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


@Article{info:doi/10.2196/68309,
author="Alreshaid, Lulwah
and Alkattan, Rana",
title="Feedback From Dental Students Using Two Alternate Coaching Methods: Qualitative Focus Group Study",
journal="JMIR Med Educ",
year="2025",
month="Mar",
day="18",
volume="11",
pages="e68309",
keywords="student feedback",
keywords="coaching",
keywords="dental education",
keywords="student evaluation",
keywords="teaching methods",
keywords="educational intervention",
abstract="Background: Student feedback is crucial for evaluating the effectiveness of institutions. However, implementing feedback can be challenging due to practical difficulties. While student feedback on courses can improve teaching, there is a debate about its effectiveness if not well-written to provide helpful information to the receiver. Objective: This study aimed to evaluate the impact of coaching on proper feedback given by dental students in Saudi Arabia. Methods: A total of 47 first-year dental students from a public dental school in Riyadh, Saudi Arabia, completed 3 surveys throughout the academic year. The surveys assessed their feedback on a Dental Anatomy and Operative Dentistry course, including their feedback on the lectures, practical sessions, examinations, and overall experience. The surveys focused on assessing student feedback on the knowledge, understanding, and practical skills achieved during the course, as aligned with the defined course learning outcomes. The surveys were distributed without coaching, after handout coaching and after workshop coaching on how to provide feedback, designated as survey \#1, survey \#2, and survey \#3, respectively. The same group of students received all 3 surveys consecutively (repeated measures design). The responses were then rated as neutral, positive, negative, or constructive by 2 raters. The feedback was analyzed using McNemar test to compare the effectiveness of the different coaching approaches. Results: While no significant changes were found between the first 2 surveys, a significant increase in constructive feedback was observed in survey \#3 after workshop coaching compared with both other surveys (P<.001). The results also showed a higher proportion of desired changes in feedback, defined as any change from positive, negative, or neutral to constructive, after survey \#3 (P<.001). Overall, 20.2\% reported desired changes at survey \#2\% and 41.5\% at survey \#3 compared with survey \#1. Conclusions: This study suggests that workshops on feedback coaching can effectively improve the quality of feedback provided by dental students. Incorporating feedback coaching into dental school curricula could help students communicate their concerns more effectively, ultimately enhancing the learning experience. ",
doi="10.2196/68309",
url="https://mededu.jmir.org/2025/1/e68309"
}


@Article{info:doi/10.2196/63136,
author="Koka, Avinash
and Stuby, Loric
and Carrera, Emmanuel
and Gabr, Ahmed
and O'Connor, Margaret
and Missilier Peruzzo, Nathalie
and Waeterloot, Olivier
and Medlin, Friedrich
and Rigolet, Fabien
and Schmutz, Thomas
and Michel, Patrik
and Desmettre, Thibaut
and Suppan, M{\'e}lanie
and Suppan, Laurent",
title="Asynchronous Distance Learning Performance and Knowledge Retention of the National Institutes of Health Stroke Scale Among Health Care Professionals Using Video or e-Learning: Web-based Randomized Controlled Trial",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="4",
volume="27",
pages="e63136",
keywords="stroke",
keywords="e-learning",
keywords="video",
keywords="medical education",
keywords="randomized controlled trial",
keywords="knowledge retention",
keywords="knowledge acquisition",
keywords="NIHSS",
keywords="National Institutes of Health Stroke Scale",
keywords="learner satisfaction",
abstract="Background: Stroke treatment has significantly improved over the last decades, but the complexity of stroke cases requires specialized care through dedicated teams with specific knowledge and training. The National Institutes of Health Stroke Scale (NIHSS), widely used to assess neurological deficits and make treatment decisions, is reliable but requires specific training and certification. The traditional didactic training method, based on a video, may not adequately address certain NIHSS intricacies nor engage health care professionals (HCPs) in continuous learning, leading to suboptimal proficiency. In the context of time-constrained clinical settings, highly interactive e-learning could be a promising alternative for NIHSS knowledge acquisition and retention. Objective: This study aimed to assess the efficacy of a highly interactive e-learning module compared with a traditional didactic video in improving NIHSS knowledge among previously trained HCPs. Furthermore, its impact on knowledge retention was also assessed. Methods: A prospective, multicentric, triple-blind, and web-based randomized controlled trial was conducted in 3 Swiss university hospitals, involving HCPs previously trained in NIHSS. Invitations were sent through email, and participants were randomized to either the e-learning or traditional didactic video group through a fully automated process upon self-registration on the website. A 50-question quiz was administered before and after exposure to the training method, and scores were compared to assess knowledge acquisition. The quiz was repeated after 1 month to evaluate retention. Subjective assessments of learning methods that is, user satisfaction, probability of recommendation, perceived difficulty, and perception of duration, were also collected through a Likert-scale questionnaire. A sample size of 72 participants were deemed necessary to have an 80\% chance of detecting a difference of 2 points in the postcourse quiz between groups at the 5\% significance level. Results: Invitations to participate were sent through email to an estimated 325 HCPs. 174 HCPs enrolled in the study, of which 97 completed the study course. Both learning methods significantly improved NIHSS knowledge, with an improvement of 3.2 (range 2.0-4.3) points in the e-learning group and of 2.1 (1.2-3.1) points in the video group. However, the e-learning group performed better, with higher scores in knowledge acquisition (median score 39.0, IQR 36.0-41.0 vs 37, IQR 34.0-39.0; P=.03) and in knowledge retention (mean score 38.2, 95\% CI 36.7-39.7 vs 35.8, 95\% CI 34.8-36.8; P=.007). Participants in the e-learning group were more likely to recommend the learning method (77\% vs 49\%, P=.02), while no significant difference was found for satisfaction (P=.17), perceived duration (P=.17), and difficulty (P=.32). Conclusions: A highly interactive e-learning module was found to be an effective asynchronous method for NIHSS knowledge acquisition and retention in previously NIHSS-trained HCPs, and may now be considered for inclusion in NIHSS training programs for HCPs. International Registered Report Identifier (IRRID): RR2-10.3390/healthcare9111460 ",
doi="10.2196/63136",
url="https://www.jmir.org/2025/1/e63136",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053772"
}


@Article{info:doi/10.2196/63708,
author="Davoody, Nadia
and Stathakarou, Natalia
and Swain, Cara
and Bonacina, Stefano",
title="Exploring the Impact of the COVID-19 Pandemic on Learning Experience, Mental Health, Adaptability, and Resilience Among Health Informatics Master's Students: Focus Group Study",
journal="JMIR Med Educ",
year="2025",
month="Feb",
day="10",
volume="11",
pages="e63708",
keywords="COVID-19 pandemic",
keywords="eHealth",
keywords="blended learning",
keywords="health informatics",
keywords="higher education adaptation",
abstract="Background: The shift to online education due to the COVID-19 pandemic posed significant challenges and opportunities for students, affecting their academic performance, mental well-being, and engagement. Objective: This study aimed to explore the overall learning experience among health informatics master's students at Karolinska Institutet, Sweden, and the strategies they used to overcome learning challenges posed by the COVID-19 pandemic. Methods: Through 3 structured focus groups, this study explored health informatics master's students' experiences of shifting learning environments for classes that started in 2019, 2020, and 2021. All focus group sessions were recorded and transcribed verbatim. Inductive content analysis was used to analyze the data. Results: The results highlight the benefits of increased autonomy and flexibility and identify challenges such as technical difficulties, diminished social interactions, and psychological impacts. This study underscores the importance of effective online educational strategies, technological preparedness, and support systems to enhance student learning experiences during emergencies. The findings of this study highlight implications for educators, students, and higher education institutions to embrace adaptation and foster innovation. Implications for educators, students, and higher education institutions include the need for educators to stay current with the latest educational technologies and design teaching strategies and pedagogical approaches suited to both online and in-person settings to effectively foster student engagement. Students must be informed about the technological requirements for online learning and adequately prepared to meet them. Institutions play a critical role in ensuring equitable access to technology, guiding and supporting educators in adopting innovative tools and methods, and offering mental health resources to assist students in overcoming the challenges of evolving educational environments. Conclusions: This research contributes to understanding the complexities of transitioning to online learning in urgent circumstances and offers insights for better preparing educational institutions for future pandemics. ",
doi="10.2196/63708",
url="https://mededu.jmir.org/2025/1/e63708"
}


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


@Article{info:doi/10.2196/54176,
author="Bonnin, Gabriel
and Kr{\"o}ber, Svea
and Schneider, Silvia
and Margraf, J{\"u}rgen
and Pflug, Verena
and Gerlach, L. Alexander
and Slotta, Timo
and Christiansen, Hanna
and Albrecht, Bj{\"o}rn
and Chavanon, Mira-Lynn
and Hirschfeld, Gerrit
and In-Albon, Tina
and Thielsch, T. Meinald
and von Brachel, Ruth",
title="A Blended Learning Course on the Diagnostics of Mental Disorders: Multicenter Cluster Randomized Noninferiority Trial",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="27",
volume="26",
pages="e54176",
keywords="diagnosis",
keywords="structured clinical interviews",
keywords="blended learning",
keywords="dissemination",
keywords="therapist training",
keywords="clinical interview",
keywords="clinical diagnosis",
keywords="clinical practice",
keywords="psychology students",
keywords="diagnostic test",
keywords="health personnel",
keywords="mental health services",
keywords="mental health",
abstract="Background: Clinical diagnoses determine if and how therapists treat their patients. As misdiagnoses can have severe adverse effects, disseminating evidence-based diagnostic skills into clinical practice is highly important. Objective: This study aimed to develop and evaluate a blended learning course in a multicenter cluster randomized controlled trial. Methods: Undergraduate psychology students (N=350) enrolled in 18 university courses at 3 universities. The courses were randomly assigned to blended learning or traditional synchronous teaching. The primary outcome was the participants' performances in a clinical diagnostic interview after the courses. The secondary outcomes were diagnostic knowledge and participants' reactions to the courses. All outcomes were analyzed on the individual participant level using noninferiority testing. Results: Compared with the synchronous course (74.6\% pass rate), participation in the blended learning course (89\% pass rate) increased the likelihood of successfully passing the behavioral test (odds ratio 2.77, 95\% CI 1.55-5.13), indicating not only noninferiority but superiority of the blended learning course. Furthermore, superiority of the blended learning over the synchronous course could be found regarding diagnostic knowledge ($\beta$=.13, 95\% CI 0.01-0.26), course clarity ($\beta$=.40, 95\% CI 0.27-0.53), course structure ($\beta$=.18, 95\% CI 0.04-0.32), and informativeness ($\beta$=.19, 95\% CI 0.06-0.32). Conclusions: Blended learning can help to improve the diagnostic skills and knowledge of (future) clinicians and thus make an important contribution to improving mental health care. Trial Registration: ClinicalTrials.gov NCT05294094; https://clinicaltrials.gov/study/NCT05294094 ",
doi="10.2196/54176",
url="https://www.jmir.org/2024/1/e54176"
}


@Article{info:doi/10.2196/52631,
author="Halim, Freda
and Widysanto, Allen
and Wahjoepramono, Perdana Petra Octavian
and Candrawinata, Siulinda Valeska
and Budihardja, Setiawan Andi
and Irawan, Andry
and Sudirman, Taufik
and Christina, Natalia
and Koerniawan, Sutanto Heru
and Tobing, Lumban Jephtah Furano
and Sungono, Veli
and Marlina, Mona
and Wahjoepramono, Julianta Eka",
title="Objective Comparison of the First-Person--View Live Streaming Method Versus Face-to-Face Teaching Method in Improving Wound Suturing Skills for Skin Closure in Surgical Clerkship Students: Randomized Controlled Trial",
journal="JMIR Med Educ",
year="2024",
month="Aug",
day="30",
volume="10",
pages="e52631",
keywords="teaching method",
keywords="live streaming",
keywords="first-person view",
keywords="face-to-face",
keywords="simple wound suturing",
abstract="Background: The use of digital online teaching media in improving the surgical skills of medical students is indispensable, yet it is still not widely explored objectively. The first-person--view online teaching method may be more effective as it provides more realism to surgical clerkship students in achieving basic surgical skills. Objective: This study aims to objectively assess the effectiveness of the first-person--view live streaming (LS) method using a GoPro camera compared to the standard face-to-face (FTF) teaching method in improving simple wound suturing skills in surgical clerkship students. Methods: A prospective, parallel, nonblinded, single-center, randomized controlled trial was performed. Between January and April 2023, clerkship students of the Department of Surgery, Pelita Harapan University, were randomly selected and recruited into either the LS or FTF teaching method for simple interrupted suturing skills. All the participants were assessed objectively before and 1 week after training, using the direct observational procedural skills (DOPS) method. DOPS results and poststudy questionnaires were analyzed. Results: A total of 74 students were included in this study, with 37 (50\%) participants in each group. Paired analysis of each participant's pre-experiment and postexperiment DOPS scores revealed that the LS method's outcome is comparable to the FTF method's outcome (LS: mean 27.5, SD 20.6 vs FTF: mean 24.4, SD 16.7; P=.48) in improving the students' surgical skills. Conclusions: First-person--view LS training sessions could enhance students' ability to master simple procedural skills such as simple wound suturing and has comparable results to the current FTF teaching method. Teaching a practical skill using the LS method also gives more confidence for the participants to perform the procedure independently. Other advantages of the LS method, such as the ability to study from outside the sterile environment, are also promising. We recommend improvements in the audiovisual quality of the camera and a stable internet connection before performing the LS teaching method. Trial Registration: ClinicalTrials.gov NCT06221917; https://clinicaltrials.gov/study/NCT06221917 ",
doi="10.2196/52631",
url="https://mededu.jmir.org/2024/1/e52631"
}


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


@Article{info:doi/10.2196/42281,
author="Lee, Yau Jason Wen
and Bello, Fernando",
title="Readiness of Health Care Professionals in Singapore to Teach Online and Their Technology-Related Teaching Needs: Quantitative Cross-sectional Pilot Study",
journal="JMIR Med Educ",
year="2023",
month="Mar",
day="6",
volume="9",
pages="e42281",
keywords="online readiness in teaching",
keywords="technology for learning",
keywords="faculty development",
keywords="training need",
keywords="technology-enhanced learning",
keywords="readiness",
keywords="teaching",
keywords="medical education",
keywords="health care education",
keywords="teacher",
keywords="online environment",
keywords="online teaching",
keywords="teaching skill",
keywords="educator",
abstract="Background: With the increasing acceptance of face-to-face classes transitioning to web-based learning due to COVID-19, there is an increasing need to have educators trained and equipped to teach online. The ability to teach in-person may not necessarily mean that one is ready teach in a web-based environment. Objective: The objective of our study was to investigate the readiness of health care professionals in Singapore to teach online and their technology-related teaching needs. Methods: This was a quantitative cross-sectional pilot study conducted among health care administrative staff and professionals in medicine, nursing, allied health, and dentistry. Participants were recruited via an open invitation email to all staff members of Singapore's largest group of health care institutions. Data were collected using a web-based questionnaire. Differences in the readiness of the professionals to teach online were analyzed using analysis of variance, and a 1-sided independent sample t test was performed to analyze the differences between respondents younger than 40 years and those older than 41 years. Results: A total of 169 responses was analyzed. Full-time academic faculty members scored the highest for readiness to teach online (2.97), followed by nursing professionals (2.91), medicine professionals (2.88), administrative staff members (2.83), and allied health professionals (2.76). However, there was no statistically significant difference (P=.77) among all the respondents in their readiness to teach online. There was an agreement among all professionals in their need for software tools to teach; in particular, there was a significant difference in the software needs among the professionals for streaming videos (P=.01). There was no statistically significant difference in the readiness to teach online between those younger than 40 years and those older than 41 years (P=.48). Conclusions: Our study shows that there are still some gaps in terms of readiness to teach online among health care professionals. Our findings can be used by policy makers and faculty developers to identify opportunities for development among their educators so that they are ready to teach online with the appropriate software tools. ",
doi="10.2196/42281",
url="https://mededu.jmir.org/2023/1/e42281",
url="http://www.ncbi.nlm.nih.gov/pubmed/36877546"
}


@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/10.2196/32183,
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/10.2196/13386,
author="Schuelper, Nikolai
and Ludwig, Sascha
and Anders, Sven
and Raupach, Tobias",
title="The Impact of Medical Students' Individual Teaching Format Choice on the Learning Outcome Related to Clinical Reasoning",
journal="JMIR Med Educ",
year="2019",
month="Jul",
day="22",
volume="5",
number="2",
pages="e13386",
keywords="undergraduate medical education",
keywords="case histories",
abstract="Background: Repeated formative assessments using key feature questions have been shown to enhance clinical reasoning. Key feature questions augmented by videos presenting clinical vignettes may be more effective than text-based questions, especially in a setting where medical students are free to choose the format they would like to work with. This study investigated learning outcomes related to clinical reasoning in students using video- or text-based key feature questions according to their individual preferences. Objective: The aim of this study was to test the hypothesis that repeated exposure to video-based key feature questions enhances clinical reasoning to a greater extent than repeated exposure to text-based key feature questions if students are allowed to choose between those different formats on their own. Methods: In this monocentric, prospective, nonrandomized trial, fourth-year medical students attended 12 computer-based case seminars during which they worked on case histories containing key feature questions. Cases were available in a text- and a video-based format. Students chose their preferred presentation format at the beginning of each case seminar. Student performance in key feature questions was assessed in formative entry, exit, and retention exams and was analyzed with regard to preceding exposure to video- or text-based case histories. Results: Of 102 eligible students, 75 provided written consent and complete data at all study exams (response rate=73.5\%). A majority of students (n=52) predominantly chose the text-based format. Compared with these, students preferring the video-based format achieved a nonsignificantly higher score in the exit exam (mean 76.2\% [SD 12.6] vs 70.0\% [SD 19.0]; P=.15) and a significantly higher score in the retention exam (mean 75.3\% [SD 16.6] vs 63.4\% [SD 20.3]; P=.02). The effect was independent of the video- or text-based presentation format, which was set as default in the respective exams. Conclusions: Despite students' overall preference for text-based case histories, the learning outcome with regard to clinical reasoning was higher in students with higher exposure to video-based items. Time-on-task is one conceivable explanation for these effects as working with video-based items was more time-consuming. The baseline performance levels of students do not account for the results as the preceding summative exam results were comparable across the 2 groups. Given that a substantial number of students chose a presentation format that was less effective, students might need to be briefed about the beneficial effects of using video-based case histories to be able to make informed choices about their study methods. ",
doi="10.2196/13386",
url="http://mededu.jmir.org/2019/2/e13386/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31333193"
}