1/e60651" } @Article{info:doi/10.2196/58766, author="Ichikawa, Tsunagu and Olsen, Elizabeth and Vinod, Arathi and Glenn, Noah and Hanna, Karim and Lund, C. Gregg and Pierce-Talsma, Stacey", title="Generative Artificial Intelligence in Medical Education---Policies and Training at US Osteopathic Medical Schools: Descriptive Cross-Sectional Survey", journal="JMIR Med Educ", year="2025", month="Feb", day="11", volume="11", pages="e58766", keywords="artificial intelligence", keywords="medical education", keywords="faculty development", keywords="policy", keywords="AI", keywords="training", keywords="United States", keywords="school", keywords="university", keywords="college", keywords="institution", keywords="osteopathic", keywords="osteopathy", keywords="curriculum", keywords="student", keywords="faculty", keywords="administrator", keywords="survey", keywords="cross-sectional", abstract="Background: Interest has recently increased in generative artificial intelligence (GenAI), a subset of artificial intelligence that can create new content. Although the publicly available GenAI tools are not specifically trained in the medical domain, they have demonstrated proficiency in a wide range of medical assessments. The future integration of GenAI in medicine remains unknown. However, the rapid availability of GenAI with a chat interface and the potential risks and benefits are the focus of great interest. As with any significant medical advancement or change, medical schools must adapt their curricula to equip students with the skills necessary to become successful physicians. Furthermore, medical schools must ensure that faculty members have the skills to harness these new opportunities to increase their effectiveness as educators. How medical schools currently fulfill their responsibilities is unclear. Colleges of Osteopathic Medicine (COMs) in the United States currently train a significant proportion of the total number of medical students. These COMs are in academic settings ranging from large public research universities to small private institutions. Therefore, studying COMs will offer a representative sample of the current GenAI integration in medical education. Objective: This study aims to describe the policies and training regarding the specific aspect of GenAI in US COMs, targeting students, faculty, and administrators. Methods: Web-based surveys were sent to deans and Student Government Association (SGA) presidents of the main campuses of fully accredited US COMs. The dean survey included questions regarding current and planned policies and training related to GenAI for students, faculty, and administrators. The SGA president survey included only those questions related to current student policies and training. Results: Responses were received from 81\% (26/32) of COMs surveyed. This included 47\% (15/32) of the deans and 50\% (16/32) of the SGA presidents (with 5 COMs represented by both the deans and the SGA presidents). Most COMs did not have a policy on the student use of GenAI, as reported by the dean (14/15, 93\%) and the SGA president (14/16, 88\%). Of the COMs with no policy, 79\% (11/14) had no formal plans for policy development. Only 1 COM had training for students, which focused entirely on the ethics of using GenAI. Most COMs had no formal plans to provide mandatory (11/14, 79\%) or elective (11/15, 73\%) training. No COM had GenAI policies for faculty or administrators. Eighty percent had no formal plans for policy development. Furthermore, 33.3\% (5/15) of COMs had faculty or administrator GenAI training. Except for examination question development, there was no training to increase faculty or administrator capabilities and efficiency or to decrease their workload. Conclusions: The survey revealed that most COMs lack GenAI policies and training for students, faculty, and administrators. The few institutions with policies or training were extremely limited in scope. Most institutions without current training or policies had no formal plans for development. The lack of current policies and training initiatives suggests inadequate preparedness for integrating GenAI into the medical school environment, therefore, relegating the responsibility for ethical guidance and training to the individual COM member. ", doi="10.2196/58766", url="https://mededu.jmir.org/2025/1/e58766" } @Article{info:doi/10.2196/55206, author="Hoyt, Garrik and Bakshi, Shekhar Chandra and Basu, Paramita", title="Integration of an Audiovisual Learning Resource in a Podiatric Medical Infectious Disease Course: Multiple Cohort Pilot Study", journal="JMIR Med Educ", year="2025", month="Feb", day="11", volume="11", pages="e55206", keywords="learning retention", keywords="preclinical education", keywords="podiatric medical education", keywords="audiovisual learning resources", keywords="multimedia-based learning resource", keywords="animation-supported learning tools", keywords="mnemonics", keywords="spaced repetition", abstract="Background: Improved long-term learning retention leads to higher exam scores and overall course grades, which is crucial for success in preclinical coursework in any podiatric medicine curriculum. Audiovisual mnemonics, in conjunction with text-based materials and an interactive user interface, have been shown to increase memory retention and higher order thinking. Objective: This pilot study aims to evaluate the effectiveness of integrating web-based multimedia learning resources for improving student engagement and increasing learning retention. Methods: A quasi-experimental study was conducted with 2 cohorts totaling 158 second-year podiatric medical students. The treatment group had access to Picmonic's audiovisual resources, while the control group followed traditional instruction methods. Exam scores, final course grades, and user interactions with Picmonic were analyzed. Logistic regression and correlation analyses were conducted to examine the relationships between Picmonic access, performance outcomes, and student engagement. Results: The treatment group (n=91) had significantly higher average exam scores (P<.001) and final course grades (P<.001) than the control group (n=67). Effect size for the average final grades (d=0.96) indicated the practical significance of these differences. Logistic regression analysis revealed a positive association between Picmonic access with an odds ratio of 2.72 with a 95\% confidence interval, indicating that it is positively associated with the likelihood of achieving high final grades. Correlation analysis revealed a positive relationship (r=0.25, P=.02) between the number of in-video questions answered and students' final grades. Survey responses reflected increased student engagement, comprehension, and higher user satisfaction (3.71 out of 5 average rating) with the multimedia-based resources compared to traditional instructional resources. Conclusions: This pilot study underscores the positive impact of animation-supported web-based instruction on preclinical medical education. The treatment group, equipped with Picmonic, exhibited improved learning outcomes, enhanced engagement, and high satisfaction. These results contribute to the discourse on innovative educational methods and highlight the potential of multimedia-based learning resources to enrich medical curricula. Despite certain limitations, this research suggests that animation-supported audiovisual instruction offers a valuable avenue for enhancing student learning experiences in medical education. ", doi="10.2196/55206", url="https://mededu.jmir.org/2025/1/e55206" } @Article{info:doi/10.2196/56369, author="Sedlakova, Jana and Staniki{\'c}, Mina and Gille, Felix and Bernard, J{\"u}rgen and Horn, B. Andrea and Wolf, Markus and Haag, Christina and Floris, Joel and Morgenshtern, Gabriela and Schneider, Gerold and Zumbrunn Wojczy?ska, Aleksandra and Mouton Dorey, Corine and Ettlin, Alois Dominik and Gero, Daniel and Friemel, Thomas and Lu, Ziyuan and Papadopoulos, Kimon and Schl{\"a}pfer, Sonja and Wang, Ning and von Wyl, Viktor", title="Refining Established Practices for Research Question Definition to Foster Interdisciplinary Research Skills in a Digital Age: Consensus Study With Nominal Group Technique", journal="JMIR Med Educ", year="2025", month="Jan", day="23", volume="11", pages="e56369", keywords="research question", keywords="digitalization", keywords="digital data", keywords="data science", keywords="health research", keywords="interdisciplinary", abstract="Background: The increased use of digital data in health research demands interdisciplinary collaborations to address its methodological complexities and challenges. This often entails merging the linear deductive approach of health research with the explorative iterative approach of data science. However, there is a lack of structured teaching courses and guidance on how to effectively and constructively bridge different disciplines and research approaches. Objective: This study aimed to provide a set of tools and recommendations designed to facilitate interdisciplinary education and collaboration. Target groups are lecturers who can use these tools to design interdisciplinary courses, supervisors who guide PhD and master's students in their interdisciplinary projects, and principal investigators who design and organize workshops to initiate and guide interdisciplinary projects. Methods: Our study was conducted in 3 steps: (1) developing a common terminology, (2) identifying established workflows for research question formulation, and (3) examining adaptations of existing study workflows combining methods from health research and data science. We also formulated recommendations for a pragmatic implementation of our findings. We conducted a literature search and organized 3 interdisciplinary expert workshops with researchers at the University of Zurich. For the workshops and the subsequent manuscript writing process, we adopted a consensus study methodology. Results: We developed a set of tools to facilitate interdisciplinary education and collaboration. These tools focused on 2 key dimensions--- content and curriculum and methods and teaching style---and can be applied in various educational and research settings. We developed a glossary to establish a shared understanding of common terminologies and concepts. We delineated the established study workflow for research question formulation, emphasizing the ``what'' and the ``how,'' while summarizing the necessary tools to facilitate the process. We propose 3 clusters of contextual and methodological adaptations to this workflow to better integrate data science practices: (1) acknowledging real-life constraints and limitations in research scope; (2) allowing more iterative, data-driven approaches to research question formulation; and (3) strengthening research quality through reproducibility principles and adherence to the findable, accessible, interoperable, and reusable (FAIR) data principles. Conclusions: Research question formulation remains a relevant and useful research step in projects using digital data. We recommend initiating new interdisciplinary collaborations by establishing terminologies as well as using the concepts of research tasks to foster a shared understanding. Our tools and recommendations can support academic educators in training health professionals and researchers for interdisciplinary digital health projects. ", doi="10.2196/56369", url="https://mededu.jmir.org/2025/1/e56369" } @Article{info:doi/10.2196/50060, author="Ramos-Garc{\'i}a, Vanesa and Rivero-Santana, Amado and Pe{\~n}ate-Castro, Wenceslao and {\'A}lvarez-P{\'e}rez, Yolanda and Duarte-D{\'i}az, Andrea and Torres-Casta{\~n}o, Alezandra and Trujillo-Mart{\'i}n, Mar Mar{\'i}a del and Gonz{\'a}lez-Gonz{\'a}lez, Isabel Ana and Serrano-Aguilar, Pedro and Perestelo-P{\'e}rez, Lilisbeth", title="A Brief Web-Based Person-Centered Care Group Training Program for the Management of Generalized Anxiety Disorder: Feasibility Randomized Controlled Trial in Spain", journal="JMIR Med Educ", year="2025", month="Jan", day="16", volume="11", pages="e50060", keywords="person-centered care", keywords="primary care", keywords="shared decision-making", keywords="anxiety disorder", keywords="training program", keywords="SDM", abstract="Background: Shared decision-making (SDM) is a crucial aspect of patient-centered care. While several SDM training programs for health care professionals have been developed, evaluation of their effectiveness is scarce, especially in mental health disorders such as generalized anxiety disorder. Objective: This study aims to assess the feasibility and impact of a brief training program on the attitudes toward SDM among primary care professionals who attend to patients with generalized anxiety disorder. Methods: A feasibility randomized controlled trial was conducted. Health care professionals recruited in primary care centers were randomized to an intervention group (training program) or a control group (waiting list). The intervention consisted of 2 web-based sessions applied by 2 psychologists (VR and YA), based on the integrated elements of the patient-centered care model and including group dynamics and video viewing. The outcome variable was the Leeds Attitudes Towards Concordance scale, second version (LATCon II), assessed at baseline and after the second session (3 months). After the randomized controlled trial phase, the control group also received the intervention and was assessed again. Results: Among 28 randomized participants, 5 withdrew before the baseline assessment. The intervention significantly increased their scores compared with the control group in the total scale (b=0.57; P=.018) and 2 subscales: communication or empathy (b=0.74; P=.036) and shared control (ie, patient participation in decisions: b=0.68; P=.040). The control group also showed significant pre-post changes after receiving the intervention. Conclusions: For a future effectiveness trial, it is necessary to improve the recruitment and retention strategies. The program produced a significant improvement in participants' attitude toward the SDM model, but due to this study's limitations, mainly the small sample size, more research is warranted. ", doi="10.2196/50060", url="https://mededu.jmir.org/2025/1/e50060" } @Article{info:doi/10.2196/54153, author="Mun, Michelle and Byrne, Samantha and Shaw, Louise and Lyons, Kayley", title="Digital Dentists: A Curriculum for the 21st Century", journal="JMIR Med Educ", year="2025", month="Jan", day="8", volume="11", pages="e54153", keywords="digital health", keywords="digital transformation", keywords="informatics", keywords="ehealth", keywords="dentistry", keywords="dental informatics", keywords="curriculum", keywords="competence", keywords="capability", keywords="dental education", doi="10.2196/54153", url="https://mededu.jmir.org/2025/1/e54153" } @Article{info:doi/10.2196/60792, author="Ebnali Harari, Rayan and Altaweel, Abdullah and Anderson, Erik and Pozner, Charles and Grossmann, Rafael and Goldsmith, Andrew and Shokoohi, Hamid", title="Augmented Reality in Enhancing Operating Room Crisis Checklist Adherence: Randomized Comparative Efficacy Study", journal="JMIR XR Spatial Comput", year="2025", month="Jan", day="6", volume="2", pages="e60792", keywords="augmented reality", keywords="operating room", keywords="crisis checklist", keywords="checklist", keywords="guideline adherence", keywords="quality improvement", keywords="patient safety", keywords="cardiac arrest", keywords="hypotension", keywords="hyperthermia", keywords="critical care", keywords="emergency department", abstract="Background: Effective crisis management in operating rooms (ORs) is crucial for patient safety. Despite their benefits, adherence to OR crisis checklists is often limited, highlighting the need for innovative solutions. Objective: The objective of this study was to evaluate the efficacy of augmented reality (AR)-enhanced checklists in improving protocol adherence, compared to traditional paper checklists and no checklist scenarios during simulated OR crises. Methods: This study was a randomized comparative efficacy study comparing the utility of AR checklists, paper checklists, and no checklist scenarios using 4 validated and simulated OR crises scenarios: asystolic cardiac arrest, air embolism, unexplained hypotension/hypoxia, and malignant hyperthermia. The study took place in a simulated OR setting and had applicability to the standard procedures in ORs, critical care units, and urgent care scenarios in the emergency department. To form the 24 OR teams, 50 professionals including 24 anesthesiologists, 24 nurses, 1 surgeon, and 1 scrub nurse from two academic hospitals were included. The primary outcome measured was the failure to adhere (FTA) rate for critical actions during simulated OR crises. Adherence was determined using retrospective video analysis involving 595 key processes evaluated across 24 surgical teams. Interrater reliability was assessed using a Cohen $\kappa$. Secondary outcomes included checklist usability and cognitive load, as measured by the low-frequency to high-frequency (LF/HF) ratio of the heart rate variability. Results: The AR checklist group showed a significantly lower FTA rate (mean 15.1\%, SD 5.77\%) compared to the paper checklist (mean 8.32\%, SD 5.65\%; t23=?2.08; P=.048) and the no checklist groups (mean 29.81\%, SD 5.59\%; t23=?6.47; P<.001). The AR checklist also resulted in a higher LF/HF ratio for anesthesiologists (F2,46=4.88; P=.02), showing a potential increase in the level of cognitive load. Survey data indicated positive receptions for both AR and paper checklists. Conclusions: These results suggest that AR checklists could offer a viable method for enhancing adherence to critical care protocols. Although, further research is needed to fully assess their impact on clinical outcomes and to address any associated increase in cognitive load. ", doi="10.2196/60792", url="https://xr.jmir.org/2025/1/e60792" } @Article{info:doi/10.2196/51101, author="Burrell, Joanna and Baker, Felicity and Bennion, Russell Matthew", title="Resilience Training Web App for National Health Service Keyworkers: Pilot Usability Study", journal="JMIR Med Educ", year="2025", month="Jan", day="6", volume="11", pages="e51101", keywords="resilience", keywords="workplace stress", keywords="National Health Service", keywords="NHS keyworker", keywords="digital learning", keywords="digital health", keywords="usability", keywords="feasibility", keywords="mental health", keywords="pilot study", keywords="learning", keywords="training", keywords="exercise", keywords="primary care provider", keywords="health care professional", keywords="occupational health", keywords="worker", keywords="hospital", keywords="emergency", keywords="survey", keywords="questionnaire", keywords="mobile phone", abstract="Background: It is well established that frontline health care staff are particularly at risk of stress. Resilience is important to help staff to manage daily challenges and to protect against burnout. Objective: This study aimed to assess the usability and user perceptions of a resilience training web app developed to support health care keyworkers in understanding their own stress response and to help them put into place strategies to manage stress and to build resilience. Methods: Nurses (n=7) and other keyworkers (n=1), the target users for the resilience training web app, participated in the usability evaluation. Participants completed a pretraining questionnaire capturing basic demographic information and then used the training before completing a posttraining feedback questionnaire exploring the impact and usability of the web app. Results: From a sample of 8 keyworkers, 6 (75\%) rated their current role as ``sometimes'' stressful. All 8 (100\%) keyworkers found the training easy to understand, and 5 of 7 (71\%) agreed that the training increased their understanding of both stress and resilience. Further, 6 of 8 (75\%) agreed that the resilience model had helped them to understand what resilience is. Many of the keyworkers (6/8, 75\%) agreed that the content was relevant to them. Furthermore, 6 of 8 (75\%) agreed that they were likely to act to develop their resilience following completion of the training. Conclusions: This study tested the usability of a web app for resilience training specifically targeting National Health Service keyworkers. This work preceded a larger scale usability study, and it is hoped this study will help guide other studies to develop similar programs in clinical settings. ", doi="10.2196/51101", url="https://mededu.jmir.org/2025/1/e51101" } @Article{info:doi/10.2196/63865, author="Bland, Tyler", title="Enhancing Medical Student Engagement Through Cinematic Clinical Narratives: Multimodal Generative AI--Based Mixed Methods Study", journal="JMIR Med Educ", year="2025", month="Jan", day="6", volume="11", pages="e63865", keywords="artificial intelligence", keywords="cinematic clinical narratives", keywords="cinemeducation", keywords="medical education", keywords="narrative learning", keywords="AI", keywords="medical student", keywords="pharmacology", keywords="preclinical education", keywords="long-term retention", keywords="AI tools", keywords="GPT-4", keywords="image", keywords="applicability", abstract="Background: Medical students often struggle to engage with and retain complex pharmacology topics during their preclinical education. Traditional teaching methods can lead to passive learning and poor long-term retention of critical concepts. Objective: This study aims to enhance the teaching of clinical pharmacology in medical school by using a multimodal generative artificial intelligence (genAI) approach to create compelling, cinematic clinical narratives (CCNs). Methods: We transformed a standard clinical case into an engaging, interactive multimedia experience called ``Shattered Slippers.'' This CCN used various genAI tools for content creation: GPT-4 for developing the storyline, Leonardo.ai and Stable Diffusion for generating images, Eleven Labs for creating audio narrations, and Suno for composing a theme song. The CCN integrated narrative styles and pop culture references to enhance student engagement. It was applied in teaching first-year medical students about immune system pharmacology. Student responses were assessed through the Situational Interest Survey for Multimedia and examination performance. The target audience comprised first-year medical students (n=40), with 18 responding to the Situational Interest Survey for Multimedia survey (n=18). Results: The study revealed a marked preference for the genAI-enhanced CCNs over traditional teaching methods. Key findings include the majority of surveyed students preferring the CCN over traditional clinical cases (14/18), as well as high average scores for triggered situational interest (mean 4.58, SD 0.53), maintained interest (mean 4.40, SD 0.53), maintained-feeling interest (mean 4.38, SD 0.51), and maintained-value interest (mean 4.42, SD 0.54). Students achieved an average score of 88\% on examination questions related to the CCN material, indicating successful learning and retention. Qualitative feedback highlighted increased engagement, improved recall, and appreciation for the narrative style and pop culture references. Conclusions: This study demonstrates the potential of using a multimodal genAI-driven approach to create CCNs in medical education. The ``Shattered Slippers'' case effectively enhanced student engagement and promoted knowledge retention in complex pharmacological topics. This innovative method suggests a novel direction for curriculum development that could improve learning outcomes and student satisfaction in medical education. Future research should explore the long-term retention of knowledge and the applicability of learned material in clinical settings, as well as the potential for broader implementation of this approach across various medical education contexts. ", doi="10.2196/63865", url="https://mededu.jmir.org/2025/1/e63865" } @Article{info:doi/10.2196/58426, author="Wang, Heng and Zheng, Danni and Wang, Mengying and Ji, Hong and Han, Jiangli and Wang, Yan and Shen, Ning and Qiao, Jie", title="Artificial Intelligence--Powered Training Database for Clinical Thinking: App Development Study", journal="JMIR Form Res", year="2025", month="Jan", day="3", volume="9", pages="e58426", keywords="artificial intelligence", keywords="clinical thinking ability", keywords="virtual medical records", keywords="distance education", keywords="medical education", keywords="online learning", abstract="Background: With the development of artificial intelligence (AI), medicine has entered the era of intelligent medicine, and various aspects, such as medical education and talent cultivation, are also being redefined. The cultivation of clinical thinking abilities poses a formidable challenge even for seasoned clinical educators, as offline training modalities often fall short in bridging the divide between current practice and the desired ideal. Consequently, there arises an imperative need for the expeditious development of a web-based database, tailored to empower physicians in their quest to learn and hone their clinical reasoning skills. Objective: This study aimed to introduce an app named ``XueYiKu,'' which includes consultations, physical examinations, auxiliary examinations, and diagnosis, incorporating AI and actual complete hospital medical records to build an online-learning platform using human-computer interaction. Methods: The ``XueYiKu'' app was designed as a contactless, self-service, trial-and-error system application based on actual complete hospital medical records and natural language processing technology to comprehensively assess the ``clinical competence'' of residents at different stages. Case extraction was performed at a hospital's case data center, and the best-matching cases were differentiated through natural language processing, word segmentation, synonym conversion, and sorting. More than 400 teaching cases covering 65 kinds of diseases were released for students to learn, and the subjects covered internal medicine, surgery, gynecology and obstetrics, and pediatrics. The difficulty of learning cases was divided into four levels in ascending order. Moreover, the learning and teaching effects were evaluated using 6 dimensions covering systematicness, agility, logic, knowledge expansion, multidimensional evaluation indicators, and preciseness. Results: From the app's first launch on the Android platform in May 2019 to the last version updated in May 2023, the total number of teacher and student users was 6209 and 1180, respectively. The top 3 subjects most frequently learned were respirology (n=606, 24.1\%), general surgery (n=506, 20.1\%), and urinary surgery (n=390, 15.5\%). For diseases, pneumonia was the most frequently learned, followed by cholecystolithiasis (n=216, 14.1\%), benign prostate hyperplasia (n=196, 12.8\%), and bladder tumor (n=193, 12.6\%). Among 479 students, roughly a third (n=168, 35.1\%) scored in the 60 to 80 range, and half of them scored over 80 points (n=238, 49.7\%). The app enabled medical students' learning to become more active and self-motivated, with a variety of formats, and provided real-time feedback through assessments on the platform. The learning effect was satisfactory overall and provided important precedence for establishing scientific models and methods for assessing clinical thinking skills in the future. Conclusions: The integration of AI and medical education will undoubtedly assist in the restructuring of education processes; promote the evolution of the education ecosystem; and provide new convenient ways for independent learning, interactive communication, and educational resource sharing. ", doi="10.2196/58426", url="https://formative.jmir.org/2025/1/e58426" } @Article{info:doi/10.2196/58037, author="Pei, Tao and Ding, Yinan and Tang, Jinsong and Liao, Yanhui", title="Evaluating the Effectiveness of a Multimodal Psychotherapy Training Program for Medical Students in China: Protocol for a Randomized Controlled Trial", journal="JMIR Res Protoc", year="2025", month="Jan", day="3", volume="14", pages="e58037", keywords="multimodal teaching", keywords="psychotherapy training", keywords="Chinese medical students", keywords="randomized controlled trial", abstract="Background: Psychotherapy is central to the treatment of mental disorders, highlighting the importance of medical students and residents developing competencies in this area. Chinese medical residents have expressed a strong need for psychotherapy training, yet they are generally dissatisfied with the current offerings. This paper presents the protocol for an evidence-based, well-structured psychotherapy teaching program aimed at medical students and residents. Objective: This study involves a randomized controlled trial of a 2-day multimodal intensive educational intervention designed to evaluate the effectiveness of a new psychotherapy teaching program for medical students and residents in China. The primary outcomes include participants' knowledge and utilization of psychotherapy, training program acceptability, self-reported self-efficacy, and motivation to apply psychotherapy. Methods: This 2-arm randomized controlled trial was conducted at Sir Run Run Shaw Hospital. The study aimed to recruit approximately 160 medical students and residents, with about 80 participants in the intervention group and 80 in the control group. Both groups completed a baseline survey before participation, reporting their psychotherapy knowledge, utilization of psychotherapy, self-efficacy, and self-motivation. The intervention group received a 2-day multimodal intensive educational intervention (supervision-based online teaching), while the waitlist control group did not receive any intervention during this period. Both groups were followed up for 8 weeks, completing the same survey administered at baseline. At the end of the study, the control group received the intervention. The primary outcome measure was the change in trainees' psychotherapy knowledge before and after the intervention training. Secondary outcome measures included changes in the trainees' utilization of psychotherapy, self-reported self-efficacy, and self-reported motivation for psychotherapy. Additionally, training program acceptability was assessed. Analysis of covariance was used to analyze the primary outcomes. Pearson correlations and regression analysis explored factors associated with the knowledge score at baseline. The secondary outcomes, including participants' psychotherapy utilization, confidence, and motivation, were analyzed using the same methods as for knowledge. All tests were 2-tailed, with a significance level set at P<.05. Results: A total of 160 participants were recruited and randomized between January 4 and 12, 2024. Baseline assessments were conducted from January 28 to February 1, 2024. The psychotherapy training program for the intervention group took place on February 3 and 4, 2024. Posttraining assessments were conducted starting April 1, 2024. Due to withdrawals, incomplete surveys, and data loss, we had a total of 113 participants: 57 in the intervention group and 56 in the control group. The amount of data varied across measures. The data analysis was finished in August 2024. Conclusions: This study aims to evaluate the effectiveness of the multimodal psychotherapy training program for medical students in China. If this brief, cognitive behavioral therapy--based psychotherapy skill training proves effective, the potential mental health impact of its nationwide expansion could be significant. Trial Registration: ClinicalTrials.gov NCT06258460; https://clinicaltrials.gov/ct2/show/NCT06258460 International Registered Report Identifier (IRRID): DERR1-10.2196/58037 ", doi="10.2196/58037", url="https://www.researchprotocols.org/2025/1/e58037", url="http://www.ncbi.nlm.nih.gov/pubmed/39752191" } @Article{info:doi/10.2196/57655, author="Zechner, Olivia and Schrom-Feiertag, Helmut and Wespi, Rafael and Pretolesi, Daniele and Nguyen, Quynh and Tscheligi, Manfred", title="Enhancing Mixed Reality Simulation Training Technology With Real-Time Performance Visualization: Mixed Methods Study With Medical First Responders", journal="JMIR XR Spatial Comput", year="2024", month="Dec", day="24", volume="1", pages="e57655", keywords="mixed reality", keywords="immersive technologies", keywords="simulation training", keywords="simulation", keywords="paramedic", keywords="medical first responders", keywords="human performance", keywords="stress", keywords="stress monitoring", keywords="human-centered design", abstract="Background: Mixed reality (MR) simulation training is emerging in paramedical education as a way to practice responding to stress-intensive scenarios like mass casualty incidents in a safe and controlled environment. Current training platforms, however, lack real-time stress and human performance monitoring tools. Objective: The study aims to enhance MR training for medical first responders through real-time evaluation of performance and stress levels, leveraging biosignal monitoring and advanced analytics to allow instructors to tailor feedback and maintain optimal challenge and safety levels. Methods: The study includes a structured, multiphase approach including initial requirement gathering (structured interviews and cocreation workshops), an online design survey, iterative prototype development, and a field trial (including training observations and interviews). Data were collected from 5 end user consortium members across Europe. Quantitative data from checklists were analyzed using frequencies and percentages to understand feature usage and event occurrences. Qualitative data from semistructured interviews and cocreation workshops were transcribed, coded, and subjected to thematic analysis to identify patterns and insights into the usability and effectiveness of the enhanced features in the MR training. Results: The study identified a number of requirements that medical first responders have for an MR training system, including requirements not included in currently available solutions. A total of 80 performance metrics were initially identified and refined to a set of 54 metrics, which were categorized into key performance indicator groups such as scene safety, triage performance, and communication. Requirements for smart wearables to monitor stress levels are provided and highlight the importance of a user-centered design process to provide users with effective tools that fit their needs. Stress visualization preferences are described in the form of a dashboard as well as in virtual environments surrounding the avatar. Using an iterative design process and user feedback, a training system was developed, integrating real-time performance tracking and stress monitoring. The field trial provided insights into the practical use of these features during a real training exercise, showed interaction preferences between trainer and trainees, and highlighted further improvement opportunities. Conclusions: This research enhances MR training for paramedics by integrating real-time performance metrics and stress indicators based on a human-centered design approach that aligns with end user needs, thereby laying the foundation for developing more effective and immersive training solutions for high-stress professions. ", doi="10.2196/57655", url="https://xr.jmir.org/2024/1/e57655" } @Article{info:doi/10.2196/65506, author="Thimmapuram, Jayaram and Patel, D. Kamlesh and Bhatt, Deepti and Chauhan, Ajay and Madhusudhan, Divya and Bhatt, K. Kashyap and Deshpande, Snehal and Budhbhatti, Urvi and Joshi, Chaitanya", title="Effect of a Web-Based Heartfulness Program on the Mental Well-Being, Biomarkers, and Gene Expression Profile of Health Care Students: Randomized Controlled Trial", journal="JMIR Bioinform Biotech", year="2024", month="Dec", day="16", volume="5", pages="e65506", keywords="heartfulness", keywords="meditation", keywords="stress", keywords="anxiety", keywords="depression", keywords="interleukins", keywords="gene expression", keywords="dehydroepiandrosterone", keywords="DHEA", keywords="gene", keywords="mental health", keywords="randomized study", keywords="web-based program", keywords="mental well-being", keywords="well-being", keywords="mental", keywords="health care students", keywords="student", keywords="mRNA", keywords="messenger ribonucleic acid", keywords="youth", keywords="young adults", keywords="web-based", keywords="biomarker", keywords="RNA", keywords="bioinformatics", keywords="randomized", keywords="statistical analysis", keywords="nursing", keywords="physiotherapy", keywords="pharmacy", abstract="Background: Health care students often experience high levels of stress, anxiety, and mental health issues, making it crucial to address these challenges. Variations in stress levels may be associated with changes in dehydroepiandrosterone sulfate (DHEA-S) and interleukin-6 (IL-6) levels and gene expression. Meditative practices have demonstrated effectiveness in reducing stress and improving mental well-being. Objective: This study aims to assess the effects of Heartfulness meditation on mental well-being, DHEA-S, IL-6, and gene expression profile. Methods: The 78 enrolled participants were randomly assigned to the Heartfulness meditation (n=42, 54\%) and control (n=36, 46\%) groups. The participants completed the Perceived Stress Scale (PSS) and Depression Anxiety Stress Scale (DASS-21) at baseline and after week 12. Gene expression with messenger RNA sequencing and DHEA-S and IL-6 levels were also measured at baseline and the completion of the 12 weeks. Statistical analysis included descriptive statistics, paired t test, and 1-way ANOVA with Bonferroni correction. Results: The Heartfulness group exhibited a significant 17.35\% reduction in PSS score (from mean 19.71, SD 5.09 to mean 16.29, SD 4.83; P<.001) compared to a nonsignificant 6\% reduction in the control group (P=.31). DASS-21 scores decreased significantly by 27.14\% in the Heartfulness group (from mean 21.15, SD 9.56 to mean 15.41, SD 7.87; P<.001) while it increased nonsignificantly by 17\% in the control group (P=.04). For the DASS-21 subcomponents---the Heartfulness group showed a statistically significant 28.53\% reduction in anxiety (P=.006) and 27.38\% reduction in stress (P=.002) versus an insignificant 22\% increase in anxiety (P=.02) and 6\% increase in stress (P=.47) in the control group. Further, DHEA-S levels showed a significant 20.27\% increase in the Heartfulness group (from mean 251.71, SD 80.98 to mean 302.74, SD 123.56; P=.002) compared to an insignificant 9\% increase in the control group (from mean 285.33, SD 112.14 to mean 309.90, SD 136.90; P=.10). IL-6 levels showed a statistically significant difference in both the groups (from mean 4.93, SD 1.35 to mean 3.67, SD 1.0; 28.6\%; P<.001 [Heartfulness group] and from mean 4.52, SD 1.40 to mean 2.72, SD 1.74; 40\%; P<.001 [control group]). Notably, group comparison at 12 weeks revealed a significant difference in perceived stress, DASS-21 and its subcomponents, and IL-6 (all P<.05/4). The gene expression profile with messenger RNA sequencing identified 875 upregulated genes and 1539 downregulated genes in the Heartfulness group compared to baseline, and there were 292 upregulated genes and 1180 downregulated genes in the Heartfulness group compared to the control group after the intervention. Conclusions: Heartfulness practice was associated with decreased depression, anxiety, and stress scores and improved health measures in DHEA-S and IL-6 levels. The gene expression data point toward possible mechanisms of alleviation of symptoms of stress, anxiety and depression. Trial Registration: ISRCTN Registry ISRCTN82860715; https://doi.org/10.1186/ISRCTN82860715 ", doi="10.2196/65506", url="https://bioinform.jmir.org/2024/1/e65506", url="http://www.ncbi.nlm.nih.gov/pubmed/39680432" } @Article{info:doi/10.2196/57451, author="Jin, Kyung Hye and Kim, EunYoung", title="Performance of GPT-3.5 and GPT-4 on the Korean Pharmacist Licensing Examination: Comparison Study", journal="JMIR Med Educ", year="2024", month="Dec", day="4", volume="10", pages="e57451", keywords="GPT-3.5", keywords="GPT-4", keywords="Korean", keywords="Korean Pharmacist Licensing Examination", keywords="KPLE", abstract="Background: ChatGPT, a recently developed artificial intelligence chatbot and a notable large language model, has demonstrated improved performance on medical field examinations. However, there is currently little research on its efficacy in languages other than English or in pharmacy-related examinations. Objective: This study aimed to evaluate the performance of GPT models on the Korean Pharmacist Licensing Examination (KPLE). Methods: We evaluated the percentage of correct answers provided by 2 different versions of ChatGPT (GPT-3.5 and GPT-4) for all multiple-choice single-answer KPLE questions, excluding image-based questions. In total, 320, 317, and 323 questions from the 2021, 2022, and 2023 KPLEs, respectively, were included in the final analysis, which consisted of 4 units: Biopharmacy, Industrial Pharmacy, Clinical and Practical Pharmacy, and Medical Health Legislation. Results: The 3-year average percentage of correct answers was 86.5\% (830/960) for GPT-4 and 60.7\% (583/960) for GPT-3.5. GPT model accuracy was highest in Biopharmacy (GPT-3.5 77/96, 80.2\% in 2022; GPT-4 87/90, 96.7\% in 2021) and lowest in Medical Health Legislation (GPT-3.5 8/20, 40\% in 2022; GPT-4 12/20, 60\% in 2022). Additionally, when comparing the performance of artificial intelligence with that of human participants, pharmacy students outperformed GPT-3.5 but not GPT-4. Conclusions: In the last 3 years, GPT models have performed very close to or exceeded the passing threshold for the KPLE. This study demonstrates the potential of large language models in the pharmacy domain; however, extensive research is needed to evaluate their reliability and ensure their secure application in pharmacy contexts due to several inherent challenges. Addressing these limitations could make GPT models more effective auxiliary tools for pharmacy education. ", doi="10.2196/57451", url="https://mededu.jmir.org/2024/1/e57451" } @Article{info:doi/10.2196/53344, author="Benjamin, Jennifer and Pillow, Tyson and MacNeill, Heather and Masters, Ken and Agrawal, Anoop and Mehta, Neil", title="Reflections From the Pandemic: Is Connectivism the Panacea for Clinicians?", journal="J Med Internet Res", year="2024", month="Dec", day="3", volume="26", pages="e53344", keywords="learning theory", keywords="learning framework", keywords="connectivism", keywords="panacea", keywords="COVID-19", keywords="generative artificial intelligence", keywords="GAI", keywords="health care community", keywords="clinician", keywords="health care", keywords="airborne disease", keywords="learning", keywords="information", keywords="misinformation", keywords="autonomy", keywords="diversity", doi="10.2196/53344", url="https://www.jmir.org/2024/1/e53344", url="http://www.ncbi.nlm.nih.gov/pubmed/39625749" } @Article{info:doi/10.2196/60670, author="Wooldridge, S. Jennalee and Soriano, C. Emily and Chu, Gage and Shirazi, Anaheed and Shapiro, Desiree and Patterson, Marta and Kim, Hyun-Chung and Herbert, S. Matthew", title="Optimizing Compassion Training in Medical Trainees Using an Adjunct mHealth App: A Preliminary Single-Arm Feasibility and Acceptability Study", journal="JMIR Form Res", year="2024", month="Nov", day="26", volume="8", pages="e60670", keywords="mobile phone", keywords="compassion", keywords="empathy", keywords="mHealth", keywords="mobile health", keywords="medical student", keywords="medical resident", keywords="mHealth app", keywords="app", keywords="medical trainee", keywords="training", keywords="feasibility", keywords="acceptability", keywords="pilot", keywords="mindfulness", keywords="self-compassion", keywords="smartphone app", keywords="applicability", abstract="Background: While structured compassion training programs have shown promise for increasing compassion among medical trainees, a major challenge is applying the concepts and practices taught during the program into the complex, dynamic, time-pressured, and often hectic hospital workplace. Objective: The purpose of this pilot study was to examine the feasibility, acceptability, and preliminary effects of Compassion Coach, a mobile health (mHealth) smartphone app designed to bolster a 6-week mindfulness and self-compassion training program for medical trainees. Methods: In Compassion Coach, notifications to remind, encourage, and measure the perceived impact of informal mindfulness and compassion practices taught during the program were delivered at 7 AM, 12 PM, and 7 PM, respectively, 3 times per week over the course of the training program. The app also contained a library of guided audio formal mindfulness and compassion practices to allow quick and easy access. In this pilot study, we collected data from 29 medical students and residents who downloaded Compassion Coach and completed surveys assessing perceived effectiveness and acceptability. Engagement with the Compassion Coach app was passively tracked through notification response rate and library resource access over time. Results: The average response rate to notifications was 58\% (SD 29\%; range 12\%-98\%), with a significant decline over time (P=.009; odds ratio 0.98, 95\% CI 0.96-0.99). Across all participants and occasions, the majority agreed the informal practices prompted by Compassion Coach helped them feel grounded and centered (110/150, 73\%), improved compassion (29/41, 71\%), reduced burnout (106/191, 56\%), and improved their mood (133/191, 70\%). In total, 16 (55\%) of the 29 participants accessed guided audio recordings on average 3 (SD 3.4) times throughout the program. At the posttreatment time point, most participants (13/18, 72\%) indicated that Compassion Coach helped them engage in compassion practices in daily life, and half (9/18, 50\%) indicated that Compassion Coach helped improve interactions with patients. Conclusions: Overall, preliminary results of Compassion Coach are encouraging and suggest the integration of a smartphone app with an ongoing mindfulness and self-compassion training program may bolster the effects of the program on medical trainees. However, there was variability in engagement with Compassion Coach and perceived helpfulness. Additional research is indicated to optimize this novel mHealth approach and conduct a study powered to formally evaluate effects. ", doi="10.2196/60670", url="https://formative.jmir.org/2024/1/e60670", url="http://www.ncbi.nlm.nih.gov/pubmed/39589766" } @Article{info:doi/10.2196/60940, author="Hertel, Kay Amanda and Ajlan, S. Radwan", title="Impact of Ophthalmic Knowledge Assessment Program Scores and Surgical Volume on Subspecialty Fellowship Application in Ophthalmology Residency: Retrospective Cohort Study", journal="JMIR Med Educ", year="2024", month="Nov", day="13", volume="10", pages="e60940", keywords="residency", keywords="fellowship", keywords="ophthalmology", keywords="OKAP", keywords="surgical training", keywords="ophthalmology resident", keywords="ophthalmology residency program", keywords="examination", keywords="surgical volume exposure", keywords="fellowship training", keywords="surgical volume", keywords="exposure", keywords="Ophthalmic Knowledge Assessment Program", abstract="Background: Ophthalmology residents take the Ophthalmic Knowledge Assessment Program (OKAP) exam annually, which provides percentile rank for multiple categories and the total score. In addition, ophthalmology residency training programs have multiple subspecialty rotations with defined minimum procedure requirements. However, residents' surgical volumes vary, with some residents exceeding their peers in specific subspecialty rotations. Objective: This study aims to identify if there is a difference in OKAP examination scores and surgical volume exposure during ophthalmology residency training between nonfellowship and fellowship applicants and among various subspecialties. Methods: A retrospective review of OKAP scores and surgical procedure numbers of graduating residents in an accredited academic ophthalmology residency program in the Midwest United States was conducted. Data were collected from 2012 to 2022. Results: A total of 31 residents were identified. Most residents decided to pursue fellowship training upon graduation (20/31, 65\% residents), and the rest chose to practice comprehensive ophthalmology (11/31, 35\% residents). A total of 18/31 residents had OKAP score reports available. The fellowship group outperformed the nonfellowship group in multiple subsections and the total exam (P=.04). Those pursuing fellowship training in glaucoma performed higher on the Glaucoma section (P=.004) and the total exam (P=.005). Residents pursuing cornea performed higher on nearly all subsections, including External Disease and Cornea (P=.02) and the total exam (P=.007). The majority of the surgical volume exposure was identical between fellowship and nonfellowship groups. Those who pursued glaucoma fellowship performed more glaucoma filtering and shunting procedures (P=.03). Residents going into pediatrics fellowship were primary surgeons in more strabismus cases (P=.01), assisted in fewer strabismus cases (P<.001), and had no difference in the total number of strabismus surgeries. Conclusions: In our program, residents pursuing fellowship training had higher OKAP scores on multiple sections and the total exam. There was no significant difference in the overall surgical volume averages between fellowship and nonfellowship groups, but few differences existed in subspecialty procedures among fellowship applicants. Larger multicenter studies are needed to clarify the relationship between OKAP scores and ophthalmology fellowship decisions nationwide. ", doi="10.2196/60940", url="https://mededu.jmir.org/2024/1/e60940" } @Article{info:doi/10.2196/64221, author="Nachman, Sophie and Ortiz-Prado, Esteban and Tucker, D. Joseph", title="Video Abstracts in Research", journal="J Med Internet Res", year="2024", month="Nov", day="4", volume="26", pages="e64221", keywords="video abstract", keywords="abstract", keywords="dissemination", keywords="public engagement", keywords="online", keywords="videos", keywords="public audience", keywords="communication", keywords="infographics", keywords="health literacy", keywords="patient education", keywords="public health", doi="10.2196/64221", url="https://www.jmir.org/2024/1/e64221" } @Article{info:doi/10.2196/52924, author="Elhariry, Maiar and Malhotra, Kashish and Goyal, Kashish and Bardus, Marco and Team, CoMICs SIMBA and and Kempegowda, Punith", title="A SIMBA CoMICs Initiative to Cocreating and Disseminating Evidence-Based, Peer-Reviewed Short Videos on Social Media: Mixed Methods Prospective Study", journal="JMIR Med Educ", year="2024", month="Oct", day="30", volume="10", pages="e52924", keywords="influencers", keywords="social media", keywords="public engagement", keywords="apps", keywords="healthcare", keywords="medical students", keywords="online medical information", keywords="simulation", keywords="peer-reviewed information", abstract="Background: Social media is a powerful platform for disseminating health information, yet it is often riddled with misinformation. Further, few guidelines exist for producing reliable, peer-reviewed content. This study describes a framework for creating and disseminating evidence-based videos on polycystic ovary syndrome (PCOS) and thyroid conditions to improve health literacy and tackle misinformation. Objective: The study aims to evaluate the creation, dissemination, and impact of evidence-based, peer-reviewed short videos on PCOS and thyroid disorders across social media. It also explores the experiences of content creators and assesses audience engagement. Methods: This mixed methods prospective study was conducted between December 2022 and May 2023 and comprised five phases: (1) script generation, (2) video creation, (3) cross-platform publication, (4) process evaluation, and (5) impact evaluation. The SIMBA-CoMICs (Simulation via Instant Messaging for Bedside Application--Combined Medical Information Cines) initiative provides a structured process where medical concepts are simplified and converted to visually engaging videos. The initiative recruited medical students interested in making visually appealing and scientifically accurate videos for social media. The students were then guided to create video scripts based on frequently searched PCOS- and thyroid-related topics. Once experts confirmed the accuracy of the scripts, the medical students produced the videos. The videos were checked by clinical experts and experts with lived experience to ensure clarity and engagement. The SIMBA-CoMICs team then guided the students in editing these videos to fit platform requirements before posting them on TikTok, Instagram, YouTube, and Twitter. Engagement metrics were tracked over 2 months. Content creators were interviewed, and thematic analysis was performed to explore their experiences. Results: The 20 videos received 718 likes, 120 shares, and 54,686 views across all platforms, with TikTok (19,458 views) and Twitter (19,678 views) being the most popular. Engagement increased significantly, with follower growth ranging from 5\% on Twitter to 89\% on TikTok. Thematic analysis of interviews with 8 out of 38 participants revealed 4 key themes: views on social media, advice for using social media, reasons for participating, and reflections on the project. Content creators highlighted the advantages of social media, such as large outreach (12 references), convenience (10 references), and accessibility to opportunities (7 references). Participants appreciated the nonrestrictive participation criteria, convenience (8 references), and the ability to record from home using prewritten scripts (6 references). Further recommendations to improve the content creation experience included awareness of audience demographics (9 references), sharing content on multiple platforms (5 references), and collaborating with organizations (3 references). Conclusions: This study demonstrates the effectiveness of the SIMBA CoMICs initiative in training medical students to create accurate medical information on PCOS and thyroid disorders for social media dissemination. The model offers a scalable solution to combat misinformation and improve health literacy. ", doi="10.2196/52924", url="https://mededu.jmir.org/2024/1/e52924" } @Article{info:doi/10.2196/53462, author="Saig{\'i}-Rubi{\'o}, Francesc and Romeu, Teresa and Hern{\'a}ndez Encuentra, Eul{\`a}lia and Guitert, Montse and Andr{\'e}s, Erik and Reixach, Elisenda", title="Design, Implementation, and Analysis of an Assessment and Accreditation Model to Evaluate a Digital Competence Framework for Health Professionals: Mixed Methods Study", journal="JMIR Med Educ", year="2024", month="Oct", day="17", volume="10", pages="e53462", keywords="eHealth literacy", keywords="eHealth competencies", keywords="digital health", keywords="competencies", keywords="eHealth", keywords="health literacy", keywords="digital technology", keywords="health care professionals", keywords="health care workers", abstract="Background: Although digital health is essential for improving health care, its adoption remains slow due to the lack of literacy in this area. Therefore, it is crucial for health professionals to acquire digital skills and for a digital competence assessment and accreditation model to be implemented to make advances in this field. Objective: This study had two objectives: (1) to create a specific map of digital competences for health professionals and (2) to define and test a digital competence assessment and accreditation model for health professionals. Methods: We took an iterative mixed methods approach, which included a review of the gray literature and consultation with local experts. We used the arithmetic mean and SD in descriptive statistics, P values in hypothesis testing and subgroup comparisons, the greatest lower bound in test diagnosis, and the discrimination index in study instrument analysis. Results: The assessment model designed in accordance with the competence content defined in the map of digital competences and based on scenarios had excellent internal consistency overall (greatest lower bound=0.91). Although most study participants (110/122, 90.2\%) reported an intermediate self-perceived digital competence level, we found that the vast majority would not attain a level-2 Accreditation of Competence in Information and Communication Technologies. Conclusions: Knowing the digital competence level of health professionals based on a defined competence framework should enable such professionals to be trained and updated to meet real needs in their specific professional contexts and, consequently, take full advantage of the potential of digital technologies. These results have informed the Health Plan for Catalonia 2021-2025, thus laying the foundations for creating and offering specific training to assess and certify the digital competence of such professionals. ", doi="10.2196/53462", url="https://mededu.jmir.org/2024/1/e53462", url="http://www.ncbi.nlm.nih.gov/pubmed/39418092" } @Article{info:doi/10.2196/50057, author="Wu, Manli and Yan, Jun and Qiao, Chongming and Yan, Chu", title="Impact of Concurrent Media Exposure on Professional Identity: Cross-Sectional Study of 1087 Medical Students During Long COVID", journal="J Med Internet Res", year="2024", month="Oct", day="17", volume="26", pages="e50057", keywords="COVID-19", keywords="media exposure", keywords="social support", keywords="professional identity", keywords="medical students", keywords="Stimulus-Organism-Response framework", abstract="Background: Long COVID has widened the health gap across society and highlighted the vulnerabilities and risks faced by health care systems. For instance, the global trend of medical workers resigning has become a prominent topic on social media. In response to this severe social problem in global public health within the digital society, it is urgent to investigate how the professional identity of medical students, who are digital natives and the future workforce of medical practitioners, is affected by the media environment. Objective: This study aims to examine how media exposure relates to medical students' perceptions of informational and emotional support, and how these perceptions further influence the development of their professional identity. Methods: Building on the Stimulus-Organism-Response (SOR) framework, this study develops a theoretical model to illustrate how media exposure affects medical students' professional identity through the mediation of social support. Specifically, media exposure was assessed through online news media and social media exposure; social support was evaluated in terms of informational and emotional support; and professional identity was measured through medical students' sense of belonging and professional commitment. A survey was conducted at a medical school in China, yielding 1087 valid responses that were analyzed using SmartPLS 4.0. Results: Consistent with our expectations, online news media exposure was positively associated with both informational support ($\beta$=.163; P<.001) and emotional support ($\beta$=.084; P=.007). Similarly, social media exposure showed positive associations with informational support ($\beta$=.122; P<.001) and emotional support ($\beta$=.235; P<.001). Thereafter, informational support ($\beta$=.228; P<.001) and emotional support ($\beta$=.344; P<.001) were positively associated with students' sense of belonging. Meanwhile, both informational support ($\beta$=.245; P<.001) and emotional support ($\beta$=.412; P<.001) positively impacted medical students' professional commitment. In addition, a mediation test was conducted. The results confirmed that informational support and emotional support partially mediated the effect of online news media, while fully mediating the effect of social media on medical students' sense of belonging and professional commitment. Conclusions: This study finds that exposure to online news media and social media can enhance medical students' sense of belonging and professional commitment through the formation of informational and emotional support. It expands the discussion on the role of media in providing social support and facilitating the development of medical students' professional identity. This is a valuable contribution to addressing complex public health crises through effective media governance in the network era. ", doi="10.2196/50057", url="https://www.jmir.org/2024/1/e50057", url="http://www.ncbi.nlm.nih.gov/pubmed/39418080" } @Article{info:doi/10.2196/51411, author="Wang, Shuang and Yang, Liuying and Li, Min and Zhang, Xinghe and Tai, Xiantao", title="Medical Education and Artificial Intelligence: Web of Science--Based Bibliometric Analysis (2013-2022)", journal="JMIR Med Educ", year="2024", month="Oct", day="10", volume="10", pages="e51411", keywords="artificial intelligence", keywords="medical education", keywords="bibliometric analysis", keywords="CiteSpace", keywords="VOSviewer", abstract="Background: Incremental advancements in artificial intelligence (AI) technology have facilitated its integration into various disciplines. In particular, the infusion of AI into medical education has emerged as a significant trend, with noteworthy research findings. Consequently, a comprehensive review and analysis of the current research landscape of AI in medical education is warranted. Objective: This study aims to conduct a bibliometric analysis of pertinent papers, spanning the years 2013?2022, using CiteSpace and VOSviewer. The study visually represents the existing research status and trends of AI in medical education. Methods: Articles related to AI and medical education, published between 2013 and 2022, were systematically searched in the Web of Science core database. Two reviewers scrutinized the initially retrieved papers, based on their titles and abstracts, to eliminate papers unrelated to the topic. The selected papers were then analyzed and visualized for country, institution, author, reference, and keywords using CiteSpace and VOSviewer. Results: A total of 195 papers pertaining to AI in medical education were identified from 2013 to 2022. The annual publications demonstrated an increasing trend over time. The United States emerged as the most active country in this research arena, and Harvard Medical School and the University of Toronto were the most active institutions. Prolific authors in this field included Vincent Bissonnette, Charlotte Blacketer, Rolando F Del Maestro, Nicole Ledows, Nykan Mirchi, Alexander Winkler-Schwartz, and Recai Yilamaz. The paper with the highest citation was ``Medical Students' Attitude Towards Artificial Intelligence: A Multicentre Survey.'' Keyword analysis revealed that ``radiology,'' ``medical physics,'' ``ehealth,'' ``surgery,'' and ``specialty'' were the primary focus, whereas ``big data'' and ``management'' emerged as research frontiers. Conclusions: The study underscores the promising potential of AI in medical education research. Current research directions encompass radiology, medical information management, and other aspects. Technological progress is expected to broaden these directions further. There is an urgent need to bolster interregional collaboration and enhance research quality. These findings offer valuable insights for researchers to identify perspectives and guide future research directions. ", doi="10.2196/51411", url="https://mededu.jmir.org/2024/1/e51411" } @Article{info:doi/10.2196/56128, author="Goodings, James Anthony and Kajitani, Sten and Chhor, Allison and Albakri, Ahmad and Pastrak, Mila and Kodancha, Megha and Ives, Rowan and Lee, Bin Yoo and Kajitani, Kari", title="Assessment of ChatGPT-4 in Family Medicine Board Examinations Using Advanced AI Learning and Analytical Methods: Observational Study", journal="JMIR Med Educ", year="2024", month="Oct", day="8", volume="10", pages="e56128", keywords="ChatGPT-4", keywords="Family Medicine Board Examination", keywords="artificial intelligence in medical education", keywords="AI performance assessment", keywords="prompt engineering", keywords="ChatGPT", keywords="artificial intelligence", keywords="AI", keywords="medical education", keywords="assessment", keywords="observational", keywords="analytical method", keywords="data analysis", keywords="examination", abstract="Background: This research explores the capabilities of ChatGPT-4 in passing the American Board of Family Medicine (ABFM) Certification Examination. Addressing a gap in existing literature, where earlier artificial intelligence (AI) models showed limitations in medical board examinations, this study evaluates the enhanced features and potential of ChatGPT-4, especially in document analysis and information synthesis. Objective: The primary goal is to assess whether ChatGPT-4, when provided with extensive preparation resources and when using sophisticated data analysis, can achieve a score equal to or above the passing threshold for the Family Medicine Board Examinations. Methods: In this study, ChatGPT-4 was embedded in a specialized subenvironment, ``AI Family Medicine Board Exam Taker,'' designed to closely mimic the conditions of the ABFM Certification Examination. This subenvironment enabled the AI to access and analyze a range of relevant study materials, including a primary medical textbook and supplementary web-based resources. The AI was presented with a series of ABFM-type examination questions, reflecting the breadth and complexity typical of the examination. Emphasis was placed on assessing the AI's ability to interpret and respond to these questions accurately, leveraging its advanced data processing and analysis capabilities within this controlled subenvironment. Results: In our study, ChatGPT-4's performance was quantitatively assessed on 300 practice ABFM examination questions. The AI achieved a correct response rate of 88.67\% (95\% CI 85.08\%-92.25\%) for the Custom Robot version and 87.33\% (95\% CI 83.57\%-91.10\%) for the Regular version. Statistical analysis, including the McNemar test (P=.45), indicated no significant difference in accuracy between the 2 versions. In addition, the chi-square test for error-type distribution (P=.32) revealed no significant variation in the pattern of errors across versions. These results highlight ChatGPT-4's capacity for high-level performance and consistency in responding to complex medical examination questions under controlled conditions. Conclusions: The study demonstrates that ChatGPT-4, particularly when equipped with specialized preparation and when operating in a tailored subenvironment, shows promising potential in handling the intricacies of medical board examinations. While its performance is comparable with the expected standards for passing the ABFM Certification Examination, further enhancements in AI technology and tailored training methods could push these capabilities to new heights. This exploration opens avenues for integrating AI tools such as ChatGPT-4 in medical education and assessment, emphasizing the importance of continuous advancement and specialized training in medical applications of AI. ", doi="10.2196/56128", url="https://mededu.jmir.org/2024/1/e56128" } @Article{info:doi/10.2196/59009, author="Khamisy-Farah, Rola and Biras, Eden and Shehadeh, Rabie and Tuma, Ruba and Atwan, Hisham and Siri, Anna and Converti, Manlio and Chirico, Francesco and Szarpak, ?ukasz and Biz, Carlo and Farah, Raymond and Bragazzi, Nicola", title="Gender and Sexuality Awareness in Medical Education and Practice: Mixed Methods Study", journal="JMIR Med Educ", year="2024", month="Oct", day="8", volume="10", pages="e59009", keywords="gender medicine", keywords="medical education", keywords="clinical practice", keywords="gender-sensitive care", keywords="gender awareness", keywords="sexuality awareness", keywords="awareness", keywords="medical education and practice", keywords="healthcare", keywords="patient outcomes", keywords="patient", keywords="patients", keywords="medical professionals", keywords="training", keywords="educational interventions", keywords="status-based", keywords="survey", keywords="effectiveness", keywords="medical workforce", abstract="Background: The integration of gender and sexuality awareness in health care is increasingly recognized as vital for patient outcomes. Despite this, there is a notable lack of comprehensive data on the current state of physicians' training and perceptions in these areas, leading to a gap in targeted educational interventions and optimal health care delivery. Objective: The study's aim was to explore the experiences and perceptions of attending and resident physicians regarding the inclusion of gender and sexuality content in medical school curricula and professional practice in Israel. Methods: This cross-sectional survey targeted a diverse group of physicians across various specializations and experience levels. Distributed through Israeli Medical Associations and professional networks, it included sections on experiences with gender and sexuality content, perceptions of knowledge, the impact of medical school curricula on professional capabilities, and views on integrating gender medicine in medical education. Descriptive and correlational analyses, along with gender-based and medical status-based comparisons, were used, complemented, and enhanced by qualitative analysis of participants' replies. Results: The survey, encompassing 189 respondents, revealed low-to-moderate exposure to gender and sexuality content in medical school curricula, with a similar perception of preparedness. A need for more comprehensive training was widely recognized. The majority valued training in these areas for enhancing professional capabilities, identifying 10 essential gender-related knowledge areas. The preference for integrating gender medicine throughout medical education was significant. Gender-based analysis indicated variations in exposure and perceptions. Conclusions: The study highlights a crucial need for the inclusion of gender and sexuality awareness in medical education and practice. It suggests the necessity for curriculum development, targeted training programs, policy advocacy, mentorship initiatives, and research to evaluate the effectiveness of these interventions. The findings serve as a foundation for future directions in medical education, aiming for a more inclusive, aware, and prepared medical workforce. ", doi="10.2196/59009", url="https://mededu.jmir.org/2024/1/e59009", url="http://www.ncbi.nlm.nih.gov/pubmed/39152652" } @Article{info:doi/10.2196/64125, author="Carrillo, Irene and Skoumalov{\'a}, Ivana and Bruus, Ireen and Klemm, Victoria and Guerra-Paiva, Sofia and Kne?evi{\'c}, Bojana and Jankauskiene, Augustina and Jocic, Dragana and Tella, Susanna and Buttigieg, C. Sandra and Srulovici, Einav and Madarasov{\'a} Geckov{\'a}, Andrea and P{\~o}lluste, Kaja and Strametz, Reinhard and Sousa, Paulo and Odalovic, Marina and Mira, Joaqu{\'i}n Jos{\'e}", title="Psychological Safety Competency Training During the Clinical Internship From the Perspective of Health Care Trainee Mentors in 11 Pan-European Countries: Mixed Methods Observational Study", journal="JMIR Med Educ", year="2024", month="Oct", day="7", volume="10", pages="e64125", keywords="psychological safety", keywords="speaking up", keywords="professional competence", keywords="patient safety", keywords="education", keywords="adverse event", abstract="Background: In the field of research, psychological safety has been widely recognized as a contributing factor to improving the quality of care and patient safety. However, its consideration in the curricula and traineeship pathways of residents and health care students is scarce. Objective: This study aims to determine the extent to which health care trainees acquire psychological safety competencies during their internships in clinical settings and identify what measures can be taken to promote their learning. Methods: A mixed methods observational study based on a consensus conference and an open-ended survey among a sample of health care trainee mentors from health care institutions in a pan-European context was conducted. First, we administered an ad hoc questionnaire to assess the perceived degree of acquisition or implementation and significance of competencies (knowledge, attitudes, and skills) and institutional interventions in psychological safety. Second, we asked mentors to propose measures to foster among trainees those competencies that, in the first phase of the study, obtained an average acquisition score of <3.4 (scale of 1-5). A content analysis of the information collected was carried out, and the spontaneity of each category and theme was determined. Results: In total, 173 mentors from 11 pan-European countries completed the first questionnaire (response rate: 173/256, 67.6\%), of which 63 (36.4\%) participated in the second consultation. The competencies with the lowest acquisition level were related to warning a professional that their behavior posed a risk to the patient, managing their possible bad reaction, and offering support to a colleague who becomes a second victim. The mentors' proposals for improvement of this competency gap referred to training in communication skills and patient safety, safety culture, work climate, individual attitudes, a reference person for trainees, formal incorporation into the curricula of health care degrees and specialization pathways, specific systems and mechanisms to give trainees a voice, institutional risk management, regulations, guidelines and standards, supervision, and resources to support trainees. In terms of teaching methodology, the mentors recommended innovative strategies, many of them based on technological tools or solutions, including videos, seminars, lectures, workshops, simulation learning or role-playing with or without professional actors, case studies, videos with practical demonstrations or model situations, panel discussions, clinical sessions for joint analysis of patient safety incidents, and debriefings to set and discuss lessons learned. Conclusions: This study sought to promote psychological safety competencies as a formal part of the training of future health care professionals, facilitating the translation of international guidelines into practice and clinical settings in the pan-European context. ", doi="10.2196/64125", url="https://mededu.jmir.org/2024/1/e64125", url="http://www.ncbi.nlm.nih.gov/pubmed/39374073" } @Article{info:doi/10.2196/49505, author="Puah, Shermain and Pua, Yee Ching and Shi, Jing and Lim, Mui Sok", title="The Effectiveness of a Digital Mental Fitness Program (Positive Intelligence) on Perceived Stress, Self-Compassion, and Ruminative Thinking of Occupational Therapy Undergraduate Students: Longitudinal Study", journal="J Med Internet Res", year="2024", month="Oct", day="7", volume="26", pages="e49505", keywords="mental health", keywords="students", keywords="digital wellness", keywords="mobile health (mHealth)", keywords="perceived stress", keywords="self-compassion", keywords="rumination", abstract="Background: Health care students often endure numerous stressors throughout their undergraduate education that can have lasting negative effects on their mental well-being. Positive Intelligence (PQ) is a digital mental fitness program designed to enhance self-mastery and help individuals reach their potential by strengthening various ``mental muscles.'' Objective: This study aims to evaluate the effectiveness of a 6-week app-delivered PQ program in reducing perceived stress, increasing self-compassion, and decreasing rumination tendencies among health care undergraduates. We hypothesized that students would show reductions in perceived stress, increases in self-compassion, and decreases in rumination tendencies by the end of the PQ program, compared with their preprogram scores. We adopted an exploratory approach for the 5-month follow-up due to the limited research consensus on the sustained effects of app-based programs over varying periods. Methods: The PQ program includes weekly hour-long videos, weekly group meetings, and daily 15-minute app-guided practices. Participants were first-year students from the occupational therapy program at a university in Singapore. Participants completed surveys measuring self-compassion, perceived stress, and rumination levels before and after the PQ program, and again at a 5-month follow-up. Data were analyzed using repeated measures ANOVA to assess differences across the pretest, immediate posttest, and follow-up posttest. Results: Out of 87 students enrolled in the study, the final sample consisted of 64 students (n=47, 73\%, female; mean age 23 years, SD 5.06 years) with complete data. At the end of the 6 weeks, students exhibited significant increases in self-compassion (before the intervention: mean 3.07, SD 0.35; after the intervention: mean 3.34, SD 0.35; P<.001) and reductions in rumination tendencies (before the intervention: mean 3.57, SD 0.40; after the intervention: mean 3.27, SD 0.34; P<.001). However, no significant change in perceived stress levels was observed (before the intervention: 2.99, SD 0.14; after the intervention: mean 2.97, SD 0.16; P=.50). These effects were not influenced by the daily app-based practice of PQ exercises, and there were no sustained effects on self-compassion (mean 3.17, SD 0.27; P=.09) or rumination tendencies (mean 3.42, SD 0.38; P=.06) at the 5-month follow-up. Additionally, there was a significant increase in perceived stress at follow-up (mean 3.17, SD 0.21; P<.001) compared with pre- and postintervention levels. Conclusions: The PQ program did not directly alter stress perceptions but may have reframed students' automatic negative thought processes, increased their awareness of self-sabotaging behaviors, and enhanced their self-compassion while reducing ruminative thinking. These findings highlight the importance of self-awareness for students' well-being. Students can benefit from practices such as mindfulness and peer discussions to enhance self-compassion and reduce rumination. Educators trained in the PQ program can foster a supportive environment that encourages self-compassion, challenges negative self-talk, and helps students manage stress. ", doi="10.2196/49505", url="https://www.jmir.org/2024/1/e49505", url="http://www.ncbi.nlm.nih.gov/pubmed/39374067" } @Article{info:doi/10.2196/55921, author="Vomhof, Markus and Bau, Tabea Jessica and H{\"u}ter, Pia and Stehl, Stefan and Haastert, Burkhard and Loerbroks, Adrian and Icks, Andrea and Calo, Teresa Stella and Schuster, Luca and Pischke, R. Claudia and Kairies-Schwarz, Nadja and Angerer, Peter and Apolin{\'a}rio-Hagen, Jennifer", title="Preferences Regarding Information Strategies for Digital Mental Health Interventions Among Medical Students: Discrete Choice Experiment", journal="JMIR Form Res", year="2024", month="Oct", day="4", volume="8", pages="e55921", keywords="preferences", keywords="digital mental health", keywords="medical students", keywords="innovation diffusion", keywords="technology acceptance", keywords="health information", abstract="Background: Digital mental health interventions (DMHIs) are capable of closing gaps in the prevention and therapy of common mental disorders. Despite their proven effectiveness and approval for prescription, use rates remain low. The reasons include a lack of familiarity and knowledge as well as lasting concerns. Medical students were shown to have a comparatively higher risk for common mental disorders and are thus an important target group for raising awareness about DMHIs. At best, knowledge is already imparted during medical school using context-sensitive information strategies. Yet, little is known about medical students' information preferences regarding DMHIs. Objective: This study aims to explore information preferences for DMHIs for personal use among medical students in Germany. Methods: A discrete choice experiment was conducted, which was developed using an exploratory sequential mixed methods research approach. In total, 5 attributes (ie, source, delivery mode, timing, recommendation, and quality criteria), each with 3 to 4 levels, were identified using formative research. Data were analyzed using logistic regression models to estimate preference weights and the relative importance of attributes. To identify subgroups of students varying in information preferences, we additionally performed a latent class analysis. Results: Of 309 participants, 231 (74.8\%) with reliable data were included in the main analysis (women: 217/309, 70.2\%; age: mean 24.1, SD 4.0 y). Overall, the conditional logit model revealed that medical students preferred to receive information about DMHIs from the student council and favored being informed via social media early (ie, during their preclinic phase or their freshman week). Recommendations from other students or health professionals were preferred over recommendations from other users or no recommendations at all. Information about the scientific evidence base was the preferred quality criterion. Overall, the timing of information was the most relevant attribute (32.6\%). Latent class analysis revealed 2 distinct subgroups. Class 1 preferred to receive extensive information about DMHIs in a seminar, while class 2 wanted to be informed digitally (via email or social media) and as early as possible in their studies. Conclusions: Medical students reported specific needs and preferences regarding DMHI information provided in medical school. Overall, the timing of information (early in medical education) was considered more important than the information source or delivery mode, which should be prioritized by decision makers (eg, members of faculties of medicine, universities, and ministries of education). Study findings suggest general and subgroup-specific information strategies, which could be implemented in a stepped approach. Easily accessible digital information may promote students' interest in DMHIs in the first step that might lead to further information-seeking behavior and the attendance of seminars about DMHIs in the second step. ", doi="10.2196/55921", url="https://formative.jmir.org/2024/1/e55921", url="http://www.ncbi.nlm.nih.gov/pubmed/39365652" } @Article{info:doi/10.2196/63010, author="Hirosawa, Takanobu and Harada, Yukinori and Tokumasu, Kazuki and Ito, Takahiro and Suzuki, Tomoharu and Shimizu, Taro", title="Comparative Study to Evaluate the Accuracy of Differential Diagnosis Lists Generated by Gemini Advanced, Gemini, and Bard for a Case Report Series Analysis: Cross-Sectional Study", journal="JMIR Med Inform", year="2024", month="Oct", day="2", volume="12", pages="e63010", keywords="artificial intelligence", keywords="clinical decision support", keywords="diagnostic excellence", keywords="generative artificial intelligence", keywords="large language models", keywords="natural language processing", abstract="Background: Generative artificial intelligence (GAI) systems by Google have recently been updated from Bard to Gemini and Gemini Advanced as of December 2023. Gemini is a basic, free-to-use model after a user's login, while Gemini Advanced operates on a more advanced model requiring a fee-based subscription. These systems have the potential to enhance medical diagnostics. However, the impact of these updates on comprehensive diagnostic accuracy remains unknown. Objective: This study aimed to compare the accuracy of the differential diagnosis lists generated by Gemini Advanced, Gemini, and Bard across comprehensive medical fields using case report series. Methods: We identified a case report series with relevant final diagnoses published in the American Journal Case Reports from January 2022 to March 2023. After excluding nondiagnostic cases and patients aged 10 years and younger, we included the remaining case reports. After refining the case parts as case descriptions, we input the same case descriptions into Gemini Advanced, Gemini, and Bard to generate the top 10 differential diagnosis lists. In total, 2 expert physicians independently evaluated whether the final diagnosis was included in the lists and its ranking. Any discrepancies were resolved by another expert physician. Bonferroni correction was applied to adjust the P values for the number of comparisons among 3 GAI systems, setting the corrected significance level at P value <.02. Results: In total, 392 case reports were included. The inclusion rates of the final diagnosis within the top 10 differential diagnosis lists were 73\% (286/392) for Gemini Advanced, 76.5\% (300/392) for Gemini, and 68.6\% (269/392) for Bard. The top diagnoses matched the final diagnoses in 31.6\% (124/392) for Gemini Advanced, 42.6\% (167/392) for Gemini, and 31.4\% (123/392) for Bard. Gemini demonstrated higher diagnostic accuracy than Bard both within the top 10 differential diagnosis lists (P=.02) and as the top diagnosis (P=.001). In addition, Gemini Advanced achieved significantly lower accuracy than Gemini in identifying the most probable diagnosis (P=.002). Conclusions: The results of this study suggest that Gemini outperformed Bard in diagnostic accuracy following the model update. However, Gemini Advanced requires further refinement to optimize its performance for future artificial intelligence--enhanced diagnostics. These findings should be interpreted cautiously and considered primarily for research purposes, as these GAI systems have not been adjusted for medical diagnostics nor approved for clinical use. ", doi="10.2196/63010", url="https://medinform.jmir.org/2024/1/e63010" } @Article{info:doi/10.2196/53314, author="Perotte, Rimma and Berns, Alyssa and Shaker, Lana and Ophaswongse, Chayapol and Underwood, Joseph and Hajicharalambous, Christina", title="Creation of an Automated and Comprehensive Resident Progress System for Residents and to Save Hours of Faculty Time: Mixed Methods Study", journal="JMIR Form Res", year="2024", month="Sep", day="23", volume="8", pages="e53314", keywords="progress dashboard", keywords="informatics in medical education", keywords="residency learning management system", keywords="residency progress system", keywords="residency education system", keywords="summarization", keywords="administrative burden", keywords="medical education", keywords="resident", keywords="residency", keywords="resident data", keywords="longitudinal", keywords="pilot study", keywords="competency", keywords="dashboards", keywords="dashboard", keywords="faculty", keywords="residents", abstract="Background: It is vital for residents to have a longitudinal view of their educational progression, and it is crucial for the medical education team to have a clear way to track resident progress over time. Current tools for aggregating resident data are difficult to use and do not provide a comprehensive way to evaluate and display resident educational advancement. Objective: This study aims to describe the creation and assessment of a system designed to improve the longitudinal presentation, quality, and synthesis of educational progress for trainees. We created a new system for residency progress management with 3 goals in mind, that are (1) a long-term and centralized location for residency education data, (2) a clear and intuitive interface that is easy to access for both the residents and faculty involved in medical education, and (3) automated data input, transformation, and analysis. We present evaluations regarding whether residents find the system useful, and whether faculty like the system and perceive that it helps them save time with administrative duties. Methods: The system was created using a suite of Google Workspace tools including Forms, Sheets, Gmail, and a collection of Apps Scripts triggered at various times and events. To assess whether the system had an effect on the residents, we surveyed and asked them to self-report on how often they accessed the system and interviewed them as to whether they found it useful. To understand what the faculty thought of the system, we conducted a 14-person focus group and asked the faculty to self-report their time spent preparing for residency progress meetings before and after the system debut. Results: The system went live in February 2022 as a quality improvement project, evolving through multiple iterations of feedback. The authors found that the system was accessed differently by different postgraduate years (PGY), with the most usage reported in the PGY1 class (weekly), and the least amount of usage in the PGY3 class (once or twice). However, all of the residents reported finding the system useful, specifically for aggregating all of their evaluations in the same place. Faculty members felt that the system enabled a more high-quality biannual clinical competency committee meeting and they reported a combined time savings of 8 hours in preparation for each clinical competency committee as a result of reviewing resident data through the system. Conclusions: Our study reports on the creation of an automated, instantaneous, and comprehensive resident progress management system. The system has been shown to be well-liked by both residents and faculty. Younger PGY classes reported more frequent system usage than older PGY classes. Faculty reported that it helped facilitate more meaningful discussion of training progression and reduced the administrative burden by 8 hours per biannual session. ", doi="10.2196/53314", url="https://formative.jmir.org/2024/1/e53314", url="http://www.ncbi.nlm.nih.gov/pubmed/39312292" } @Article{info:doi/10.2196/62654, author="Sari, Wulan Dianis and Kugai, Haruna and Igarashi, Ayumi and Takaoka, Manami and Matsumoto, Hiroshige and Suzuki, Haruno and Wu, Jinyan and Fitryasari, Rizki and Nasifah, Ayunda Ike and Has, M. Eka Mishbahatul and Yamamoto-Mitani, Noriko", title="Education Program for Enhancing Health Care Students' Attitudes Toward People Living With Dementia: Protocol for a Single-Arm Pre-Post Study", journal="JMIR Res Protoc", year="2024", month="Sep", day="18", volume="13", pages="e62654", keywords="ageism", keywords="dementia", keywords="health professional", keywords="education program", keywords="long-term care", abstract="Background: Health care students are instrumental in shaping the future of dementia care. Cultivating a positive attitude and understanding toward people living with dementia is crucial for diminishing the stigma associated with the condition, providing effective and person-centered care, and enhancing the quality of life for people living with dementia. Educational programs about dementia are increasingly recognizing the potential of gaming tools. Objective: This study aimed to evaluate the effectiveness of gaming-based dementia educational programs in improving attitudes toward people living with dementia among health care students. Methods: This single-arm pre-post study will be conducted among health care students in Indonesian universities. This educational program based on gaming tools will consist of a lecture on dementia, the use of N-impro (gaming tool), and the enactment of short dramas depicting desirable and undesirable communication with people living with dementia behaviors. We will assess attitudes toward people living with dementia, intention to help people living with dementia, knowledge of dementia, and the stigma associated with people living with dementia. The gaming-based dementia education program will be integrated into the curriculum of the health care students. The program will be implemented once with a duration of 90 minutes. Results: Data collection will occur from August 2023 to March 2024. Analysis of the data will be finalized by May 2024, and the outcome will be determined by July 2024. The impact of the gaming-based dementia educational program on improving attitudes toward people living with dementia will be reported. The study findings will be published in a peer-reviewed journal. Conclusions: The gaming education program demonstrates significant potential in enhancing attitudes toward people living with dementia across various countries, introducing an innovative method for the community-based support of people living with dementia. Trial Registration: ClinicalTrials.gov NCT06122623; https://clinicaltrials.gov/study/NCT06122623 International Registered Report Identifier (IRRID): DERR1-10.2196/62654 ", doi="10.2196/62654", url="https://www.researchprotocols.org/2024/1/e62654" } @Article{info:doi/10.2196/58396, author="Kamel Boulos, N. Maged and Dellavalle, Robert", title="NVIDIA's ``Chat with RTX'' Custom Large Language Model and Personalized AI Chatbot Augments the Value of Electronic Dermatology Reference Material", journal="JMIR Dermatol", year="2024", month="Jul", day="24", volume="7", pages="e58396", keywords="AI chatbots", keywords="artificial intelligence", keywords="AI", keywords="generative AI", keywords="large language models", keywords="dermatology", keywords="education", keywords="self-study", keywords="NVIDIA RTX", keywords="retrieval-augmented generation", keywords="RAG", doi="10.2196/58396", url="https://derma.jmir.org/2024/1/e58396" } @Article{info:doi/10.2196/47438, author="Aqib, Ayma and Fareez, Faiha and Assadpour, Elnaz and Babar, Tubba and Kokavec, Andrew and Wang, Edward and Lo, Thomas and Lam, Jean-Paul and Smith, Christopher", title="Development of a Novel Web-Based Tool to Enhance Clinical Skills in Medical Education", journal="JMIR Med Educ", year="2024", month="Jun", day="20", volume="10", pages="e47438", keywords="medical education", keywords="objective structured clinical examination", keywords="OSCE", keywords="e-OSCE", keywords="Medical Council of Canada", keywords="MCC", keywords="virtual health", keywords="exam", keywords="examination", keywords="utility", keywords="usability", keywords="online learning", keywords="e-learning", keywords="medical student", keywords="medical students", keywords="clinical practice", keywords="clinical skills", keywords="clinical skill", keywords="OSCE tool", doi="10.2196/47438", url="https://mededu.jmir.org/2024/1/e47438" } @Article{info:doi/10.2196/54283, author="Takagi, Soshi and Koda, Masahide and Watari, Takashi", title="The Performance of ChatGPT-4V in Interpreting Images and Tables in the Japanese Medical Licensing Exam", journal="JMIR Med Educ", year="2024", month="May", day="23", volume="10", pages="e54283", keywords="ChatGPT", keywords="medical licensing examination", keywords="generative artificial intelligence", keywords="medical education", keywords="large language model", keywords="images", keywords="tables", keywords="artificial intelligence", keywords="AI", keywords="Japanese", keywords="reliability", keywords="medical application", keywords="medical applications", keywords="diagnostic", keywords="diagnostics", keywords="online data", keywords="web-based data", doi="10.2196/54283", url="https://mededu.jmir.org/2024/1/e54283" } @Article{info:doi/10.2196/54758, author="Xue, Elisabetta and Bracken-Clarke, Dara and Iannantuono, Maria Giovanni and Choo-Wosoba, Hyoyoung and Gulley, L. James and Floudas, S. Charalampos", title="Utility of Large Language Models for Health Care Professionals and Patients in Navigating Hematopoietic Stem Cell Transplantation: Comparison of the Performance of ChatGPT-3.5, ChatGPT-4, and Bard", journal="J Med Internet Res", year="2024", month="May", day="17", volume="26", pages="e54758", keywords="hematopoietic stem cell transplant", keywords="large language models", keywords="chatbot", keywords="chatbots", keywords="stem cell", keywords="large language model", keywords="artificial intelligence", keywords="AI", keywords="medical information", keywords="hematopoietic", keywords="HSCT", keywords="ChatGPT", abstract="Background: Artificial intelligence is increasingly being applied to many workflows. Large language models (LLMs) are publicly accessible platforms trained to understand, interact with, and produce human-readable text; their ability to deliver relevant and reliable information is also of particular interest for the health care providers and the patients. Hematopoietic stem cell transplantation (HSCT) is a complex medical field requiring extensive knowledge, background, and training to practice successfully and can be challenging for the nonspecialist audience to comprehend. Objective: We aimed to test the applicability of 3 prominent LLMs, namely ChatGPT-3.5 (OpenAI), ChatGPT-4 (OpenAI), and Bard (Google AI), in guiding nonspecialist health care professionals and advising patients seeking information regarding HSCT. Methods: We submitted 72 open-ended HSCT--related questions of variable difficulty to the LLMs and rated their responses based on consistency---defined as replicability of the response---response veracity, language comprehensibility, specificity to the topic, and the presence of hallucinations. We then rechallenged the 2 best performing chatbots by resubmitting the most difficult questions and prompting to respond as if communicating with either a health care professional or a patient and to provide verifiable sources of information. Responses were then rerated with the additional criterion of language appropriateness, defined as language adaptation for the intended audience. Results: ChatGPT-4 outperformed both ChatGPT-3.5 and Bard in terms of response consistency (66/72, 92\%; 54/72, 75\%; and 63/69, 91\%, respectively; P=.007), response veracity (58/66, 88\%; 40/54, 74\%; and 16/63, 25\%, respectively; P<.001), and specificity to the topic (60/66, 91\%; 43/54, 80\%; and 27/63, 43\%, respectively; P<.001). Both ChatGPT-4 and ChatGPT-3.5 outperformed Bard in terms of language comprehensibility (64/66, 97\%; 53/54, 98\%; and 52/63, 83\%, respectively; P=.002). All displayed episodes of hallucinations. ChatGPT-3.5 and ChatGPT-4 were then rechallenged with a prompt to adapt their language to the audience and to provide source of information, and responses were rated. ChatGPT-3.5 showed better ability to adapt its language to nonmedical audience than ChatGPT-4 (17/21, 81\% and 10/22, 46\%, respectively; P=.03); however, both failed to consistently provide correct and up-to-date information resources, reporting either out-of-date materials, incorrect URLs, or unfocused references, making their output not verifiable by the reader. Conclusions: In conclusion, despite LLMs' potential capability in confronting challenging medical topics such as HSCT, the presence of mistakes and lack of clear references make them not yet appropriate for routine, unsupervised clinical use, or patient counseling. Implementation of LLMs' ability to access and to reference current and updated websites and research papers, as well as development of LLMs trained in specialized domain knowledge data sets, may offer potential solutions for their future clinical application. ", doi="10.2196/54758", url="https://www.jmir.org/2024/1/e54758", url="http://www.ncbi.nlm.nih.gov/pubmed/38758582" } @Article{info:doi/10.2196/53997, author="Grosjean, Julien and Dufour, Frank and Benis, Arriel and Januel, Jean-Marie and Staccini, Pascal and Darmoni, Jacques St{\'e}fan", title="Digital Health Education for the Future: The SaNuRN (Sant{\'e} Num{\'e}rique Rouen-Nice) Consortium's Journey", journal="JMIR Med Educ", year="2024", month="Apr", day="30", volume="10", pages="e53997", keywords="digital health", keywords="medical informatics", keywords="education", keywords="health education", keywords="curriculum", keywords="students", keywords="teaching materials", keywords="hybrid learning", keywords="program development", keywords="capacity building", keywords="access to information", keywords="e-learning", keywords="open access", keywords="open data", keywords="skills framework", keywords="competency-based learning", keywords="telemedicine training", keywords="medical simulation", keywords="objective structured clinical examination", keywords="OSCE", keywords="script concordance test", keywords="SCT", keywords="virtual patient", doi="10.2196/53997", url="https://mededu.jmir.org/2024/1/e53997" } @Article{info:doi/10.2196/55678, author="Ferrer Costa, Jose and Moran, Nuria and Garcia Marti, Carlos and Colmenares Hernandez, Javier Leomar and Radu Ciorba Ciorba, Florin and Ciudad, Jose Maria", title="Immediate Impact of an 8-Week Virtual Reality Educational Program on Burnout and Work Engagement Among Health Care Professionals: Pre-Post Pilot Study", journal="JMIR XR Spatial Comput", year="2024", month="Apr", day="25", volume="1", pages="e55678", keywords="virtual reality", keywords="burnout", keywords="mindfulness", keywords="health care professionals", keywords="mental health", keywords="health promotion", keywords="educational intervention", abstract="Background: Health care professionals globally face increasing levels of burnout characterized by emotional exhaustion, depersonalization, and a reduced sense of accomplishment, and it has been notably exacerbated during the COVID-19 pandemic. This condition not only impacts the well-being of health care workers but also affects patient care and contributes to significant economic burden. Traditional approaches to mitigating burnout have included various psychosocial interventions, with mindfulness being recognized for its effectiveness in enhancing mental health and stress management. The emergence of virtual reality (VR) technology offers a novel immersive platform for delivering mindfulness and emotional management training. Objective: This study aimed to evaluate the immediate impact of an 8-week VR educational program on burnout and work engagement among health care professionals. Methods: This nonrandomized pre-post intervention study enrolled 90 health care professionals, including nurses, physicians, and allied health staff, from 3 different centers. Of these 90 professionals, 83 (92\%) completed the program. The intervention consisted of 8 weekly VR sessions of 10-13 minutes each, using Meta Quest 2 headsets. The sessions focused on mindfulness and emotional management. The Maslach Burnout Inventory (MBI) and Utrecht Work Engagement Scale (UWES) were used for assessments. Data analysis involved inferential statistical techniques for evaluating the impact on the scales, including paired t tests for normally distributed variables and Wilcoxon signed rank tests for nonnormally distributed variables. The significance of changes was indicated by P values <.05, with effect sizes measured using Cohen d for t tests and Cohen r for Wilcoxon tests for quantifying the magnitude of the intervention's effect. Results: The statistical analysis revealed significant improvements in the MBI and UWES indices after the intervention (P<.05). Specifically, the MBI showed reductions in emotional exhaustion (t82=5.58; P<.001; Cohen d=0.61) and depersonalization (t82=4.67; P<.001; Cohen d=0.51), and an increase in personal accomplishment (t82=?3.62; P<.001; Cohen d=0.4). The UWES revealed enhancements in vigor (t82=?3.77; P<.001; Cohen d=0.41), dedication (Z=?3.63; P<.001; Cohen r=0.41), and absorption (Z=?3.52; P<.001; Cohen r=0.4). Conclusions: The study provides initial data supporting the effectiveness of VR-based educational programs for reducing burnout and enhancing work engagement among health care professionals. While limitations, such as the absence of a control group, are acknowledged, the significant improvements in burnout and engagement indices coupled with high participant adherence and minimal VR discomfort underline the potential of VR interventions in health care settings. These encouraging findings pave the way for more comprehensive studies, including randomized controlled trials, to further validate and expand upon these results. ", doi="10.2196/55678", url="https://xr.jmir.org/2024/1/e55678" } @Article{info:doi/10.2196/52483, author="Wu, Yijun and Zheng, Yue and Feng, Baijie and Yang, Yuqi and Kang, Kai and Zhao, Ailin", title="Embracing ChatGPT for Medical Education: Exploring Its Impact on Doctors and Medical Students", journal="JMIR Med Educ", year="2024", month="Apr", day="10", volume="10", pages="e52483", keywords="artificial intelligence", keywords="AI", keywords="ChatGPT", keywords="medical education", keywords="doctors", keywords="medical students", doi="10.2196/52483", url="https://mededu.jmir.org/2024/1/e52483", url="http://www.ncbi.nlm.nih.gov/pubmed/38598263" } @Article{info:doi/10.2196/50965, author="Meyer, Annika and Riese, Janik and Streichert, Thomas", title="Comparison of the Performance of GPT-3.5 and GPT-4 With That of Medical Students on the Written German Medical Licensing Examination: Observational Study", journal="JMIR Med Educ", year="2024", month="Feb", day="8", volume="10", pages="e50965", keywords="ChatGPT", keywords="artificial intelligence", keywords="large language model", keywords="medical exams", keywords="medical examinations", keywords="medical education", keywords="LLM", keywords="public trust", keywords="trust", keywords="medical accuracy", keywords="licensing exam", keywords="licensing examination", keywords="improvement", keywords="patient care", keywords="general population", keywords="licensure examination", abstract="Background: The potential of artificial intelligence (AI)--based large language models, such as ChatGPT, has gained significant attention in the medical field. This enthusiasm is driven not only by recent breakthroughs and improved accessibility, but also by the prospect of democratizing medical knowledge and promoting equitable health care. However, the performance of ChatGPT is substantially influenced by the input language, and given the growing public trust in this AI tool compared to that in traditional sources of information, investigating its medical accuracy across different languages is of particular importance. Objective: This study aimed to compare the performance of GPT-3.5 and GPT-4 with that of medical students on the written German medical licensing examination. Methods: To assess GPT-3.5's and GPT-4's medical proficiency, we used 937 original multiple-choice questions from 3 written German medical licensing examinations in October 2021, April 2022, and October 2022. Results: GPT-4 achieved an average score of 85\% and ranked in the 92.8th, 99.5th, and 92.6th percentiles among medical students who took the same examinations in October 2021, April 2022, and October 2022, respectively. This represents a substantial improvement of 27\% compared to GPT-3.5, which only passed 1 out of the 3 examinations. While GPT-3.5 performed well in psychiatry questions, GPT-4 exhibited strengths in internal medicine and surgery but showed weakness in academic research. Conclusions: The study results highlight ChatGPT's remarkable improvement from moderate (GPT-3.5) to high competency (GPT-4) in answering medical licensing examination questions in German. While GPT-4's predecessor (GPT-3.5) was imprecise and inconsistent, it demonstrates considerable potential to improve medical education and patient care, provided that medically trained users critically evaluate its results. As the replacement of search engines by AI tools seems possible in the future, further studies with nonprofessional questions are needed to assess the safety and accuracy of ChatGPT for the general population. ", doi="10.2196/50965", url="https://mededu.jmir.org/2024/1/e50965", url="http://www.ncbi.nlm.nih.gov/pubmed/38329802" } @Article{info:doi/10.2196/50735, author="Denny, Alanna and Curtin, Brian and Taylor-Robinson, Simon and Chirambo, Baxter Griphin and Cilliers, Liezel and Wu, Joseph Tsung-Shu and O'Meara, Ciara and Booth, Richard and O'Donoghue, John", title="Evaluating the Appropriateness of Podcasts to Improve the Knowledge and Awareness of Selected Health Topics Among Undergraduate General Nursing Students: Protocol for an International Feasibility Study", journal="JMIR Res Protoc", year="2024", month="Feb", day="6", volume="13", pages="e50735", keywords="podcasting", keywords="podcast", keywords="nursing student", keywords="gestational diabetes", keywords="mental health", keywords="health", keywords="knowledge", abstract="Background: Podcasts have proven to be a successful alternative source of educational material for students. Given the ability to listen to podcasts 24/7 and while on the go, this technology has the potential to provide informative and educational material to a large number of people at any given time. Podcasts are usually freely available on commonly used mobile devices, such as smartphones, laptops, and tablets. Objective: This paper describes the impact of health-related podcasts as an intervention tool to support the knowledge and awareness of nursing students on a given topic. Methods: Pre- and postpodcast questionnaires will gather data regarding the participants' knowledge and awareness of two topics---gestational diabetes and mental health. This intervention will be tested on general nursing undergraduate students. The total number of students (N=2395) from the participating universities are broken down as follows: (1) University College Cork (n=850) and the University of Galway (n=450) in Ireland, (2) Mzuzu University in Malawi (n=719), and (3) University of Fort Hare in South Africa (n=376). Results: The study received ethical approval from the University College Cork Ethics Committee (2022-027A1). The approval obtained from University College Cork sufficed as ethics coverage for the University of Galway in Ireland. Ethics approval was also received from the Mzuzu University Research Ethics Committee (ID MZUNIREC/DOR/23/28) and the Inter-Faculty Research Ethics Committee of the University of Fort Hare (ID CIL002-21). Data collection is currently underway and will continue until the end of February 2024. The quantitative and qualitative data are expected to be analyzed in March 2024. Conclusions: Results from this study will allow for an investigation into the impact of podcasts in different settings: a high-income country (Ireland), an upper-middle--income country (South Africa), and a low-to-middle--income country (Malawi). The data gathered from this feasibility study will provide more clarity on the potential utility of podcasts as an intervention tool. We will gather data regarding listener demographics (eg, country of residence, age, gender, and year of study). International Registered Report Identifier (IRRID): DERR1-10.2196/50735 ", doi="10.2196/50735", url="https://www.researchprotocols.org/2024/1/e50735", url="http://www.ncbi.nlm.nih.gov/pubmed/38319702" } @Article{info:doi/10.2196/48785, author="Preiksaitis, Carl and Rose, Christian", title="Opportunities, Challenges, and Future Directions of Generative Artificial Intelligence in Medical Education: Scoping Review", journal="JMIR Med Educ", year="2023", month="Oct", day="20", volume="9", pages="e48785", keywords="medical education", keywords="artificial intelligence", keywords="ChatGPT", keywords="Bard", keywords="AI", keywords="educator", keywords="scoping", keywords="review", keywords="learner", keywords="generative", abstract="Background: Generative artificial intelligence (AI) technologies are increasingly being utilized across various fields, with considerable interest and concern regarding their potential application in medical education. These technologies, such as Chat GPT and Bard, can generate new content and have a wide range of possible applications. Objective: This study aimed to synthesize the potential opportunities and limitations of generative AI in medical education. It sought to identify prevalent themes within recent literature regarding potential applications and challenges of generative AI in medical education and use these to guide future areas for exploration. Methods: We conducted a scoping review, following the framework by Arksey and O'Malley, of English language articles published from 2022 onward that discussed generative AI in the context of medical education. A literature search was performed using PubMed, Web of Science, and Google Scholar databases. We screened articles for inclusion, extracted data from relevant studies, and completed a quantitative and qualitative synthesis of the data. Results: Thematic analysis revealed diverse potential applications for generative AI in medical education, including self-directed learning, simulation scenarios, and writing assistance. However, the literature also highlighted significant challenges, such as issues with academic integrity, data accuracy, and potential detriments to learning. Based on these themes and the current state of the literature, we propose the following 3 key areas for investigation: developing learners' skills to evaluate AI critically, rethinking assessment methodology, and studying human-AI interactions. Conclusions: The integration of generative AI in medical education presents exciting opportunities, alongside considerable challenges. There is a need to develop new skills and competencies related to AI as well as thoughtful, nuanced approaches to examine the growing use of generative AI in medical education. ", doi="10.2196/48785", url="https://mededu.jmir.org/2023/1/e48785/" } @Article{info:doi/10.2196/48672, author="Stevens, Kathleen and Moralejo, Donna and Crossman, Renee", title="Evaluation of Incremental Validity of Casper in Predicting Program and National Licensure Performance of Undergraduate Nursing Students: Protocol for a Mixed Methods Study", journal="JMIR Res Protoc", year="2023", month="Oct", day="18", volume="12", pages="e48672", keywords="communication", keywords="empathy", keywords="incremental validity", keywords="mixed methods", keywords="nursing school admissions", keywords="problem-solving", keywords="professionalism", keywords="situational judgement testing", keywords="undergraduate nursing students", abstract="Background: Academic success has been the primary criterion for admission to many nursing programs. However, academic success as an admission criterion may have limited predictive value for success in noncognitive skills. Adding situational judgment tests, such as Casper, to admissions procedures may be one strategy to strengthen decisions and address the limited predictive value of academic admission criteria. In 2021, admissions processes were modified to include Casper based on concerns identified with noncognitive skills. Objective: This study aims to (1) assess the incremental validity of Casper scores in predicting nursing student performance at years 1, 2, 3, and 4 and on the National Council Licensing Examination (NCLEX) performance; and (2) examine faculty members' perceptions of student performance and influences related to communication, professionalism, empathy, and problem-solving. Methods: We will use a multistage evaluation mixed methods design with 5 phases. At the end of each year, students will complete questionnaires related to empathy and professionalism and have their performance assessed for communication and problem-solving in psychomotor laboratory sessions. The final phase will assess graduate performance on the NCLEX. Each phase also includes qualitative data collection (ie, focus groups with faculty members). The goal of the focus groups is to help explain the quantitative findings (explanatory phase) as well as inform data collection (eg, focus group questions) in the subsequent phase (exploratory sequence). All students enrolled in the first year of the nursing program in 2021 were asked to participate (n=290). Faculty will be asked to participate in the focus groups at the end of each year of the program. Hierarchical multiple regression will be conducted for each outcome of interest (eg, communication, professionalism, empathy, and problem-solving) to determine the extent to which scores on Casper with admission grades, compared to admission grades alone, predict nursing student performance at years 1-4 of the program and success on the national exam. Thematic analysis of focus group transcripts will be conducted using interpretive description. The quantitative and qualitative data will be integrated after each phase is complete and at the end of the study. Results: This study was funded in September 2021, and data collection began in March 2022. Year 1 data collection and analysis are complete. Year 2 data collection is complete, and data analysis is in progress. Conclusions: At the end of the study, we will provide the results of a comprehensive analysis to determine the extent to which the addition of scores on Casper compared to admission grades alone predicts nursing student performance at years 1-4 of the program and on the NCLEX exam. International Registered Report Identifier (IRRID): RR1-10.2196/48672 ", doi="10.2196/48672", url="https://www.researchprotocols.org/2023/1/e48672", url="http://www.ncbi.nlm.nih.gov/pubmed/37851504" } @Article{info:doi/10.2196/43895, author="Castellucci, Clara and Malorgio, Amos and Budowski, Dinah Alexandra and Akbas, Samira and Kolbe, Michaela and Grande, Bastian and Braun, Julia and Noethiger, B. Christoph and Spahn, R. Donat and Tscholl, Werner David and Roche, Raoul Tadzio", title="Coagulation Management of Critically Bleeding Patients With Viscoelastic Testing Presented as a 3D-Animated Blood Clot (The Visual Clot): Randomized Controlled High-Fidelity Simulation Study", journal="J Med Internet Res", year="2023", month="Oct", day="12", volume="25", pages="e43895", keywords="avatar technology", keywords="coagulation management", keywords="high-fidelity simulation", keywords="point-of-care testing", keywords="thrombelastography", keywords="user-centered design", keywords="Visual Clot", abstract="Background: Guidelines recommend using viscoelastic coagulation tests to guide coagulation management, but interpreting the results remains challenging. Visual Clot, a 3D animated blood clot, facilitates interpretation through a user-centered and situation awareness--oriented design. Objective: This study aims to compare the effects of Visual Clot versus conventional viscoelastic test results (rotational thrombelastometry [ROTEM] temograms) on the coagulation management performance of anesthesia teams in critical bleeding situations. Methods: We conducted a prospective, randomized, high-fidelity simulation study in which anesthesia teams (consisting of a senior anesthesiologist, a resident anesthesiologist, and an anesthesia nurse) managed perioperative bleeding scenarios. Teams had either Visual Clot or ROTEM temograms available to perform targeted coagulation management. We analyzed the 15-minute simulations with post hoc video analysis. The primary outcome was correct targeted coagulation therapy. Secondary outcomes were time to targeted coagulation therapy, confidence, and workload. In addition, we have conducted a qualitative survey on user acceptance of Visual Clot. We used Poisson regression, Cox regression, and mixed logistic regression models, adjusted for various potential confounders, to analyze the data. Results: We analyzed 59 simulations. Teams using Visual Clot were more likely to deliver the overall targeted coagulation therapy correctly (rate ratio 1.56, 95\% CI 1.00-2.47; P=.05) and administer the first targeted coagulation product faster (hazard ratio 2.58, 95\% CI 1.37-4.85; P=.003). In addition, participants showed higher decision confidence with Visual Clot (odds ratio 3.60, 95\% CI 1.49-8.71; P=.005). We found no difference in workload (coefficient --0.03, 95\% CI --3.08 to 2.88; P=.99). Conclusions: Using Visual Clot led to a more accurate and faster-targeted coagulation therapy than using ROTEM temograms. We suggest that relevant viscoelastic test manufacturers consider augmenting their complex result presentation with intuitive, easy-to-understand visualization to ease users' burden from unnecessary cognitive load and enhance patient care. ", doi="10.2196/43895", url="https://www.jmir.org/2023/1/e43895", url="http://www.ncbi.nlm.nih.gov/pubmed/37824182" } @Article{info:doi/10.2196/52509, author="Jain, Shikha and Allan, M. Jessica and Bhayani, K. Rakhee", title="System-Wide Change Is Essential to Value the Contributions of Women in Medicine and Science", journal="J Med Internet Res", year="2023", month="Sep", day="22", volume="25", pages="e52509", keywords="women", keywords="women physicians", keywords="women scientists", keywords="gender equity", keywords="health care", keywords="diversity", keywords="leadership", keywords="intersectionality", keywords="minority tax", keywords="gratitude tax", keywords="glass ceiling", keywords="glass cliff", keywords="academia", keywords="academic medicine", keywords="hierarchy", keywords="change", doi="10.2196/52509", url="https://www.jmir.org/2023/1/e52509", url="http://www.ncbi.nlm.nih.gov/pubmed/37738082" } @Article{info:doi/10.2196/51494, author="Leung, I. Tiffany and Sagar, Ankita and Shroff, Swati and Henry, L. Tracey", title="Can AI Mitigate Bias in Writing Letters of Recommendation?", journal="JMIR Med Educ", year="2023", month="Aug", day="23", volume="9", pages="e51494", keywords="sponsorship", keywords="implicit bias", keywords="gender bias", keywords="bias", keywords="letters of recommendation", keywords="artificial intelligence", keywords="large language models", keywords="medical education", keywords="career advancement", keywords="tenure and promotion", keywords="promotion", keywords="leadership", doi="10.2196/51494", url="https://mededu.jmir.org/2023/1/e51494", url="http://www.ncbi.nlm.nih.gov/pubmed/37610808" } @Article{info:doi/10.2196/47784, author="Majmudar, Shivani and Graff, L. Stephanie and Kays, Marah and Braz, X. Beatriz and Matt-Amaral, Laurie and Markham, J. Merry and Subbiah, M. Ishwaria and Bergsland, Emily and Jain, Shikha", title="The Careers and Professional Well-Being of Women Oncologists During the COVID-19 Pandemic: Responding for Tomorrow", journal="J Med Internet Res", year="2023", month="Aug", day="21", volume="25", pages="e47784", keywords="oncology", keywords="women", keywords="gender equity", keywords="COVID-19", keywords="gender inequity", keywords="oncologist", keywords="health care", keywords="women physician", keywords="burnout", keywords="mental health", keywords="well-being", doi="10.2196/47784", url="https://www.jmir.org/2023/1/e47784", url="http://www.ncbi.nlm.nih.gov/pubmed/37603399" } @Article{info:doi/10.2196/44789, author="Dalavaye, Nishaanth and Baskaran, Ravanth and Mukhopadhyay, Srinjay and Gamage, Peramuna Movin and Ng, Vincent and Sharif, Hama and Rutherford, Stephen", title="Exploring the Educational Value of Popular Culture in Web-Based Medical Education: Pre-Post Study on Teaching Jaundice Using ``The Simpsons''", journal="JMIR Med Educ", year="2023", month="Aug", day="17", volume="9", pages="e44789", keywords="educational innovation", keywords="jaundice", keywords="medical education", keywords="popular culture", keywords="web-based teaching", abstract="Background: The potential of popular culture as a tool for knowledge delivery and enhancing engagement in education is promising but not extensively studied. Furthermore, concerns exist regarding learning fatigue due to increased reliance on videoconferencing platforms following the COVID-19 pandemic. To ensure effective web-based teaching sessions that maintain attention spans and enhance understanding, innovative solutions are necessary. Objective: This study aims to evaluate the use of specific popular culture case studies to enhance student engagement in a web-based near-peer teaching session. Methods: We delivered a web-based teaching session to undergraduate medical students in the United Kingdom. The session included clinical vignettes and single-best-answer questions using characters from ``The Simpsons'' television show as patient analogies for various causes of jaundice. A pre-post survey, employing a 7-point Likert scale, was distributed to gather data from participants. Results: A total of 53 survey responses were collected. Participants reported significantly improved understanding of jaundice after the session compared to before the session (median 6, IQR 5-6 vs median 4, IQR 3-4.5; P<.001). The majority of participants agreed that the inclusion of ``The Simpsons'' characters enhanced their knowledge and made the teaching session more memorable and engaging (memorability: median 6, IQR 5-7; engagement: median 6, IQR 5-7). Conclusions: When appropriately integrated, popular culture can effectively engage students and improve self-perceived knowledge retention. ``The Simpsons'' characters can be used pedagogically and professionally as patient analogies to deliver teaching on the topic of jaundice. ", doi="10.2196/44789", url="https://mededu.jmir.org/2023/1/e44789", url="http://www.ncbi.nlm.nih.gov/pubmed/37590059" } @Article{info:doi/10.2196/50945, author="Safranek, W. Conrad and Sidamon-Eristoff, Elizabeth Anne and Gilson, Aidan and Chartash, David", title="The Role of Large Language Models in Medical Education: Applications and Implications", journal="JMIR Med Educ", year="2023", month="Aug", day="14", volume="9", pages="e50945", keywords="large language models", keywords="ChatGPT", keywords="medical education", keywords="LLM", keywords="artificial intelligence in health care", keywords="AI", keywords="autoethnography", doi="10.2196/50945", url="https://mededu.jmir.org/2023/1/e50945", url="http://www.ncbi.nlm.nih.gov/pubmed/37578830" } @Article{info:doi/10.2196/47748, author="Liaw, Ying Sok and Tan, Zhi Jian and Bin Rusli, Dzakirin Khairul and Ratan, Rabindra and Zhou, Wentao and Lim, Siriwan and Lau, Ching Tang and Seah, Betsy and Chua, Ling Wei", title="Artificial Intelligence Versus Human-Controlled Doctor in Virtual Reality Simulation for Sepsis Team Training: Randomized Controlled Study", journal="J Med Internet Res", year="2023", month="Jul", day="26", volume="25", pages="e47748", keywords="artificial intelligence", keywords="interprofessional education", keywords="interprofessional communication", keywords="sepsis care", keywords="team training", keywords="virtual reality", keywords="simulation", keywords="AI", keywords="health care education", keywords="nursing student", keywords="nursing education", keywords="medical education", abstract="Background: Interprofessional communication is needed to enhance the early recognition and management of patients with sepsis. Preparing medical and nursing students using virtual reality simulation has been shown to be an effective learning approach for sepsis team training. However, its scalability is constrained by unequal cohort sizes between medical and nursing students. An artificial intelligence (AI) medical team member can be implemented in a virtual reality simulation to engage nursing students in sepsis team training. Objective: This study aimed to evaluate the effectiveness of an AI-powered doctor versus a human-controlled doctor in training nursing students for sepsis care and interprofessional communication. Methods: A randomized controlled trial study was conducted with 64 nursing students who were randomly assigned to undertake sepsis team training with an AI-powered doctor (AI-powered group) or with medical students using virtual reality simulation (human-controlled group). Participants from both groups were tested on their sepsis and communication performance through simulation-based assessments (posttest). Participants' sepsis knowledge and self-efficacy in interprofessional communication were also evaluated before and after the study interventions. Results: A total of 32 nursing students from each group completed the simulation-based assessment, sepsis and communication knowledge test, and self-efficacy questionnaire. Compared with the baseline scores, both the AI-powered and human-controlled groups demonstrated significant improvements in communication knowledge (P=.001) and self-efficacy in interprofessional communication (P<.001) in posttest scores. For sepsis care knowledge, a significant improvement in sepsis care knowledge from the baseline was observed in the AI-powered group (P<.001) but not in the human-controlled group (P=.16). Although no significant differences were found in sepsis care performance between the groups (AI-powered group: mean 13.63, SD 4.23, vs human-controlled group: mean 12.75, SD 3.85, P=.39), the AI-powered group (mean 9.06, SD 1.78) had statistically significantly higher sepsis posttest knowledge scores (P=.009) than the human-controlled group (mean 7.75, SD 2.08). No significant differences were found in interprofessional communication performance between the 2 groups (AI-powered group: mean 29.34, SD 8.37, vs human-controlled group: mean 27.06, SD 5.69, P=.21). However, the human-controlled group (mean 69.6, SD 14.4) reported a significantly higher level of self-efficacy in interprofessional communication (P=.008) than the AI-powered group (mean 60.1, SD 13.3). Conclusions: Our study suggested that AI-powered doctors are not inferior to human-controlled virtual reality simulations with respect to sepsis care and interprofessional communication performance, which supports the viability of implementing AI-powered doctors to achieve scalability in sepsis team training. Our findings also suggested that future innovations should focus on the sociability of AI-powered doctors to enhance users' interprofessional communication training. Perhaps in the nearer term, future studies should examine how to best blend AI-powered training with human-controlled virtual reality simulation to optimize clinical performance in sepsis care and interprofessional communication. Trial Registration: ClinicalTrials.gov NCT05953441; https://clinicaltrials.gov/study/NCT05953441 ", doi="10.2196/47748", url="https://www.jmir.org/2023/1/e47748", url="http://www.ncbi.nlm.nih.gov/pubmed/37494112" } @Article{info:doi/10.2196/48392, author="Mesko, Bertalan", title="The ChatGPT (Generative Artificial Intelligence) Revolution Has Made Artificial Intelligence Approachable for Medical Professionals", journal="J Med Internet Res", year="2023", month="Jun", day="22", volume="25", pages="e48392", keywords="artificial intelligence", keywords="digital health", keywords="future", keywords="technology", keywords="ChatGPT", keywords="medical practice", keywords="large language model", keywords="language model", keywords="generative", keywords="conversational agent", keywords="conversation agents", keywords="chatbot", keywords="generated text", keywords="computer generated", keywords="medical education", keywords="continuing education", keywords="professional development", keywords="curriculum", keywords="curricula", doi="10.2196/48392", url="https://www.jmir.org/2023/1/e48392", url="http://www.ncbi.nlm.nih.gov/pubmed/37347508" } @Article{info:doi/10.2196/47933, author="Allan, M. Jessica and Brooks, K. Amber and Crusto, Cindy and Feld, D. Lauren and Oxentenko, S. Amy and Spector, D. Nancy and Verduzco-Gutierrez, Monica and Silver, K. Julie", title="Five Strategies Leaders in Academic Medicine Can Implement Now to Enhance Gender Equity", journal="J Med Internet Res", year="2023", month="Jun", day="13", volume="25", pages="e47933", keywords="gender equity", keywords="diversity", keywords="leadership", keywords="academic medicine", keywords="gender", keywords="medicine", keywords="women in medicine", keywords="strategies", keywords="equity", doi="10.2196/47933", url="https://www.jmir.org/2023/1/e47933", url="http://www.ncbi.nlm.nih.gov/pubmed/37310782" } @Article{info:doi/10.2196/47800, author="Kays, N. Marah and Rupert, D. Deborah and Negris, Olivia and Thompson, Beatrix and Clayman, L. Marla and Mordell, Lisa and Pendergrast, Tricia and Bloomgarden, Eve and Bhayani, K. Rakhee and Jain, Shikha", title="Flattening Hierarchical Structures to Empower Women Trainee Leaders on Social Media Teams", journal="J Med Internet Res", year="2023", month="Jun", day="5", volume="25", pages="e47800", keywords="social media", keywords="medical education", keywords="gender equity", keywords="women", keywords="empowerment", keywords="pyramidal hierarchy", keywords="residency", keywords="medical training", keywords="health care", keywords="women empowerment", doi="10.2196/47800", url="https://www.jmir.org/2023/1/e47800", url="http://www.ncbi.nlm.nih.gov/pubmed/37276011" } @Article{info:doi/10.2196/46599, author="Thirunavukarasu, James Arun and Hassan, Refaat and Mahmood, Shathar and Sanghera, Rohan and Barzangi, Kara and El Mukashfi, Mohanned and Shah, Sachin", title="Trialling a Large Language Model (ChatGPT) in General Practice With the Applied Knowledge Test: Observational Study Demonstrating Opportunities and Limitations in Primary Care", journal="JMIR Med Educ", year="2023", month="Apr", day="21", volume="9", pages="e46599", keywords="ChatGPT", keywords="large language model", keywords="natural language processing", keywords="decision support techniques", keywords="artificial intelligence", keywords="AI", keywords="deep learning", keywords="primary care", keywords="general practice", keywords="family medicine", keywords="chatbot", abstract="Background: Large language models exhibiting human-level performance in specialized tasks are emerging; examples include Generative Pretrained Transformer 3.5, which underlies the processing of ChatGPT. Rigorous trials are required to understand the capabilities of emerging technology, so that innovation can be directed to benefit patients and practitioners. Objective: Here, we evaluated the strengths and weaknesses of ChatGPT in primary care using the Membership of the Royal College of General Practitioners Applied Knowledge Test (AKT) as a medium. Methods: AKT questions were sourced from a web-based question bank and 2 AKT practice papers. In total, 674 unique AKT questions were inputted to ChatGPT, with the model's answers recorded and compared to correct answers provided by the Royal College of General Practitioners. Each question was inputted twice in separate ChatGPT sessions, with answers on repeated trials compared to gauge consistency. Subject difficulty was gauged by referring to examiners' reports from 2018 to 2022. Novel explanations from ChatGPT---defined as information provided that was not inputted within the question or multiple answer choices---were recorded. Performance was analyzed with respect to subject, difficulty, question source, and novel model outputs to explore ChatGPT's strengths and weaknesses. Results: Average overall performance of ChatGPT was 60.17\%, which is below the mean passing mark in the last 2 years (70.42\%). Accuracy differed between sources (P=.04 and .06). ChatGPT's performance varied with subject category (P=.02 and .02), but variation did not correlate with difficulty (Spearman $\rho$=--0.241 and --0.238; P=.19 and .20). The proclivity of ChatGPT to provide novel explanations did not affect accuracy (P>.99 and .23). Conclusions: Large language models are approaching human expert--level performance, although further development is required to match the performance of qualified primary care physicians in the AKT. Validated high-performance models may serve as assistants or autonomous clinical tools to ameliorate the general practice workforce crisis. ", doi="10.2196/46599", url="https://mededu.jmir.org/2023/1/e46599", url="http://www.ncbi.nlm.nih.gov/pubmed/37083633" } @Article{info:doi/10.2196/42340, author="Mart{\'i}n-Carbonell, Marta and Espejo, Bego{\~n}a and Castro-Melo, Patricia Greys and Sequeira-Daza, Doris and Checa, Irene", title="Psychometric Properties of and Measurement Invariance in the Questionnaire of Stereotypes Toward Older Adulthood in Health Care College Students and Health Professionals of Colombia: Psychometric Study", journal="J Med Internet Res", year="2023", month="Mar", day="9", volume="25", pages="e42340", keywords="psychometric properties", keywords="structural equation modeling", keywords="older adulthood", keywords="geriatric", keywords="gerontology", keywords="health care college students", keywords="health care professionals", keywords="questionnaire", keywords="stereotype", keywords="agism", abstract="Background: In health professionals, negative stereotypes toward older adulthood have been associated with the difficulty in recognizing pathological processes and the refusal to care for older patients because of assuming that communication with them will be uncomfortable and frustrating. For these reasons, research on stereotypes in these groups has acquired growing importance. The usual strategy to identify and evaluate agist stereotypes is to use scales and questionnaires. Although multiple scales are currently used, in Latin America, the Questionnaire for the Evaluation of Negative Stereotypes Toward Older Adulthood (Cuestionario de Estereotipos Negativos sobre la Vejez [CENVE]), developed in Spain, is widely used but without evidence of construct validity in our context. In addition, although in the original version, a factorial structure of 3 factors was found, in later studies, a unifactorial structure was obtained. Objective: The objective is to study the construct validity of the CENVE in a sample of Colombian health personnel to clarify its factorial structure and concurrent validity. Likewise, the measurement invariance according to gender and age was studied. Methods: A nonprobabilistic sample of 877 Colombian health professionals and intern health students was obtained. The data were collected online using the LimeSurvey tool. To study the factor structure of the CENVE, 2 confirmatory factor analysis (CFA) models were carried out, one to test a single factor and the other to test the 3-related-factor structure. The factor measurement reliability was evaluated with the composite reliability index (CRI) and the average variance extracted (AVE). The measurement invariance was studied according to gender (men and women) and age (emerging adults, 18-29 years old, and adults, 30 years old or older). Using a structural equation model, the relationship between age and the latent CENVE total score was studied to obtain evidence of concurrent validity, since studies indicate that the younger the age, the greater the number of stereotypes. Results: The 1-factor structure was confirmed. The reliability results indicated that both indices show adequate values. Likewise, the existence of a strong invariance in measurement by gender and age group was verified. After contrasting the means of the groups, the results showed that men show more negative stereotypes toward old age than women. Likewise, emerging adults also showed more stereotypes than adults. We also verified that age is inversely related to the latent score of the questionnaire, such that the younger the age, the greater the stereotype. These results are in agreement with those obtained by other authors. Conclusions: The CENVE shows good construct and concurrent validity, as well as good reliability, and it can be used to assess stereotypes toward older adulthood in Colombian health professionals and health sciences college students. This will allow us to better understand the effect of stereotypes on agism. ", doi="10.2196/42340", url="https://www.jmir.org/2023/1/e42340", url="http://www.ncbi.nlm.nih.gov/pubmed/36892936" } @Article{info:doi/10.2196/43916, author="Preiksaitis, Carl and Dayton, R. John and Kabeer, Rana and Bunney, Gabrielle and Boukhman, Milana", title="Teaching Principles of Medical Innovation and Entrepreneurship Through Hackathons: Case Study and Qualitative Analysis", journal="JMIR Med Educ", year="2023", month="Feb", day="24", volume="9", pages="e43916", keywords="hackathon", keywords="innovation", keywords="entrepreneurship", keywords="medical education", keywords="gamification", keywords="curriculum", keywords="biodesign", keywords="emergency medicine", keywords="health care innovation", keywords="medical innovation", keywords="training", keywords="design", keywords="implementation", keywords="development", keywords="physician", keywords="educational", abstract="Background: Innovation and entrepreneurship training are increasingly recognized as being important in medical education. However, the lack of faculty comfort with the instruction of these concepts as well as limited scholarly recognition for this work has limited the implementation of curricula focused on these skills. Furthermore, this lack of familiarity limits the inclusion of practicing physicians in health care innovation, where their experience is valuable. Hackathons are intense innovation competitions that use gamification principles to increase comfort with creative thinking, problem-solving, and interpersonal collaboration, but they require further exploration in medical innovation. Objective: To address this, we aimed to design, implement, and evaluate a health care hackathon with 2 main goals: to improve emergency physician familiarity with the principles of health care innovation and entrepreneurship and to develop innovative solutions to 3 discrete problems facing emergency medicine physicians and patients. Methods: We used previously described practices for conducting hackathons to develop and implement our hackathon (HackED!). We partnered with the American College of Emergency Physicians, the Stanford School of Biodesign, and the Institute of Design at Stanford (d.school) to lend institutional support and expertise in health care innovation to our event. We determined a location, time frame, and logistics for the competition and settled on 3 use cases for teams to work on. We planned to explore the learning experience of participants within a pragmatic paradigm and complete an abductive thematic analysis using data from a variety of sources. Results: HackED! took place from October 1-3, 2022. In all, 3 teams developed novel solutions to each of the use cases. Our investigation into the educational experience of participants suggested that the event was valuable and uncovered themes suggesting that the learning experience could be understood within a framework from entrepreneurship education not previously described in relation to hackathons. Conclusions: Health care hackathons appear to be a viable method of increasing physician experience with innovation and entrepreneurship principles and addressing complex problems in health care. Hackathons should be considered as part of educational programs that focus on these concepts. ", doi="10.2196/43916", url="https://mededu.jmir.org/2023/1/e43916", url="http://www.ncbi.nlm.nih.gov/pubmed/36826988" } @Article{info:doi/10.2196/39794, author="Chartash, David and Rosenman, Marc and Wang, Karen and Chen, Elizabeth", title="Informatics in Undergraduate Medical Education: Analysis of Competency Frameworks and Practices Across North America", journal="JMIR Med Educ", year="2022", month="Sep", day="13", volume="8", number="3", pages="e39794", keywords="undergraduate medical education", keywords="medical informatics", keywords="curriculum", keywords="medical education", keywords="education", keywords="North America", keywords="framework", keywords="clinical", keywords="informatics", keywords="Canada", keywords="United States", keywords="US", keywords="teaching", keywords="management", keywords="cognitive", abstract="Background: With the advent of competency-based medical education, as well as Canadian efforts to include clinical informatics within undergraduate medical education, competency frameworks in the United States have not emphasized the skills associated with clinical informatics pertinent to the broader practice of medicine. Objective: By examining the competency frameworks with which undergraduate medical education in clinical informatics has been developed in Canada and the United States, we hypothesized that there is a gap: the lack of a unified competency set and frame for clinical informatics education across North America. Methods: We performed directional competency mapping between Canadian and American graduate clinical informatics competencies and general graduate medical education competencies. Directional competency mapping was performed between Canadian roles and American common program requirements using keyword matching at the subcompetency and enabling competency levels. In addition, for general graduate medical education competencies, the Physician Competency Reference Set developed for the Liaison Committee on Medical Education was used as a direct means of computing the ontological overlap between competency frameworks. Results: Upon mapping Canadian roles to American competencies via both undergraduate and graduate medical education competency frameworks, the difference in focus between the 2 countries can be thematically described as a difference between the concepts of clinical and management reasoning. Conclusions: We suggest that the development or deployment of informatics competencies in undergraduate medical education should focus on 3 items: the teaching of diagnostic reasoning, such that the information tasks that comprise both clinical and management reasoning can be discussed; precision medical education, where informatics can provide for more fine-grained evaluation; and assessment methods to support traditional pedagogical efforts (both at the bedside and beyond). Assessment using cases or structured assessments (eg, Objective Structured Clinical Examinations) would help students draw parallels between clinical informatics and fundamental clinical subjects and would better emphasize the cognitive techniques taught through informatics. ", doi="10.2196/39794", url="https://mededu.jmir.org/2022/3/e39794", url="http://www.ncbi.nlm.nih.gov/pubmed/36099007" } @Article{info:doi/10.2196/38126, author="Leung, I. Tiffany and Wang, H. Karen and Lin, L. Tammy and Gin, T. Geneen and Pendharkar, S. Sima and Chen, Angie Chwen-Yuen", title="Women Physicians in Transition Learning to Navigate the Pipeline from Early to Mid-Career: Protocol for a Qualitative Study", journal="JMIR Res Protoc", year="2022", month="Jun", day="2", volume="11", number="6", pages="e38126", keywords="gender equity", keywords="women physician", keywords="female physicians", keywords="career development", keywords="professional development", keywords="career pipeline", keywords="leaky pipeline", keywords="mid-career physicians", keywords="early-career physicians", keywords="physician", keywords="healthcare profession", keywords="peer support", keywords="physician perspective", keywords="physician experience", keywords="professional learning", keywords="healthcare", keywords="health care", keywords="healthcare education", keywords="career support", keywords="gender equality", keywords="gender bias", keywords="healthcare learning", abstract="Background: Women physicians face unique obstacles while progressing through their careers, navigating career advancement and seeking balance between professional and personal responsibilities. Systemic changes, along with individual and institutional changes, are needed to overcome obstacles perpetuating physician gender inequities. Developing a deeper understanding of women physicians' experiences during important transition points could reveal both barriers and opportunities for recruitment, retention, and promotion, and inform best practices developed based on these experiences. Objective: The aim is to learn from the experiences and perspectives of women physicians as they transition from early to mid-career, then develop best practices that can serve to support women physicians as they advance through their careers. Methods: Semistructured interviews were conducted with women physicians in the United States in 2020 and 2021. Eligibility criteria included self-identification as a woman who is in the process of transitioning or who recently transitioned from early to mid-career stage. Purposeful sampling facilitated identification of participants who represented diversity in career pathway, practice setting, specialty, and race/ethnicity. Each participant was offered compensation for their participation. Interviews were audio-recorded and professionally transcribed. Interview questions were open-ended, exploring participants' perceptions of this transition. Qualitative thematic analysis will be performed. We will use an open coding and grounded theory approach on interview transcripts. Results: The Ethics Review Committee of the Faculty of Health, Medicine, and Life Sciences at Maastricht University approved the study; Stanford University expedited review approved the study; and the University of California, San Diego certified the study as exempt from review. Twelve in-depth interviews of 50-100 minutes in duration were completed. Preliminary analyses indicate one key theme is a tension resulting from finite time divided between demands from a physician career and demands from family needs. In turn, this results in constant boundary control between these life domains that are inextricable and seemingly competing against each other within a finite space; family needs impinge on planned career goals, if the boundary between them is not carefully managed. To remedy this, women sought resources to help them redistribute home responsibilities, freeing themselves to have more time, especially for children. Women similarly sought resources to help with career advancement, although not with regard to time directly, but to first address foundational knowledge gaps about career milestones and how to achieve them. Conclusions: Preliminary results provide initial insights about how women identify or activate a career shift and how they marshaled resources and support to navigate barriers they faced. Further analyses are continuing as of March 2022 and are expected to be completed by June 2022. The dissemination plan includes peer-reviewed open-access journal publication of the results and presentation at the annual meeting of the American Medical Association's Women Physicians Section. ", doi="10.2196/38126", url="https://www.researchprotocols.org/2022/6/e38126", url="http://www.ncbi.nlm.nih.gov/pubmed/35653172" } @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/10.2196/36448, author="Archer, Jessica and Robinson, Luke and Brown, Ted", title="The Impact of Health Care Funding on Interprofessional Collaboration and Integrated Service Delivery in Primary and Allied Care: Protocol for a Scoping Review", journal="JMIR Res Protoc", year="2022", month="May", day="13", volume="11", number="5", pages="e36448", keywords="allied health", keywords="healthcare funding", keywords="interprofessional collaboration", keywords="integrated healthcare", keywords="primary health", keywords="primary care", abstract="Background: Improving funding models and implementing policies that facilitate greater interprofessional collaboration and integration at the primary and allied health level could improve the ongoing quality and safety and future sustainability of the wider health care system by reducing inefficiencies and inequalities. Defining these key health care funding--related models, policies, and concepts, identifying research gaps, and systematically mapping the associated literature will inform future research on this topic. Objective: The aim of this scoping review is to provide a descriptive overview of contemporary health care funding models and the key policies involved in the delivery of primary and allied health care. Further, it will investigate the impact these models and policies have on interprofessional collaboration and integrated service delivery at the primary and allied health care levels. Methods: A search of published and grey literature will be conducted using the following databases: the Allied and Complementary Medicine Database, CINAHL, Embase, Emcare, MEDLINE, PsycINFO, Scopus, Open Access Theses and Dissertations, and Web of Science. The search will be limited to resources available in the English language and published since 2011. Following the search, an independent screening of titles and abstracts will be undertaken by 2 independent reviewers, with a third reviewer available to resolve any potential disagreements. Full-text resources will then be assessed against the inclusion criteria following the same process. Extracted data will be presented using a convergent narrative approach, accompanied by tables and figures. Results: Electronic database searches have retrieved 8013 articles. The results of this scoping review are expected in May 2022. Conclusions: The findings from this review will be used to inform future research projects investigating the role of primary health care funding, interprofessional collaboration, and service integration in improving health care access, efficiency, effectiveness, and sustainability. International Registered Report Identifier (IRRID): DERR1-10.2196/36448 ", doi="10.2196/36448", url="https://www.researchprotocols.org/2022/5/e36448", url="http://www.ncbi.nlm.nih.gov/pubmed/35559853" } @Article{info:doi/10.2196/34990, author="Landis-Lewis, Zach and Flynn, Allen and Janda, Allison and Shah, Nirav", title="A Scalable Service to Improve Health Care Quality Through Precision Audit and Feedback: Proposal for a Randomized Controlled Trial", journal="JMIR Res Protoc", year="2022", month="May", day="10", volume="11", number="5", pages="e34990", keywords="learning health system", keywords="audit and feedback", keywords="anesthesiology", keywords="knowledge-based system", keywords="human-centered design", abstract="Background: Health care delivery organizations lack evidence-based strategies for using quality measurement data to improve performance. Audit and feedback (A\&F), the delivery of clinical performance summaries to providers, demonstrates the potential for large effects on clinical practice but is currently implemented as a blunt one size fits most intervention. Each provider in a care setting typically receives a performance summary of identical metrics in a common format despite the growing recognition that precisionizing interventions hold significant promise in improving their impact. A precision approach to A\&F prioritizes the display of information in a single metric that, for each recipient, carries the highest value for performance improvement, such as when the metric's level drops below a peer benchmark or minimum standard for the first time, thereby revealing an actionable performance gap. Furthermore, precision A\&F uses an optimal message format (including framing and visual displays) based on what is known about the recipient and the intended gist meaning being communicated to improve message interpretation while reducing the cognitive processing burden. Well-established psychological principles, frameworks, and theories form a feedback intervention knowledge base to achieve precision A\&F. From an informatics perspective, precision A\&F requires a knowledge-based system that enables mass customization by representing knowledge configurable at the group and individual levels. Objective: This study aims to implement and evaluate a demonstration system for precision A\&F in anesthesia care and to assess the effect of precision feedback emails on care quality and outcomes in a national quality improvement consortium. Methods: We propose to achieve our aims by conducting 3 studies: a requirements analysis and preferences elicitation study using human-centered design and conjoint analysis methods, a software service development and implementation study, and a cluster randomized controlled trial of a precision A\&F service with a concurrent process evaluation. This study will be conducted with the Multicenter Perioperative Outcomes Group, a national anesthesia quality improvement consortium with >60 member hospitals in >20 US states. This study will extend the Multicenter Perioperative Outcomes Group quality improvement infrastructure by using existing data and performance measurement processes. Results: The proposal was funded in September 2021 with a 4-year timeline. Data collection for Aim 1 began in March 2022. We plan for a 24-month trial timeline, with the intervention period of the trial beginning in March 2024. Conclusions: The proposed aims will collectively demonstrate a precision feedback service developed using an open-source technical infrastructure for computable knowledge management. By implementing and evaluating a demonstration system for precision feedback, we create the potential to observe the conditions under which feedback interventions are effective. International Registered Report Identifier (IRRID): PRR1-10.2196/34990 ", doi="10.2196/34990", url="https://www.researchprotocols.org/2022/5/e34990", url="http://www.ncbi.nlm.nih.gov/pubmed/35536637" } @Article{info:doi/10.2196/34302, author="Dunn, Sheila and Munro, Sarah and Devane, Courtney and Guilbert, Edith and Jeong, Dahn and Stroulia, Eleni and Soon, A. Judith and Norman, V. Wendy", title="A Virtual Community of Practice to Support Physician Uptake of a Novel Abortion Practice: Mixed Methods Case Study", journal="J Med Internet Res", year="2022", month="May", day="5", volume="24", number="5", pages="e34302", keywords="mifepristone", keywords="abortion", keywords="community of practice", keywords="virtual community of practice", keywords="diffusion of innovation", keywords="learning community", abstract="Background: Virtual communities of practice (VCoPs) have been used to support innovation and quality in clinical care. The drug mifepristone was introduced in Canada in 2017 for medical abortion. We created a VCoP to support implementation of mifepristone abortion practice across Canada. Objective: The aim of this study was to describe the development and use of the Canadian Abortion Providers Support-Communaut{\'e} de pratique canadienne sur l'avortement (CAPS-CPCA) VCoP and explore physicians' experience with CAPS-CPCA and their views on its value in supporting implementation. Methods: This was a mixed methods intrinsic case study of Canadian health care providers' use and physicians' perceptions of the CAPS-CPCA VCoP during the first 2 years of a novel practice. We sampled both physicians who joined the CAPS-CPCA VCoP and those who were interested in providing the novel practice but did not join the VCoP. We designed the VCoP features to address known and discovered barriers to implementation of medication abortion in primary care. Our secure web-based platform allowed asynchronous access to information, practice resources, clinical support, discussion forums, and email notices. We collected data from the platform and through surveys of physician members as well as interviews with physician members and nonmembers. We analyzed descriptive statistics for website metrics, physicians' characteristics and practices, and their use of the VCoP. We used qualitative methods to explore the physicians' experiences and perceptions of the VCoP. Results: From January 1, 2017, to June 30, 2019, a total of 430 physicians representing all provinces and territories in Canada joined the VCoP and 222 (51.6\%) completed a baseline survey. Of these 222 respondents, 156 (70.3\%) were family physicians, 170 (80.2\%) were women, and 78 (35.1\%) had no prior abortion experience. In a survey conducted 12 months after baseline, 77.9\% (120/154) of the respondents stated that they had provided mifepristone abortion and 33.9\% (43/127) said the VCoP had been important or very important. Logging in to the site was burdensome for some, but members valued downloadable resources such as patient information sheets, consent forms, and clinical checklists. They found email announcements helpful for keeping up to date with changing regulations. Few asked clinical questions to the VCoP experts, but physicians felt that this feature was important for isolated or rural providers. Information collected through member polls about health system barriers to implementation was used in the project's knowledge translation activities with policy makers to mitigate these barriers. Conclusions: A VCoP developed to address known and discovered barriers to uptake of a novel medication abortion method engaged physicians from across Canada and supported some, including those with no prior abortion experience, to implement this practice. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2018-028443 ", doi="10.2196/34302", url="https://www.jmir.org/2022/5/e34302", url="http://www.ncbi.nlm.nih.gov/pubmed/35511226" } @Article{info:doi/10.2196/36948, author="Ayivi-Vinz, Gloria and Bakwa Kanyinga, Felly and Bergeron, Lysa and D{\'e}cary, Simon and Adisso, Lionel {\'E}v{\`e}hou{\'e}nou and Zomahoun, Vignon Herv{\'e} Tchala and Daniel, J. Sam and Tremblay, Martin and Plourde, V. Karine and Guay-B{\'e}langer, Sabrina and L{\'e}gar{\'e}, France", title="Use of the CPD-REACTION Questionnaire to Evaluate Continuing Professional Development Activities for Health Professionals: Systematic Review", journal="JMIR Med Educ", year="2022", month="May", day="2", volume="8", number="2", pages="e36948", keywords="CPD-REACTION", keywords="behavior", keywords="intention", keywords="education medical", keywords="continuing", keywords="health care professionals", keywords="questionnaire", keywords="web-based", keywords="continuing professional development", abstract="Background: Continuing professional development (CPD) is essential for physicians to maintain and enhance their knowledge, competence, skills, and performance. Web-based CPD plays an essential role. However, validated theory--informed measures of their impact are lacking. The CPD-REACTION questionnaire is a validated theory--informed tool that evaluates the impact of CPD activities on clinicians' behavioral intentions. Objective: We aimed to review the use of the CPD-REACTION questionnaire, which measures the impact of CPD activities on health professionals' intentions to change clinical behavior. We examined CPD activity characteristics, ranges of intention, mean scores, score distributions, and psychometric properties. Methods: We conducted a systematic review informed by the Cochrane review methodology. We searched 8 databases from January 1, 2014, to April 20, 2021. Gray literature was identified using Google Scholar and Research Gate. Eligibility criteria included all health care professionals, any study design, and participants' completion of the CPD-REACTION questionnaire either before, after, or before and after a CPD activity. Study selection, data extraction, and study quality evaluation were independently performed by 2 reviewers. We extracted data on characteristics of studies, the CPD activity (eg, targeted clinical behavior and format), and CPD-REACTION use. We used the Mixed Methods Appraisal Tool to evaluate the methodological quality of the studies. Data extracted were analyzed using descriptive statistics and the Student t test (2-tailed) for bivariate analysis. The results are presented as a narrative synthesis reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: Overall, 65 citations were eligible and referred to 52 primary studies. The number of primary studies reporting the use of CPD-REACTION has increased continuously since 2014 from 1 to 16 publications per year (2021). It is available in English, French, Spanish, and Dutch. Most of the studies were conducted in Canada (30/52, 58\%). Furthermore, 40 different clinical behaviors were identified. The most common CPD format was e-learning (34/52, 65\%). The original version of the CPD-REACTION questionnaire was used in 31 of 52 studies, and an adapted version in 18 of 52 studies. In addition, 31\% (16/52) of the studies measured both the pre- and postintervention scores. In 22 studies, CPD providers were university-based. Most studies targeted interprofessional groups of health professionals (31/52, 60\%). Conclusions: The use of CPD-REACTION has increased rapidly and across a wide range of clinical behaviors and formats, including a web-based format. Further research should investigate the most effective way to adapt the CPD-REACTION questionnaire to a variety of clinical behaviors and contexts. Trial Registration: PROSPERO CRD42018116492; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=116492 ", doi="10.2196/36948", url="https://mededu.jmir.org/2022/2/e36948", url="http://www.ncbi.nlm.nih.gov/pubmed/35318188" } @Article{info:doi/10.2196/32657, author="Beverly, Elizabeth and Rigot, Brooke and Love, Carrie and Love, Matt", title="Perspectives of 360-Degree Cinematic Virtual Reality: Interview Study Among Health Care Professionals", journal="JMIR Med Educ", year="2022", month="Apr", day="29", volume="8", number="2", pages="e32657", keywords="virtual reality", keywords="qualitative", keywords="medical education", keywords="health care", keywords="digital learning", keywords="learning platform", keywords="health care providers", abstract="Background: The global market for medical education is projected to increase exponentially over the next 5 years. A mode of delivery expected to drive the growth of this market is virtual reality (VR). VR simulates real-world objects, events, locations, and interactions in 3D multimedia sensory environments. It has been used successfully in medical education for surgical training, learning anatomy, and advancing drug discovery. New VR research has been used to simulate role-playing and clinical encounters; however, most of this research has been conducted with health professions students and not current health care professionals. Thus, more research is needed to explore how health care professionals experience VR with role-playing and clinical encounters. Objective: The aim of this study was to explore health care professionals' experiences with a cinematic VR (cine-VR) training program focused on role-playing and clinical encounters addressing social determinants of health, Appalachian culture, and diabetes. Cine-VR leverages 360-degree video with the narrative storytelling of cinema to create an engaging educational experience. Methods: We conducted in-depth telephone interviews with health care professionals who participated in the cine-VR training. The interviews were audio recorded and transcribed verbatim. A multidisciplinary team coded and analyzed the data using content and thematic analyses with NVivo software. Results: We conducted 24 in-depth interviews with health care professionals (age=45.3, SD 11.3, years; n=16, 67\%, women; n=22, 92\%, White; and n=4, 17\%, physicians) to explore their experiences with the cine-VR training. Qualitative analysis revealed five themes: immersed in the virtual world: seeing a 360-degree sphere allowed participants to immerse themselves in the virtual world; facilitated knowledge acquisition: all the participants accurately recalled the culture of Appalachia and listed the social determinants of health presented in the training; empathized with multiple perspectives: the cine-VR provided a glimpse into the real life of the main character, and participants described thinking about, feeling, and empathizing with the character's frustrations and disappointments; perceived ease of use of cine-VR: 96\% (23/24) of the participants described the cine-VR as easy to use, and they liked the 360-degree movement, image resolution, and sound quality but noted limitations with the buttons on the headsets and risk for motion sickness; and perceived utility of cine-VR as a teaching tool: participants described cine-VR as an effective teaching tool because it activated visual and affective learning for them. Conclusions: Participants emphasized the realism of the cine-VR training program. They attributed the utility of the cine-VR to visual learning in conjunction with the emotional connection to the VR characters. Furthermore, participants reported that the cine-VR increased their empathy for people. More research is needed to confirm an association between the level of immersion and empathy in cine-VR training for health care professionals. ", doi="10.2196/32657", url="https://mededu.jmir.org/2022/2/e32657", url="http://www.ncbi.nlm.nih.gov/pubmed/35486427" } @Article{info:doi/10.2196/30988, author="White, A. Andrew and King, M. Ann and D'Addario, E. Angelo and Brigham, Berg Karen and Dintzis, Suzanne and Fay, E. Emily and Gallagher, H. Thomas and Mazor, M. Kathleen", title="Video-Based Communication Assessment of Physician Error Disclosure Skills by Crowdsourced Laypeople and Patient Advocates Who Experienced Medical Harm: Reliability Assessment With Generalizability Theory", journal="JMIR Med Educ", year="2022", month="Apr", day="29", volume="8", number="2", pages="e30988", keywords="medical error disclosure", keywords="simulation studies", keywords="communication assessment", keywords="graduate medical education", keywords="crowdsourcing", keywords="patient-centered care", keywords="generalizability theory", keywords="medical education", keywords="medical error", keywords="communication", abstract="Background: Residents may benefit from simulated practice with personalized feedback to prepare for high-stakes disclosure conversations with patients after harmful errors and to meet American Council on Graduate Medical Education mandates. Ideally, feedback would come from patients who have experienced communication after medical harm, but medical researchers and leaders have found it difficult to reach this community, which has made this approach impractical at scale. The Video-Based Communication Assessment app is designed to engage crowdsourced laypeople to rate physician communication skills but has not been evaluated for use with medical harm scenarios. Objective: We aimed to compare the reliability of 2 assessment groups (crowdsourced laypeople and patient advocates) in rating physician error disclosure communication skills using the Video-Based Communication Assessment app. Methods: Internal medicine residents used the Video-Based Communication Assessment app; the case, which consisted of 3 sequential vignettes, depicted a delayed diagnosis of breast cancer. Panels of patient advocates who have experienced harmful medical error, either personally or through a family member, and crowdsourced laypeople used a 5-point scale to rate the residents' error disclosure communication skills (6 items) based on audiorecorded responses. Ratings were aggregated across items and vignettes to create a numerical communication score for each physician. We used analysis of variance, to compare stringency, and Pearson correlation between patient advocates and laypeople, to identify whether rank order would be preserved between groups. We used generalizability theory to examine the difference in assessment reliability between patient advocates and laypeople. Results: Internal medicine residents (n=20) used the Video-Based Communication Assessment app. All patient advocates (n=8) and 42 of 59 crowdsourced laypeople who had been recruited provided complete, high-quality ratings. Patient advocates rated communication more stringently than crowdsourced laypeople (patient advocates: mean 3.19, SD 0.55; laypeople: mean 3.55, SD 0.40; P<.001), but patient advocates' and crowdsourced laypeople's ratings of physicians were highly correlated (r=0.82, P<.001). Reliability for 8 raters and 6 vignettes was acceptable (patient advocates: G coefficient 0.82; crowdsourced laypeople: G coefficient 0.65). Decision studies estimated that 12 crowdsourced layperson raters and 9 vignettes would yield an acceptable G coefficient of 0.75. Conclusions: Crowdsourced laypeople may represent a sustainable source of reliable assessments of physician error disclosure skills. For a simulated case involving delayed diagnosis of breast cancer, laypeople correctly identified high and low performers. However, at least 12 raters and 9 vignettes are required to ensure adequate reliability and future studies are warranted. Crowdsourced laypeople rate less stringently than raters who have experienced harm. Future research should examine the value of the Video-Based Communication Assessment app for formative assessment, summative assessment, and just-in-time coaching of error disclosure communication skills. ", doi="10.2196/30988", url="https://mededu.jmir.org/2022/2/e30988", url="http://www.ncbi.nlm.nih.gov/pubmed/35486423" } @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/10.2196/35083, author="Ewais, Tatjana and Hunt, Georgia and Munro, Jonathan and Pun, Paul and Hogan, Christy and William, Leeroy and Teodorczuk, Andrew", title="Schwartz Rounds for Staff in an Australian Tertiary Hospital: Protocol for a Pilot Uncontrolled Trial", journal="JMIR Res Protoc", year="2022", month="Apr", day="27", volume="11", number="4", pages="e35083", keywords="Schwartz Rounds", keywords="compassionate care", keywords="health care staff well-being", abstract="Background: Schwartz Rounds are a unique, organization-wide interdisciplinary intervention aimed at enhancing staff well-being, compassionate care, teamwork, and organizational culture in health care settings. They provide a safe space wherein both clinical and nonclinical health staff can connect and share their experiences about the social and emotional aspects of health care. Objective: Although Schwartz Rounds have been assessed and widely implemented in the United States and United Kingdom, they are yet to be formally evaluated in Australian health care settings. The purpose of this study is to evaluate the feasibility and impact of Schwartz Rounds on staff well-being, compassionate care, and organizational culture, in a tertiary metropolitan hospital in Brisbane, Australia. Methods: This mixed methods repeated measures pilot study will recruit 24 participants in 2 groups from 2 departments, the intensive care unit and the gastroenterology department. Participants from each group will take part in 3 unit-based Schwartz Rounds. Primary outcomes will include the study and intervention feasibility measures, while secondary outcomes will include scores on the Maslach Burnout Inventory--Human Services Survey, the Schwartz Centre Compassionate Care Scale, and the Culture of Care Barometer. Primary and secondary outcomes will be collected at baseline, after the Rounds, and 3-month follow-up. Two focus groups will be held approximately 2 months after completion of the Schwartz Rounds. Descriptive statistics, paired t tests, chi-square tests, and analysis of variance will be used to compare quantitative data across time points and groups. Qualitative data from focus groups and free-text survey questions will be analyzed using an inductive thematic analysis approach. Results: The study was approved by the Mater Hospital Human Research Ethics Committee (reference number: HREC/MML/71868) and recruitment commenced in July 2021; study completion is anticipated by May 2022. Conclusions: The study will contribute to the assessment of feasibility and preliminary efficacy of the Schwartz Rounds in a tertiary Australian hospital during the COVID-19 pandemic. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12621001473853; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382769\&isReview=true International Registered Report Identifier (IRRID): DERR1-10.2196/35083 ", doi="10.2196/35083", url="https://www.researchprotocols.org/2022/4/e35083", url="http://www.ncbi.nlm.nih.gov/pubmed/35475785" } @Article{info:doi/10.2196/34781, author="Puladi, Behrus and Ooms, Mark and Bellgardt, Martin and Cesov, Mark and Lipprandt, Myriam and Raith, Stefan and Peters, Florian and M{\"o}hlhenrich, Christian Stephan and Prescher, Andreas and H{\"o}lzle, Frank and Kuhlen, Wolfgang Torsten and Modabber, Ali", title="Augmented Reality-Based Surgery on the Human Cadaver Using a New Generation of Optical Head-Mounted Displays: Development and Feasibility Study", journal="JMIR Serious Games", year="2022", month="Apr", day="25", volume="10", number="2", pages="e34781", keywords="digital health in surgery", keywords="surgical technique", keywords="surgical training", keywords="computer-assisted surgery", keywords="optical see-through head-mounted display", keywords="HoloLens", keywords="surgical navigation", keywords="medical regulation", keywords="open-source", keywords="AR", keywords="augmented reality", keywords="surgery", keywords="surgeon", keywords="cadaver", keywords="serious game", keywords="head-mounted display", abstract="Background: Although nearly one-third of the world's disease burden requires surgical care, only a small proportion of digital health applications are directly used in the surgical field. In the coming decades, the application of augmented reality (AR) with a new generation of optical-see-through head-mounted displays (OST-HMDs) like the HoloLens (Microsoft Corp) has the potential to bring digital health into the surgical field. However, for the application to be performed on a living person, proof of performance must first be provided due to regulatory requirements. In this regard, cadaver studies could provide initial evidence. Objective: The goal of the research was to develop an open-source system for AR-based surgery on human cadavers using freely available technologies. Methods: We tested our system using an easy-to-understand scenario in which fractured zygomatic arches of the face had to be repositioned with visual and auditory feedback to the investigators using a HoloLens. Results were verified with postoperative imaging and assessed in a blinded fashion by 2 investigators. The developed system and scenario were qualitatively evaluated by consensus interview and individual questionnaires. Results: The development and implementation of our system was feasible and could be realized in the course of a cadaver study. The AR system was found helpful by the investigators for spatial perception in addition to the combination of visual as well as auditory feedback. The surgical end point could be determined metrically as well as by assessment. Conclusions: The development and application of an AR-based surgical system using freely available technologies to perform OST-HMD--guided surgical procedures in cadavers is feasible. Cadaver studies are suitable for OST-HMD--guided interventions to measure a surgical end point and provide an initial data foundation for future clinical trials. The availability of free systems for researchers could be helpful for a possible translation process from digital health to AR-based surgery using OST-HMDs in the operating theater via cadaver studies. ", doi="10.2196/34781", url="https://games.jmir.org/2022/2/e34781", url="http://www.ncbi.nlm.nih.gov/pubmed/35468090" } @Article{info:doi/10.2196/33630, author="Sanavro, M. Sanne and van der Worp, Henk and Jansen, Danielle and Koning, Paul and Blanker, H. Marco and ", title="Evaluation of the First Year(s) of Physicians Collaboration on an Interdisciplinary Electronic Consultation Platform in the Netherlands: Mixed Methods Observational Study", journal="JMIR Hum Factors", year="2022", month="Apr", day="1", volume="9", number="2", pages="e33630", keywords="primary care", keywords="digital consultation", keywords="interdisciplinary", keywords="specialist care", abstract="Background: Complexity of health problems and aging of the population create an ongoing burden on the health care system with the general practitioner (GP) being the gatekeeper in primary care. In GPs daily practice, collaboration with specialists and exchange of knowledge from the secondary care play a crucial role in this system. Communication between primary and secondary care has shortcomings for health care workers that want to practice sustainable patient-centered health care. Therefore, a new digital interactive platform was developed: Prisma. Objective: This study aims to describe the development of a digital consultation platform (Prisma) to connect GPs with hospital specialists via the Siilo application and to evaluate the first year of use, including consultations, topic diversity, and number of participating physicians. Methods: We conducted a mixed methods observational study, analyzing qualitative and quantitative data for cases posted on the platform between June 2018 and May 2020. Any GP can post questions to an interdisciplinary group of secondary care specialists, with the platform designed to facilitate discussion and knowledge exchange for all users. Results: In total, 3674 cases were posted by 424 GPs across 16 specialisms. Most questions and answers concerned diagnosis, nonmedical treatment, and medication. Mean response time was 76 minutes (range 44-252). An average of 3 users engaged with each case (up to 7 specialists). Almost half of the internal medicine cases received responses from at least two specialisms in secondary care, contrasting with about one-fifth for dermatology. Of note, the growth in consultations was steepest for dermatology. Conclusions: Digital consultations offer the possibility for GPs to receive quick responses when seeking advice. The interdisciplinary approach of Prisma creates opportunities for digital patient-centered networking. ", doi="10.2196/33630", url="https://humanfactors.jmir.org/2022/2/e33630", url="http://www.ncbi.nlm.nih.gov/pubmed/35363155" } @Article{info:doi/10.2196/32183, author="Wang, Jiaqi Judy and Singh, K. Rishabh and Miselis, Hough Heather and Stapleton, Nicole Stephanie", title="Technology Literacy in Undergraduate Medical Education: Review and Survey of the US Medical School Innovation and Technology Programs", journal="JMIR Med Educ", year="2022", month="Mar", day="31", volume="8", number="1", pages="e32183", keywords="curricular development", keywords="medical innovation", keywords="medical technology", keywords="student engagement", abstract="Background: Modern innovations, like machine learning, genomics, and digital health, are being integrated into medical practice at a rapid pace. Physicians in training receive little exposure to the implications, drawbacks, and methodologies of upcoming technologies prior to their deployment. As a result, there is an increasing need for the incorporation of innovation and technology (I\&T) training, starting in medical school. Objective: We aimed to identify and describe curricular and extracurricular opportunities for innovation in medical technology in US undergraduate medical education to highlight challenges and develop insights for future directions of program development. Methods: A review of publicly available I\&T program information on the official websites of US allopathic medical schools was conducted in June 2020. Programs were categorized by structure and implementation. The geographic distribution of these categories across US regions was analyzed. A survey was administered to school-affiliated student organizations with a focus on I\&T and publicly available contact information. The data collected included the founding year, thematic focus, target audience, activities offered, and participant turnout rate. Results: A total of 103 I\&T opportunities at 69 distinct Liaison Committee on Medical Education--accredited medical schools were identified and characterized into the following six categories: (1) integrative 4-year curricula, (2) facilitated doctor of medicine/master of science dual degree programs in a related field, (3) interdisciplinary collaborations, (4) areas of concentration, (5) preclinical electives, and (6) student-run clubs. The presence of interdisciplinary collaboration is significantly associated with the presence of student-led initiatives (P=.001). ``Starting and running a business in healthcare'' and ``medical devices'' were the most popular thematic focuses of student-led I\&T groups, representing 87\% (13/15) and 80\% (12/15) of respondents, respectively. ``Career pathways exploration for students'' was the only type of activity that was significantly associated with a high event turnout rate of >26 students per event (P=.03). Conclusions: Existing school-led and student-driven opportunities in medical I\&T indicate growing national interest and reflect challenges in implementation. The greater visibility of opportunities, collaboration among schools, and development of a centralized network can be considered to better prepare students for the changing landscape of medical practice. ", doi="10.2196/32183", url="https://mededu.jmir.org/2022/1/e32183", url="http://www.ncbi.nlm.nih.gov/pubmed/35357319" } @Article{info:doi/10.2196/33934, author="Sukhera, Javeed and Ahmed, Hasan", title="Leveraging Machine Learning to Understand How Emotions Influence Equity Related Education: Quasi-Experimental Study", journal="JMIR Med Educ", year="2022", month="Mar", day="30", volume="8", number="1", pages="e33934", keywords="bias", keywords="equity", keywords="sentiment analysis", keywords="medical education", keywords="emotion", keywords="education", abstract="Background: Teaching and learning about topics such as bias are challenging due to the emotional nature of bias-related discourse. However, emotions can be challenging to study in health professions education for numerous reasons. With the emergence of machine learning and natural language processing, sentiment analysis (SA) has the potential to bridge the gap. Objective: To improve our understanding of the role of emotions in bias-related discourse, we developed and conducted a SA of bias-related discourse among health professionals. Methods: We conducted a 2-stage quasi-experimental study. First, we developed a SA (algorithm) within an existing archive of interviews with health professionals about bias. SA refers to a mechanism of analysis that evaluates the sentiment of textual data by assigning scores to textual components and calculating and assigning a sentiment value to the text. Next, we applied our SA algorithm to an archive of social media discourse on Twitter that contained equity-related hashtags to compare sentiment among health professionals and the general population. Results: When tested on the initial archive, our SA algorithm was highly accurate compared to human scoring of sentiment. An analysis of bias-related social media discourse demonstrated that health professional tweets (n=555) were less neutral than the general population (n=6680) when discussing social issues on professionally associated accounts ($\chi$2 [2, n=555)]=35.455; P<.001), suggesting that health professionals attach more sentiment to their posts on Twitter than seen in the general population. Conclusions: The finding that health professionals are more likely to show and convey emotions regarding equity-related issues on social media has implications for teaching and learning about sensitive topics related to health professions education. Such emotions must therefore be considered in the design, delivery, and evaluation of equity and bias-related education. ", doi="10.2196/33934", url="https://mededu.jmir.org/2022/1/e33934", url="http://www.ncbi.nlm.nih.gov/pubmed/35353048" } @Article{info:doi/10.2196/35199, author="Tamblyn, Robert and Brieva, Jorge and Cain, Madeleine and Martinez, Eduardo F.", title="The Effects of Introducing a Mobile App--Based Procedural Logbook on Trainee Compliance to a Central Venous Catheter Insertion Accreditation Program: Before-and-After Study", journal="JMIR Hum Factors", year="2022", month="Mar", day="7", volume="9", number="1", pages="e35199", keywords="logbook", keywords="education", keywords="training", keywords="central venous catheter", keywords="CVC", keywords="intensive care", keywords="smartphone", keywords="mobile phone", keywords="mobile apps", keywords="mHealth", keywords="mobile health", keywords="accreditation program", keywords="digital health", keywords="digital record", abstract="Background: To reduce complications associated with central venous catheter (CVC) insertions, local accreditation programs using a supervised procedural logbook are essential. To increase compliance with such a logbook, a mobile app could provide the ideal platform for training doctors in an adult intensive care unit (ICU). Objective: The aim of this paper was to compare trainee compliance with the completion of a logbook as part of a CVC insertion accreditation program, before and after the introduction of an app-based logbook. Methods: This is a retrospective observational study of logbook data, before and after the introduction of a purpose-built, app-based, electronic logbook to complement an existing paper-based logbook. Carried out over a 2-year period in the adult ICU of the John Hunter Hospital, Newcastle, NSW, Australia, the participants were ICU trainee medical officers completing a CVC insertion accreditation program. The primary outcome was the proportion of all CVC insertions documented in the patients' electronic medical records appearing as logbook entries. To assess logbook entry quality, we measured and compared the proportion of logbook entries that were approved by a supervisor and contained a supervisor's signature for the before and after periods. We also analyzed trainee participation before and after the intervention by comparing the total number of active logbook users, and the proportion of first-time users who logged 3 or more CVC insertions. Results: Of the 2987 CVC insertions documented in the electronic medical records between April 7, 2019, and April 6, 2021, 2161 (72\%) were included and separated into cohorts before and after the app's introduction. Following the introduction of the app-based logbook, the percentage of CVC insertions appearing as logbook entries increased from 3.6\% (38/1059) to 20.5\% (226/1102; P<.001). There was no difference in the proportion of supervisor-approved entries containing a supervisor's signature before and after the introduction of the app, with 76.3\% (29/38) and 83.2\% (188/226), respectively (P=.31). After the introduction of the app, there was an increase in the percentage of active logbook users from 15.3\% (13/85) to 62.8\% (54/86; P<.001). Adherence to one's logbook was similar in both groups with 60\% (6/10) of first-time users in the before group and 79.5\% (31/39) in the after group going on to log at least 3 or more CVCs during their time working in ICU. Conclusions: The addition of an electronic app-based logbook to a preexisting paper-based logbook was associated with a higher rate of logbook compliance in trainee doctors undertaking an accreditation program for CVC insertion in an adult ICU. There was a large increase in logbook use observed without a reduction in the quality of logbook entries. The overall trainee participation also improved with an observed increase in active logbook users and no reduction in the average number of entries per user following the introduction of the app. Further studies on app-based logbooks for ICU procedural accreditation programs are warranted. ", doi="10.2196/35199", url="https://humanfactors.jmir.org/2022/1/e35199", url="http://www.ncbi.nlm.nih.gov/pubmed/35051900" } @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/10.2196/32747, author="Yeung, Kan Andy Wai and Parvanov, D. Emil and Hribersek, Mojca and Eibensteiner, Fabian and Klager, Elisabeth and Kletecka-Pulker, Maria and R{\"o}ssler, Bernhard and Schebesta, Karl and Willschke, Harald and Atanasov, G. Atanas and Schaden, Eva", title="Digital Teaching in Medical Education: Scientific Literature Landscape Review", journal="JMIR Med Educ", year="2022", month="Feb", day="9", volume="8", number="1", pages="e32747", keywords="medical education", keywords="digital teaching", keywords="virtual reality", keywords="augmented reality", keywords="anatomy", keywords="basic life support", keywords="satisfaction", keywords="bibliometric", keywords="medicine", keywords="life support", keywords="online learning", keywords="literature", keywords="trend", keywords="citation", abstract="Background: Digital teaching in medical education has grown in popularity in the recent years. However, to the best of our knowledge, no bibliometric report to date has been published that analyzes this important literature set to reveal prevailing topics and trends and their impacts reflected in citation counts. Objective: We used a bibliometric approach to unveil and evaluate the scientific literature on digital teaching research in medical education, demonstrating recurring research topics, productive authors, research organizations, countries, and journals. We further aimed to discuss some of the topics and findings reported by specific highly cited works. Methods: The Web of Science electronic database was searched to identify relevant papers on digital teaching research in medical education. Basic bibliographic data were obtained by the ``Analyze'' and ``Create Citation Report'' functions of the database. Complete bibliographic data were exported to VOSviewer for further analyses. Visualization maps were generated to display the recurring author keywords and terms mentioned in the titles and abstracts of the publications. Results: The analysis was based on data from 3978 papers that were identified. The literature received worldwide contributions with the most productive countries being the United States and United Kingdom. Reviews were significantly more cited, but the citations between open access vs non--open access papers did not significantly differ. Some themes were cited more often, reflected by terms such as virtual reality, innovation, trial, effectiveness, and anatomy. Different aspects in medical education were experimented for digital teaching, such as gross anatomy education, histology, complementary medicine, medicinal chemistry, and basic life support. Some studies have shown that digital teaching could increase learning satisfaction, knowledge gain, and even cost-effectiveness. More studies were conducted on trainees than on undergraduate students. Conclusions: Digital teaching in medical education is expected to flourish in the future, especially during this era of COVID-19 pandemic. ", doi="10.2196/32747", url="https://mededu.jmir.org/2022/1/e32747", url="http://www.ncbi.nlm.nih.gov/pubmed/35138260" } @Article{info:doi/10.2196/30804, author="Nigusie, Adane and Endehabtu, F. Berhanu and Angaw, Abebaw Dessie and Teklu, Alemayehu and Mekonnen, Abebaw Zeleke and Feletto, Marta and Assan, Abraham and Samuel, Assegid and Sheikh, Kabir and Tilahun, Binyam", title="Status of Compassionate, Respectful, and Caring Health Service Delivery: Scoping Review", journal="JMIR Hum Factors", year="2022", month="Feb", day="7", volume="9", number="1", pages="e30804", keywords="compassionate", keywords="respectful", keywords="caring", keywords="CRC", keywords="health care delivery", abstract="Background: A compassionate, respectful, and caring (CRC) health professional is very important for human-centered care, serving clients ethically and with respect, adhering to the professional oath, and serving as a model for young professionals. As countries try to achieve universal health coverage (UHC), quality delivery of health services is crucial. CRC health care is an initiative around the need to provide quality care services to clients and patients. However, there is an evidence gap on the status of CRC health care service delivery. Objective: This scoping review aimed to map global evidence on the status of CRC health service delivery practice. Methods: An exhaustive literature review and Delphi technique were used to answer the 2 research questions: ``What is the current status of CRC health care practices among health workers?'' and ``Is it possible for health professionals, health managers, administrators, and policy makers to incorporate it into their activity while designing strategies that could improve the humanistic and holistic approach to health care provision?'' The studies were searched from the year 2014 to September 2020 using electronic databases such as MEDLINE (PubMed), Cochrane Library, Web of Science, Hinari, and the World Health Organization (WHO) library. Additionally, grey literature such as Google, Google Scholar, and WorldWideScience were scrutinized. Studies that applied any study design and data collection and analysis methods related to CRC care were included. Two authors extracted the data and compared the results. Discrepancies were resolved by discussion, or the third reviewer made the decision. Findings from the existing literature were presented using thematic analysis. Results: A total of 1193 potentially relevant studies were generated from the initial search, and 20 studies were included in the final review. From this review, we identified 5 thematic areas: the status of CRC implementation, facilitators for CRC health care service delivery, barriers to CRC health care delivery, disrespectful and abusive care encountered by patients, and perspectives on CRC. The findings of this review indicated that improving the mechanisms for monitoring health facilities, improving accountability, and becoming aware of the consequences of maltreatment within facilities are critical steps to improving health care delivery practices. Conclusions: This scoping review identified that there is limited CRC service provision. Lack of training, patient flow volume, and bed shortages were found to be the main contributors of CRC health care delivery. Therefore, the health care system should consider the components of CRC in health care delivery during in-service training, pre-service training, monitoring and evaluation, community engagement, workload division, and performance appraisal. ", doi="10.2196/30804", url="https://humanfactors.jmir.org/2022/1/e30804", url="http://www.ncbi.nlm.nih.gov/pubmed/35129450" } @Article{info:doi/10.2196/34171, author="Jung, Dukyoo and De Gagne, C. Jennie and Choi, Eunju and Lee, Kyuri", title="An Online International Collaborative Learning Program During the COVID-19 Pandemic for Nursing Students: Mixed Methods Study", journal="JMIR Med Educ", year="2022", month="Jan", day="24", volume="8", number="1", pages="e34171", keywords="COVID-19", keywords="distance education", keywords="global competencies", keywords="nursing students", keywords="program evaluation", keywords="synchronous virtual classroom", keywords="video conferencing", abstract="Background: Given the limitations imposed by the COVID-19 pandemic, a better understanding of how nursing programs around the globe have implemented distance education methods and related initiatives to provide international collaborative learning opportunities as well as complementary aspects of practical education would be constructive for nursing students. It is expected that international collaboratives through web-based communication will continue to be increasingly utilized after the pandemic; therefore, it is time to discuss the effects and direction of these developments. Objective: We aimed to examine the impact of an online international collaborative learning program on prelicensure nursing students' international and global competencies in South Korea. Methods: We conducted a mixed methods study (web-based surveys and focus group interviews). A total of 15 students participated in the study. The surveys were used to examine changes in participants' global leadership competencies, and the focus group interviews were used to evaluate the program's effectiveness and to identify opportunities for improvement. The online international collaborative program consisted of 7 synchronous web-based classroom sessions. Each session ran for 60 to 90 minutes. Faculty experts and nurses working in the United States discussed various topics with students, such as nursing education in the United States and evidence-based teaching and learning. The students gave presentations on the South Korean nursing education system. Data were analyzed with descriptive statistics, the Mann-Whitney U test, and content analysis methods. Results: Participants reported improvement in their global leadership competencies. Four main categories emerged from analysis of the focus interviews: (1) realistic applicability, (2) clarification, (3) expansion of perspectives, and (4) initiative. Conclusions: The online international collaborative learning program had a positive impact on the development of students' international competencies. The findings support the further development of international exchange programs through web-based meetings in the postpandemic era. ", doi="10.2196/34171", url="https://mededu.jmir.org/2022/1/e34171", url="http://www.ncbi.nlm.nih.gov/pubmed/34982035" } @Article{info:doi/10.2196/28770, author="Cabrera, Daniel and Nickson, P. Christopher and Roland, Damian and Hall, Elissa and Ankel, Felix", title="Distributed Autonomous Organization of Learning: Future Structure for Health Professions Education Institutions", journal="JMIR Med Educ", year="2022", month="Jan", day="4", volume="8", number="1", pages="e28770", keywords="blockchain", keywords="multidisciplinary", keywords="credentialing", keywords="medical education", keywords="health professionals", keywords="education", keywords="decentralization", keywords="training", keywords="curriculum", keywords="instruction", doi="10.2196/28770", url="https://mededu.jmir.org/2022/1/e28770", url="http://www.ncbi.nlm.nih.gov/pubmed/34982722" } @Article{info:doi/10.2196/26763, author="Wang, Hsiao-Han and Lin, Yu-Hsuan", title="Assessing Physicians' Recall Bias of Work Hours With a Mobile App: Interview and App-Recorded Data Comparison", journal="J Med Internet Res", year="2021", month="Dec", day="24", volume="23", number="12", pages="e26763", keywords="smartphone", keywords="mobile app", keywords="work hours", keywords="recall bias", keywords="time perception", keywords="physicians", keywords="labor policy", abstract="Background: Previous studies have shown inconsistencies in the accuracy of self-reported work hours. However, accurate documentation of work hours is fundamental for the formation of labor policies. Strict work-hour policies decrease medical errors, improve patient safety, and promote physicians' well-being. Objective: The aim of this study was to estimate physicians' recall bias of work hours with a mobile app, and to examine the association between the recall bias and physicians' work hours. Methods: We quantified recall bias by calculating the differences between the app-recorded and self-reported work hours of the previous week and the penultimate week. We recruited 18 physicians to install the ``Staff Hours'' app, which automatically recorded GPS-defined work hours for 2 months, contributing 1068 person-days. We examined the association between work hours and two recall bias indicators: (1) the difference between self-reported and app-recorded work hours and (2) the percentage of days for which work hours were not precisely recalled during interviews. Results: App-recorded work hours highly correlated with self-reported counterparts (r=0.86-0.88, P<.001). Self-reported work hours were consistently significantly lower than app-recorded hours by --8.97 (SD 8.60) hours and --6.48 (SD 8.29) hours for the previous week and the penultimate week, respectively (both P<.001). The difference for the previous week was significantly correlated with work hours in the previous week (r=--0.410, P=.01), whereas the correlation of the difference with the hours in the penultimate week was not significant (r=--0.119, P=.48). The percentage of hours not recalled (38.6\%) was significantly higher for the penultimate week (38.6\%) than for the first week (16.0\%), and the former was significantly correlated with work hours of the penultimate week (r=0.489, P=.002) Conclusions: Our study identified the existence of recall bias of work hours, the extent to which the recall was biased, and the influence of work hours on recall bias. ", doi="10.2196/26763", url="https://www.jmir.org/2021/12/e26763", url="http://www.ncbi.nlm.nih.gov/pubmed/34951600" } @Article{info:doi/10.2196/32356, author="Peng, R. Cynthia and Schertzer, A. Kimberly and Caretta-Weyer, A. Holly and Sebok-Syer, S. Stefanie and Lu, William and Tansomboon, Charissa and Gisondi, A. Michael", title="Assessment of Entrustable Professional Activities Using a Web-Based Simulation Platform During Transition to Emergency Medicine Residency: Mixed Methods Pilot Study", journal="JMIR Med Educ", year="2021", month="Nov", day="17", volume="7", number="4", pages="e32356", keywords="simulation", keywords="graduate medical education", keywords="assessment", keywords="gamification", keywords="entrustable professional activities", keywords="emergency medicine", keywords="undergraduate medical education", abstract="Background: The 13 core entrustable professional activities (EPAs) are key competency-based learning outcomes in the transition from undergraduate to graduate medical education in the United States. Five of these EPAs (EPA2: prioritizing differentials, EPA3: recommending and interpreting tests, EPA4: entering orders and prescriptions, EPA5: documenting clinical encounters, and EPA10: recognizing urgent and emergent conditions) are uniquely suited for web-based assessment. Objective: In this pilot study, we created cases on a web-based simulation platform for the diagnostic assessment of these EPAs and examined the feasibility and acceptability of the platform. Methods: Four simulation cases underwent 3 rounds of consensus panels and pilot testing. Incoming emergency medicine interns (N=15) completed all cases. A maximum of 4 ``look for'' statements, which encompassed specific EPAs, were generated for each participant: (1) performing harmful or missing actions, (2) narrowing differential or wrong final diagnosis, (3) errors in documentation, and (4) lack of recognition and stabilization of urgent diagnoses. Finally, we interviewed a sample of interns (n=5) and residency leadership (n=5) and analyzed the responses using thematic analysis. Results: All participants had at least one missing critical action, and 40\% (6/15) of the participants performed at least one harmful action across all 4 cases. The final diagnosis was not included in the differential diagnosis in more than half of the assessments (8/15, 54\%). Other errors included selecting incorrect documentation passages (6/15, 40\%) and indiscriminately applying oxygen (9/15, 60\%). The interview themes included psychological safety of the interface, ability to assess learning, and fidelity of cases. The most valuable feature cited was the ability to place orders in a realistic electronic medical record interface. Conclusions: This study demonstrates the feasibility and acceptability of a web-based platform for diagnostic assessment of specific EPAs. The approach rapidly identifies potential areas of concern for incoming interns using an asynchronous format, provides feedback in a manner appreciated by residency leadership, and informs individualized learning plans. ", doi="10.2196/32356", url="https://mededu.jmir.org/2021/4/e32356", url="http://www.ncbi.nlm.nih.gov/pubmed/34787582" } @Article{info:doi/10.2196/29239, author="Qua, Kelli and Yu, Fei and Patel, Tanha and Dave, Gaurav and Cornelius, Katherine and Pelfrey, M. Clara", title="Scholarly Productivity Evaluation of KL2 Scholars Using Bibliometrics and Federal Follow-on Funding: Cross-Institution Study", journal="J Med Internet Res", year="2021", month="Sep", day="29", volume="23", number="9", pages="e29239", keywords="bibliometrics", keywords="Clinical and Translational Science Award", keywords="KL2", keywords="translational research", keywords="career development", abstract="Background: Evaluating outcomes of the clinical and translational research (CTR) training of a Clinical and Translational Science Award (CTSA) hub (eg, the KL2 program) requires the selection of reliable, accessible, and standardized measures. As measures of scholarly success usually focus on publication output and extramural funding, CTSA hubs have started to use bibliometrics to evaluate the impact of their supported scholarly activities. However, the evaluation of KL2 programs across CTSAs is limited, and the use of bibliometrics and follow-on funding is minimal. Objective: This study seeks to evaluate scholarly productivity, impact, and collaboration using bibliometrics and federal follow-on funding of KL2 scholars from 3 CTSA hubs and to define and assess CTR training success indicators. Methods: The sample included KL2 scholars from 3 CTSA institutions (A-C). Bibliometric data for each scholar in the sample were collected from both SciVal and iCite, including scholarly productivity, citation impact, and research collaboration. Three federal follow-on funding measures (at the 5-year, 8-year, and overall time points) were collected internally and confirmed by examining a federal funding database. Both descriptive and inferential statistical analyses were computed using SPSS to assess the bibliometric and federal follow-on funding results. Results: A total of 143 KL2 scholars were included in the sample with relatively equal groups across the 3 CTSA institutions. The included KL2 scholars produced more publications and citation counts per year on average at the 8-year time point (3.75 publications and 26.44 citation counts) than the 5-year time point (3.4 publications vs 26.16 citation counts). Overall, the KL2 publications from all 3 institutions were cited twice as much as others in their fields based on the relative citation ratio. KL2 scholars published work with researchers from other US institutions over 2 times (5-year time point) or 3.5 times (8-year time point) more than others in their research fields. Within 5 years and 8 years postmatriculation, 44.1\% (63/143) and 51.7\% (74/143) of KL2 scholars achieved federal funding, respectively. The KL2-scholars of Institution C had a significantly higher citation rate per publication than the other institutions (P<.001). Institution A had a significantly lower rate of nationally field-weighted collaboration than did the other institutions (P<.001). Institution B scholars were more likely to have received federal funding than scholars at Institution A or C (P<.001). Conclusions: Multi-institutional data showed a high level of scholarly productivity, impact, collaboration, and federal follow-on funding achieved by KL2 scholars. This study provides insights on the use of bibliometric and federal follow-on funding data to evaluate CTR training success across institutions. CTSA KL2 programs and other CTR career training programs can benefit from these findings in terms of understanding metrics of career success and using that knowledge to develop highly targeted strategies to support early-stage career development of CTR investigators. ", doi="10.2196/29239", url="https://www.jmir.org/2021/9/e29239", url="http://www.ncbi.nlm.nih.gov/pubmed/34586077" } @Article{info:doi/10.2196/29157, author="Milligan, John Kevin and Daulton, Scott Robert and St Clair, Taylor Zachary and Epperson, Veronica Madison and Holloway, Mackenzie Rachel and Schlaudecker, David Jeffrey", title="Creation of a Student-Run Medical Education Podcast: Tutorial", journal="JMIR Med Educ", year="2021", month="Jul", day="8", volume="7", number="3", pages="e29157", keywords="podcast", keywords="medical student", keywords="near-peer", keywords="medical education", abstract="Background: Podcasting has become a popular medium for medical education content. Educators and trainees of all levels are turning to podcasts for high-quality, asynchronous content. Although numerous medical education podcasts have emerged in recent years, few student-run podcasts exist. Student-run podcasts are a novel approach to supporting medical students. Near-peer mentoring has been shown to promote medical students' personal and professional identity formation. Student-run podcasts offer a new medium for delivering near-peer advice to medical students in an enduring and accessible manner. Objective: This paper describes the creation of the UnsCripted Medicine Podcast---a student-run medical education podcast produced at the University of Cincinnati College of Medicine. Methods: The planning and preparatory phases spanned 6 months. Defining a target audience and establishing a podcast mission were key first steps. Efforts were directed toward securing funding; obtaining necessary equipment; and navigating the technical considerations of recording, editing, and publishing a podcast. In order to ensure that high professionalism standards were met, key partnerships were created with faculty from the College of Medicine. Results: The UnsCripted Medicine Podcast published 53 episodes in its first 2 years. The number of episodes released per month ranges from 0 to 5, with a mean of 2.0 episodes. The podcast has a Twitter account with 217 followers. The number of listeners who subscribed to the podcast via Apple Podcasts grew to 86 in the first year and then to 218 in the second year. The show has an average rating of 4.8 (out of 5) on Apple Podcasts, which is based on 24 ratings. The podcast has hosted 70 unique guests, including medical students, resident physicians, attending physicians, nurses, physicians' family members, graduate medical education leadership, and educators. Conclusions: Medical student--run podcasts are a novel approach to supporting medical students and fostering professional identity formation. Podcasts are widely available and convenient for listeners. Additionally, podcast creators can publish content with lower barriers of entry compared to those of other forms of published content. Medical schools should consider supporting student podcast initiatives to allow for near-peer mentoring, augment the community, facilitate professional identity formation, and prepare the rising physician workforce for the technological frontier of medical education and practice. ", doi="10.2196/29157", url="https://mededu.jmir.org/2021/3/e29157", url="http://www.ncbi.nlm.nih.gov/pubmed/34255694" } @Article{info:doi/10.2196/10400, author="Mazor, M. Kathleen and King, M. Ann and Hoppe, B. Ruth and Kochersberger, O. Annie and Yan, Jie and Reim, D. Jesse", title="Video-Based Communication Assessment: Development of an Innovative System for Assessing Clinician-Patient Communication", journal="JMIR Med Educ", year="2019", month="Feb", day="14", volume="5", number="1", pages="e10400", keywords="communication", keywords="crowdsourcing", keywords="health care", keywords="mobile phone", keywords="patient-centered care", keywords="video-based communication assessment", doi="10.2196/10400", url="http://mededu.jmir.org/2019/1/e10400/", url="http://www.ncbi.nlm.nih.gov/pubmed/30710460" } @Article{info:doi/10.2196/mededu.9128, author="Berryman, K. Elizabeth and Leonard, J. Daniel and Gray, R. Andrew and Pinnock, Ralph and Taylor, Barry", title="Self-Reflected Well-Being via a Smartphone App in Clinical Medical Students: Feasibility Study", journal="JMIR Med Educ", year="2018", month="Mar", day="07", volume="4", number="1", pages="e7", keywords="mental health", keywords="medical students", keywords="medical education", keywords="bullying", keywords="teaching", keywords="mhealth", abstract="Background: Well-being in medical students has become an area of concern, with a number of studies reporting high rates of clinical depression, anxiety, burnout, and suicidal ideation in this population. Objective: The aim of this study was to increase awareness of well-being in medical students by using a smartphone app. The primary objective of this study was to determine the validity and feasibility of the Particip8 app for student self-reflected well-being data collection. Methods: Undergraduate medical students of the Dunedin School of Medicine were recruited into the study. They were asked to self-reflect daily on their well-being and to note what experiences they had encountered during that day. Qualitative data were also collected both before and after the study in the form of focus groups and ``free-text'' email surveys. All participants consented for the data collected to be anonymously reported to the medical faculty. Results: A total of 29 participants (69\%, 20/29 female; 31\%, 9/29 male; aged 21-30 years) were enrolled, with overall median compliance of 71\% at the study day level. The self-reflected well-being scores were associated with both positive and negative experiences described by the participants, with most negative experiences associated with around 20\% lower well-being scores for that day; the largest effect being ``receiving feedback that was not constructive or helpful,'' and the most positive experiences associated with around 20\% higher scores for that day. Conclusions: The study of daily data collection via the Particip8 app was found to be feasible, and the self-reflected well-being scores showed validity against participant's reflections of experiences during that day. ", doi="10.2196/mededu.9128", url="http://mededu.jmir.org/2018/1/e7/", url="http://www.ncbi.nlm.nih.gov/pubmed/29514774" } @Article{info:doi/10.2196/mededu.5950, author="Singh, Devin and Alam, Fahad and Matava, Clyde", title="A Critical Analysis of Anesthesiology Podcasts: Identifying Determinants of Success", journal="JMIR Med Educ", year="2016", month="Aug", day="17", volume="2", number="2", pages="e14", keywords="anesthesia", keywords="podcasts", keywords="peer review", keywords="success", keywords="e-learning", keywords="e-resources", abstract="Background: Audio and video podcasts have gained popularity in recent years. Increasingly, podcasts are being used in the field of medicine as a tool to disseminate information. This format has multiple advantages including highly accessible creation tools, low distribution costs, and portability for the user. However, despite its ongoing use in medical education, there are no data describing factors associated with the success or quality of podcasts. Objective: The goal of the study was to assess the landscape of anesthesia podcasts in Canada and develop a methodology for evaluating the quality of the podcast. To achieve our objective, we identified the scope of podcasts in anesthesia specifically, constructed an algorithmic model for measuring success, and identified factors linked to both successful podcasts and a peer-review process. Methods: Independent reviewers performed a systematic search of anesthesia-related podcasts on iTunes Canada. Data and metrics recorded for each podcast included podcast's authorship, number posted, podcast series duration, target audience, topics, and social media presence. Descriptive statistics summarized mined data, and univariate analysis was used to identify factors associated with podcast success and a peer-review process. Results: Twenty-two podcasts related to anesthesia were included in the final analysis. Less than a third (6/22=27\%) were still active. The median longevity of the podcasts' series was just 13 months (interquartile range: 1-39 months). Anesthesiologists were the target audience for 77\% of podcast series with clinical topics being most commonly addressed. We defined a novel algorithm for measuring success: Podcast Success Index. Factors associated with a high Podcast Success Index included podcasts targeting fellows (Spearman R=0.434; P=.04), inclusion of professional topics (Spearman R=0.456-0.603; P=.01-.03), and the use of Twitter as a means of social media (Spearman R=0.453;P=.03). In addition, more than two-thirds (16/22=73\%) of podcasts demonstrated evidence of peer review with podcasts targeting anesthesiologists most strongly associated with peer-reviewed podcasts (Spearman R=0.886; P=.004) Conclusions: We present the first report on the scope of anesthesia podcasts in Canada. We have developed a novel tool for assessing the success of an anesthesiology podcast series and identified factors linked to this success measure as well as evidence of a peer-review process for a given podcast. To enable advancement in this area of anesthesia e-resources, podcast creators and users should consider factors associated with success when creating podcasts. The lack of these aspects may be associated with the early demise of a podcast series. ", doi="10.2196/mededu.5950", url="http://mededu.jmir.org/2016/2/e14/", url="http://www.ncbi.nlm.nih.gov/pubmed/27731857" } @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" }