%0 Journal Article %@ 2369-3762 %I JMIR Publications %V 11 %N %P e62803 %T Exploring the Role of Immersive Virtual Reality Simulation in Health Professions Education: Thematic Analysis %A Talan,Jordan %A Forster,Molly %A Joseph,Leian %A Pradhan,Deepak %K virtual reality %K medical education %K virtual reality simulation %K extended reality %K simulation %K VR %K health professions education %K health education %K thematic analysis %K evolving technology %K qualitative study %K qualitative %K semistructured interviews %K educational experiences %K theoretical framework %D 2025 %7 12.3.2025 %9 %J JMIR Med Educ %G English %X Background: Although technology is rapidly advancing in immersive virtual reality (VR) simulation, there is a paucity of literature to guide its implementation into health professions education, and there are no described best practices for the development of this evolving technology. Objective: We conducted a qualitative study using semistructured interviews with early adopters of immersive VR simulation technology to investigate use and motivations behind using this technology in educational practice, and to identify the educational needs that this technology can address. Methods: We conducted 16 interviews with VR early adopters. Data were analyzed via directed content analysis through the lens of the Unified Theory of Acceptance and Use of Technology. Results: The main themes that emerged included focus on cognitive skills, access to education, resource investment, and balancing immersion. These findings help to clarify the intended role of VR simulation in health professions education. Based on our data, we synthesized a set of research questions that may help define best practices for future VR development and implementation. Conclusions: Immersive VR simulation technology primarily serves to teach cognitive skills, expand access to educational experiences, act as a collaborative repository of widely relevant and diverse simulation scenarios, and foster learning through deep immersion. By applying the Unified Theory of Acceptance and Use of Technology theoretical framework to the context of VR simulation, we not only collected validation evidence for this established theory, but also proposed several modifications to better explain use behavior in this specific setting. %R 10.2196/62803 %U https://mededu.jmir.org/2025/1/e62803 %U https://doi.org/10.2196/62803 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 11 %N %P e64768 %T Organizational Leaders’ Views on Digital Health Competencies in Medical Education: Qualitative Semistructured Interview Study %A Zainal,Humairah %A Xiao Hui,Xin %A Thumboo,Julian %A Kok Yong,Fong %+ Department of Rheumatology and Immunology, Singapore General Hospital, 10 Hospital Boulevard, Singapore, 168582, Singapore, 65 6908 8949, fong.kok.yong@singhealth.com.sg %K technology %K medical education %K curriculum %K clinical competence %K digital competence %K Singapore %K digital health %K qualitative study %K medical school %K risk %K comprehensive framework %K doctor %K thematic analysis %K information technology %K evidence-based %K undergraduate %K healthcare systems %K mobile phone %D 2025 %7 7.3.2025 %9 Original Paper %J JMIR Med Educ %G English %X 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. %M 40053774 %R 10.2196/64768 %U https://mededu.jmir.org/2025/1/e64768 %U https://doi.org/10.2196/64768 %U http://www.ncbi.nlm.nih.gov/pubmed/40053774 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 11 %N %P e58100 %T Comparison of an Emergency Medicine Asynchronous Learning Platform Usage Before and During the COVID-19 Pandemic: Retrospective Analysis Study %A Briggs,Blake %A Mulekar,Madhuri %A Morales,Hannah %A Husain,Iltifat %K asynchronous learning %K medical education %K podcast %K COVID-19 %K emergency medicine %K online learning %K engagement %K web-based %K online study %K online class %K videoconferencing %K assessment %K effectiveness %K challenges %K knowledge retention %K performance %K virtual learning %K pre-pandemic %K post-pandemic %D 2025 %7 21.2.2025 %9 %J JMIR Med Educ %G English %X Background: The COVID-19 pandemic challenged medical educators due to social distancing. Podcasts and asynchronous learning platforms help distill medical education in a socially distanced environment. Medical educators interested in providing asynchronous teaching should know how these methods performed during the pandemic. Objective: The purpose of this study was to assess the level of engagement for an emergency medicine (EM) board review podcast and website platform, before and during the COVID-19 pandemic. We measured engagement via website traffic, including such metrics as visits, bounce rate, unique visitors, and page views. We also evaluated podcast analytics, which included total listeners, engaged listeners, and number of plays. Methods: Content was designed after the American Board of EM Model, covering only 1 review question per episode. Website traffic and podcast analytics were studied monthly from 2 time periods of 20 months each, before the pandemic (July 11, 2018, to February 31, 2020) and during the pandemic (May 1, 2020, to December 31, 2021). March and April 2020 data were omitted from the analysis due to variations in closure at various domestic and international locations. Results underwent statistical analysis in March 2022. Results: A total of 132 podcast episodes and 93 handouts were released from July 11, 2018, to December 31, 2021. The mean number of listeners per podcast increased significantly from 2.11 (SD 1.19) to 3.77 (SD 0.76; t test, P<.001), the mean number engaged per podcast increased from 1.72 (SD 1.00) to 3.09 (SD 0.62; t test, P<.001), and the mean number of plays per podcast increased from 42.54 (SD 40.66) to 69.23 (SD 17.54; t test, P=.012). Similarly, the mean number of visits per posting increased from 5.85 (SD 3.28) to 15.39 (SD 3.06; t test, P<.001), the mean number of unique visitors per posting increased from 3.74 (SD 1.83) to 10.41 (SD 2.33; t test, P<.001), and the mean number of page views per posting increased from 17.13 (SD 10.63) to 33.32 (SD 7.01; t test, P<.001). Note that, all measures showed a decrease from November 2021 to December 2021. Conclusions: During the COVID-19 pandemic, there was an increased engagement for our EM board review podcast and website platform over a long-term period, specifically through website visitors and the number of podcast plays. Medical educators should be aware of the increasing usage of web-based education tools, and that asynchronous learning is favorably viewed by learners. Limitations include the inability to view Spotify (Spotify Technology S.A.) analytics during the study period, and confounding factors like increased popularity of social media inadvertently promoting the podcast. %R 10.2196/58100 %U https://mededu.jmir.org/2025/1/e58100 %U https://doi.org/10.2196/58100 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e51939 %T Assessing the Feasibility and Utility of Patient-Specific 3D Advanced Visualization Modeling in Cerebrovascular Disease: Retrospective Analysis and Prospective Survey Pilot Study %A Sarkar,Korak %A Bhimarasetty,Vishal %A Rahim,Abdul %A Curtis,Colin %A Hughes,Kimberly %+ Department of Academics, Ochsner BioDesign Lab, Ochsner Health, 1514 Jefferson Highway, New Orleans, LA, 70119, United States, 1 504 894 2799, korak.sarkar.md@gmail.com %K cerebrovascular disease %K advanced visualization %K 3D modeling %K cerebrovascular %K intracerebral arteriovenous malformations %K artery %K vein %K vessel %K medical extended reality %K 3D printing %K medical simulation %K virtual reality %K augmented reality %K usability %K survey %K stroke %K brain %K cerebral %D 2025 %7 21.2.2025 %9 Original Paper %J JMIR Form Res %G English %X Background: The prevalence, clinical burden, and health care costs (>US $100 billion) associated with cerebrovascular disease (CVD) will increase significantly as the US population grows and ages over the next 25 years. Existing 2D imaging modalities have inherent limitations in visualizing complex CVD, which may be mitigated with the use of patient-specific 3D advanced visualization (AV) technologies. There remain gaps in knowledge, however, regarding how and with what impact these technologies are being used in CVD. Objective: The aim of this study was to characterize the clinical attributes and reported utility associated with the use of 3D AV modeling in CVDs, specifically intracerebral arteriovenous malformations. Methods: This pilot study employs a combination of retrospective analysis and prospective surveys to describe the utilization and utility of patient-specific AV models at a single high-volume certified comprehensive stroke center. Results: From July 2017 to February 2023, 25 AV models were created for 4 different clinicians. The average patient age was 37.4 years; 44% (11/25) of the patients were African Americans, 52% (13/25) were on public insurance, and 56% (14/25) were associated with a neurovascular procedure. In this study, 18 clinicians with diverse experience responded to AV model surveys, with a 92.2% (166/180) completion rate. There was an average reported utility of 8.0 on a 0-10 scale, with higher scores reflecting increased utility. Compared to 2D viewing, AV models allowed staff to appreciate novel abnormal anatomy, and therefore, they would have changed their therapeutic approach in 45% (23/51) of the cases. Conclusions: AV models were used in complex CVDs associated with young, publicly insured individuals requiring resource-intensive interventions. There was strong and diverse clinician engagement with overall report of substantial utility of AV models. Staff clinicians frequently reported novel anatomical and therapeutic insights based on AV models compared to traditional 2D viewing. This study establishes the infrastructure for future larger randomized studies that can be repeated for CVDs or other disease states and incorporate assessments of other AV modalities such as 3D printing and medical extended reality. %M 39983107 %R 10.2196/51939 %U https://formative.jmir.org/2025/1/e51939 %U https://doi.org/10.2196/51939 %U http://www.ncbi.nlm.nih.gov/pubmed/39983107 %0 Journal Article %@ 2564-1891 %I JMIR Publications %V 5 %N %P e58615 %T Assessment of Reliability and Validity of Celiac Disease–Related YouTube Videos: Content Analysis %A Polat,Yunus Halil %A Cankurtaran,Rasim Eren %+ Department of Gastroenterology, Ankara Training and Research Hospital, bağlıca neighbourhood 1336 street no:7/7 Etimesgut, PO:06870, Ankara, 06870, Turkey, 90 5556801815, yunushpolat@gmail.com %K gastroenterology %K celiac %K YouTube %K internet-based information %K medical information %K health-related %K reliability %K validity %K quality %K videos %K celiac sprue %K sprue %K gluten enteropathy %K cross-sectional %D 2025 %7 4.2.2025 %9 Original Paper %J JMIR Infodemiology %G English %X Background: YouTube is an increasingly used platform for medical information. However, the reliability and validity of health-related information on celiac disease (CD) on YouTube have not been determined. Objective: This study aimed to analyze the reliability and validity of CD-related YouTube videos. Methods: On November 15, 2023, a search was performed on YouTube using the keyword “celiac disease.” This search resulted in a selection of videos, which were then reviewed by 2 separate evaluators for content, origin, and specific features. The evaluators assessed the reliability and quality of these videos using a modified DISCERN (mDISCERN) score, the Journal of the American Medical Association (JAMA) benchmark criteria score, the usefulness score, video power index (VPI), and the Global Quality Scale (GQS) score. Results: In the analysis of 120 initially screened CD videos, 85 met the criteria for inclusion in the study after certain videos were excluded based on predefined criteria. While the duration of the videos uploaded by health care professionals was significantly longer than the other group (P=.009), it was concluded that the median scores for mDISCERN (4, IQR 4-5 vs 2, IQR 2-3; P<.001), GQS (4, IQR 4-5 vs 3, IQR 2-3; P<.001), JAMA (4, IQR 3-4 vs 2, IQR 2-3; P<.001), and usefulness (8, IQR 7-9 vs 6, IQR 3-6; P<.001) of the videos from this group were significantly higher than those from non–health care professionals. Video interaction parameters, including the median number of views, views per day, likes, dislikes, comments, and VPI, demonstrated no significant difference between the 2 groups. Conclusions: This study showed that YouTube videos about CD vary significantly in reliability and quality depending on their source. Increasing the production of reliable videos by health care professionals may help to improve patient education and make YouTube a more reliable resource. %M 39756057 %R 10.2196/58615 %U https://infodemiology.jmir.org/2025/1/e58615 %U https://doi.org/10.2196/58615 %U http://www.ncbi.nlm.nih.gov/pubmed/39756057 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e56132 %T Long-Term Knowledge Retention of Biochemistry Among Medical Students in Riyadh, Saudi Arabia: Cross-Sectional Survey %A Mehyar,Nimer %A Awawdeh,Mohammed %A Omair,Aamir %A Aldawsari,Adi %A Alshudukhi,Abdullah %A Alzeer,Ahmed %A Almutairi,Khaled %A Alsultan,Sultan %K biochemistry %K knowledge %K retention %K medical students %K retention interval %K Saudi Arabia %D 2024 %7 16.12.2024 %9 %J JMIR Med Educ %G English %X Background: Biochemistry is a cornerstone of medical education. Its knowledge is integral to the understanding of complex biological processes and how they are applied in several areas in health care. Also, its significance is reflected in the way it informs the practice of medicine, which can guide and help in both diagnosis and treatment. However, the retention of biochemistry knowledge over time remains a dilemma. Long-term retention of such crucial information is extremely important, as it forms the foundation upon which clinical skills are developed and refined. The effectiveness of biochemistry education, and consequently its long-term retention, is influenced by several factors. Educational methods play a critical role; interactional and integrative teaching approaches have been suggested to enhance retention compared with traditional didactic methods. The frequency and context in which biochemistry knowledge is applied in clinical settings can significantly impact its retention. Practical application reinforces theoretical understanding, making the knowledge more accessible in the long term. Prior knowledge (familiarity) of information suggests that it is stored in long-term memory, which makes its retention in the long term easier to recall. Objectives: This investigation was conducted at King Saud bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. The aim of the study is to understand the dynamics of long-term retention of biochemistry among medical students. Specifically, it looks for the association between students’ familiarity with biochemistry content and actual knowledge retention levels. Methods: A cross-sectional correlational survey involving 240 students from King Saud bin Abdulaziz University for Health Sciences was conducted. Participants were recruited via nonprobability convenience sampling. A validated biochemistry assessment tool with 20 questions was used to gauge students’ retention in biomolecules, catalysis, bioenergetics, and metabolism. To assess students’ familiarity with the knowledge content of test questions, each question is accompanied by options that indicate students’ prior knowledge of the content of the question. Statistical analyses tests such as Mann-Whitney U test, Kruskal-Wallis test, and chi-square tests were used. Results: Our findings revealed a significant correlation between students’ familiarity of the content with their knowledge retention in the biomolecules (r=0.491; P<.001), catalysis (r=0.500; P<.001), bioenergetics (r=0.528; P<.001), and metabolism (r=0.564; P<.001) biochemistry knowledge domains. Conclusions: This study highlights the significance of familiarity (prior knowledge) in evaluating the retention of biochemistry knowledge. Although limited in terms of generalizability and inherent biases, the research highlights the crucial significance of student’s familiarity in actual knowledge retention of several biochemistry domains. These results might be used by educators to customize instructional methods in order to improve students’ long-term retention of biochemistry information and boost their clinical performance. %R 10.2196/56132 %U https://mededu.jmir.org/2024/1/e56132 %U https://doi.org/10.2196/56132 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e50389 %T Development of an Interprofessional Education Project in Dentistry Based on the Positive Behavior Support Theory: Pilot Curriculum Development and Validation Study %A Pang,MengWei %A Lu,WeiYu %A Huang,Chuling %A Lin,Meixiu %A Ran,Jiangsheng %A Tang,Xiaomei %A Huang,YuanDing %A Yang,Sheng %A Song,Jinlin %+ College of Stomatology, Chongqing Medical University, No. 426, Songshi North Road, Chongqing, 401147, China, 86 13594327961, songjinlin@hospital.cqmu.edu.cn %K innovative interprofessional education %K dentistry %K dental technology %K positive behavior support %K IPE %K positive behavior %K training system %K dental education %K %D 2024 %7 11.11.2024 %9 Original Paper %J JMIR Form Res %G English %X Background: Effective interprofessional education (IPE) can facilitate teamwork between dentists and dental technicians, thereby enabling the efficient provision of high-quality dental care. Objective: This study aimed to design and assess an IPE module named Project 35, which was offered to dental and dental technology students early in their undergraduate training as a precursor to a more comprehensive IPE curriculum in dentistry and dental technology. Methods: Leveraging positive behavior support (PBS) theory, Project 35 was devised as an innovation and entrepreneurship educational training framework. It used project-based learning to cultivate teamwork skills and to promote the professional development of dental and dental technology students. The pilot study was designed to present the IPE module and preliminarily assess its validity. In survey 1, which was conducted immediately after the course, the dental and dental technology students’ self-reported skill acquisition and attitudes were assessed and compared. Survey 2, conducted 1 year after the course, focused on the comparative benefits of Project 35 training for dental technology students versus an untrained group. Results: A total of 66 students, including 36 dental students and 30 dental technology students who had undertaken the training, were recruited. Project 35 training improved teamwork skills for students in both disciplines comparably, and the students recognized the training as highly valuable and effective. The mean values for all items indicating skills improvement of students ranged from 4.13 (SD 0.797) to 4.63 (SD 0.495) for dental students and from 4.13 (SD 0.869) to 4.74 (SD 0.619) for dental technology students. Among the dental technology students, the trained group showed greater independent and innovative approaches and was more optimistic about the future of the profession than the nontrained group (P<.05). Conclusions: Despite the small sample size, the validity of the Project 35 training system was evident, and the success of our pilot study provides a sound basis for the future development of IPE in clinical dental and dental technology education programs. %M 39527801 %R 10.2196/50389 %U https://formative.jmir.org/2024/1/e50389 %U https://doi.org/10.2196/50389 %U http://www.ncbi.nlm.nih.gov/pubmed/39527801 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e63430 %T ChatGPT-4 Omni Performance in USMLE Disciplines and Clinical Skills: Comparative Analysis %A Bicknell,Brenton T %A Butler,Danner %A Whalen,Sydney %A Ricks,James %A Dixon,Cory J %A Clark,Abigail B %A Spaedy,Olivia %A Skelton,Adam %A Edupuganti,Neel %A Dzubinski,Lance %A Tate,Hudson %A Dyess,Garrett %A Lindeman,Brenessa %A Lehmann,Lisa Soleymani %K large language model %K ChatGPT %K medical education %K USMLE %K AI in medical education %K medical student resources %K educational technology %K artificial intelligence in medicine %K clinical skills %K LLM %K medical licensing examination %K medical students %K United States Medical Licensing Examination %K ChatGPT 4 Omni %K ChatGPT 4 %K ChatGPT 3.5 %D 2024 %7 6.11.2024 %9 %J JMIR Med Educ %G English %X Background: Recent studies, including those by the National Board of Medical Examiners, have highlighted the remarkable capabilities of recent large language models (LLMs) such as ChatGPT in passing the United States Medical Licensing Examination (USMLE). However, there is a gap in detailed analysis of LLM performance in specific medical content areas, thus limiting an assessment of their potential utility in medical education. Objective: This study aimed to assess and compare the accuracy of successive ChatGPT versions (GPT-3.5, GPT-4, and GPT-4 Omni) in USMLE disciplines, clinical clerkships, and the clinical skills of diagnostics and management. Methods: This study used 750 clinical vignette-based multiple-choice questions to characterize the performance of successive ChatGPT versions (ChatGPT 3.5 [GPT-3.5], ChatGPT 4 [GPT-4], and ChatGPT 4 Omni [GPT-4o]) across USMLE disciplines, clinical clerkships, and in clinical skills (diagnostics and management). Accuracy was assessed using a standardized protocol, with statistical analyses conducted to compare the models’ performances. Results: GPT-4o achieved the highest accuracy across 750 multiple-choice questions at 90.4%, outperforming GPT-4 and GPT-3.5, which scored 81.1% and 60.0%, respectively. GPT-4o’s highest performances were in social sciences (95.5%), behavioral and neuroscience (94.2%), and pharmacology (93.2%). In clinical skills, GPT-4o’s diagnostic accuracy was 92.7% and management accuracy was 88.8%, significantly higher than its predecessors. Notably, both GPT-4o and GPT-4 significantly outperformed the medical student average accuracy of 59.3% (95% CI 58.3‐60.3). Conclusions: GPT-4o’s performance in USMLE disciplines, clinical clerkships, and clinical skills indicates substantial improvements over its predecessors, suggesting significant potential for the use of this technology as an educational aid for medical students. These findings underscore the need for careful consideration when integrating LLMs into medical education, emphasizing the importance of structured curricula to guide their appropriate use and the need for ongoing critical analyses to ensure their reliability and effectiveness. %R 10.2196/63430 %U https://mededu.jmir.org/2024/1/e63430 %U https://doi.org/10.2196/63430 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e51173 %T A Pilot Project to Promote Research Competency in Medical Students Through Journal Clubs: Mixed Methods Study %A Karabacak,Mert %A Ozcan,Zeynep %A Ozkara,Burak Berksu %A Furkan,Zeynep Sude %A Bisdas,Sotirios %K medical student %K research %K peer education %K student society %K journal club %K skills %K scientific investigation %K undergraduate %K student-led %K initiative %K resources %K research training %K competency %K continuing education %K research improvement %K motivation %K mentor %K mentorship %K medical education %D 2024 %7 31.10.2024 %9 %J JMIR Med Educ %G English %X Background: Undergraduate medical students often lack hands-on research experience and fundamental scientific research skills, limiting their exposure to the practical aspects of scientific investigation. The Cerrahpasa Neuroscience Society introduced a program to address this deficiency and facilitate student-led research. Objective: The primary goal of this initiative was to enhance medical students’ research output by enabling them to generate and publish peer-reviewed papers within the framework of this pilot project. The project aimed to provide an accessible, global model for research training through structured journal clubs, mentorship from experienced peers, and resource access. Methods: In January 2022, a total of 30 volunteer students from various Turkish medical schools participated in this course-based undergraduate research experience program. Students self-organized into 2 groups according to their preferred study type: original research or systematic review. Two final-year students with prior research experience led the project, developing training modules using selected materials. The project was implemented entirely online, with participants completing training modules before using their newly acquired theoretical knowledge to perform assigned tasks. Results: Based on student feedback, the project timeline was adjusted to allow for greater flexibility in meeting deadlines. Despite these adjustments, participants successfully completed their tasks, applying the theoretical knowledge they had gained to their respective assignments. As of April 2024, the initiative has culminated in 3 published papers and 3 more under peer review. The project has also seen an increase in student interest in further involvement and self-paced learning. Conclusions: This initiative leverages globally accessible resources for research training, effectively fostering research competency among participants. It has successfully demonstrated the potential for undergraduates to contribute to medical research output and paved the way for a self-sustaining, student-led research program. Despite some logistical challenges, the project provided valuable insights for future implementations, showcasing the potential for students to engage in meaningful, publishable research. %R 10.2196/51173 %U https://mededu.jmir.org/2024/1/e51173 %U https://doi.org/10.2196/51173 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e54112 %T Transforming the Future of Digital Health Education: Redesign of a Graduate Program Using Competency Mapping %A Mun,Michelle %A Chanchlani,Sonia %A Lyons,Kayley %A Gray,Kathleen %K digital health %K digital transformation %K health care %K clinical informatics %K competencies %K graduate education %D 2024 %7 31.10.2024 %9 %J JMIR Med Educ %G English %X Digital transformation has disrupted many industries but is yet to revolutionize health care. Educational programs must be aligned with the reality that goes beyond developing individuals in their own professions, professionals wishing to make an impact in digital health will need a multidisciplinary understanding of how business models, organizational processes, stakeholder relationships, and workforce dynamics across the health care ecosystem may be disrupted by digital health technology. This paper describes the redesign of an existing postgraduate program, ensuring that core digital health content is relevant, pedagogically sound, and evidence-based, and that the program provides learning and practical application of concepts of the digital transformation of health. Existing subjects were mapped to the American Medical Informatics Association Clinical Informatics Core Competencies, followed by consultation with leadership to further identify gaps or opportunities to revise the course structure. New additions of core and elective subjects were proposed to align with the competencies. Suitable electives were chosen based on stakeholder feedback and a review of subjects in fields relevant to digital transformation of health. The program was revised with a new title, course overview, course intended learning outcomes, reorganizing of core subjects, and approval of new electives, adding to a suite of professional development offerings and forming a structured pathway to further qualification. Programs in digital health must move beyond purely informatics-based competencies toward enabling transformational change. Postgraduate program development in this field is possible within a short time frame with the use of established competency frameworks and expert and student consultation. %R 10.2196/54112 %U https://mededu.jmir.org/2024/1/e54112 %U https://doi.org/10.2196/54112 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e52924 %T A SIMBA CoMICs Initiative to Cocreating and Disseminating Evidence-Based, Peer-Reviewed Short Videos on Social Media: Mixed Methods Prospective Study %A Elhariry,Maiar %A Malhotra,Kashish %A Goyal,Kashish %A Bardus,Marco %A Team,SIMBA and CoMICs %A Kempegowda,Punith %+ Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom, 44 7721930777, p.kempegowda@bham.ac.uk %K influencers %K social media %K public engagement %K apps %K healthcare %K medical students %K online medical information %K simulation %K peer-reviewed information %D 2024 %7 30.10.2024 %9 Original Paper %J JMIR Med Educ %G English %X 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. %M 39475500 %R 10.2196/52924 %U https://mededu.jmir.org/2024/1/e52924 %U https://doi.org/10.2196/52924 %U http://www.ncbi.nlm.nih.gov/pubmed/39475500 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e64125 %T 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 %A Carrillo,Irene %A Skoumalová,Ivana %A Bruus,Ireen %A Klemm,Victoria %A Guerra-Paiva,Sofia %A Knežević,Bojana %A Jankauskiene,Augustina %A Jocic,Dragana %A Tella,Susanna %A Buttigieg,Sandra C %A Srulovici,Einav %A Madarasová Gecková,Andrea %A Põlluste,Kaja %A Strametz,Reinhard %A Sousa,Paulo %A Odalovic,Marina %A Mira,José Joaquín %+ Department of Health Psychology, Miguel Hernández University of Elche, Avenida de la Universidad s/n, Elche, 03202, Spain, 34 966658350, icarrillo@umh.es %K psychological safety %K speaking up %K professional competence %K patient safety %K education %K adverse event %D 2024 %7 7.10.2024 %9 Original Paper %J JMIR Med Educ %G English %X 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. %M 39374073 %R 10.2196/64125 %U https://mededu.jmir.org/2024/1/e64125 %U https://doi.org/10.2196/64125 %U http://www.ncbi.nlm.nih.gov/pubmed/39374073 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e52533 %T Preuniversity Students' Perceptions and Attitudes About an Anatomy and Physiology Outreach Program: Survey Study and Inductive Thematic Analysis %A Vallabhajosyula,Ranganath %A Perumal,Vivek %A Chandrasekaran,Ramya %A Mogali,Sreenivasulu Reddy %+ Department of Anatomy, Lee Kong Chian School of Medicine, Nanyang Technological University, 11, Mandalay Road, Singapore, 308232, Singapore, 65 94455527, sreenivasulu.reddy@ntu.edu.sg %K anatomy %K physiology %K educational outreach %K preuniversity outreach %K team-based learning %K anatomy workshop %K medical education %K health profession education %K health professions %K health care careers %K student %K students %K outreach activity %K physiological %K school %K university %K Singapore %K thematic analysis %K learning %K education %K motivation %K health care %K health profession %K medical school %D 2024 %7 12.8.2024 %9 Original Paper %J JMIR Form Res %G English %X Background: Science and health outreach activities are aimed at motivating and sparking interest among prospective students to pursue careers in these fields; however, research studies supporting this hypothesis are limited. Objective: The aim of our study was to organize an integrated Anatomy and Physiology outreach to examine preuniversity students’ learning experiences (learning tools, activities, and facilitators) and motivation to pursue a career in health care and to gather evidence on their attitudes and perceptions of such activities. Methods: A 2-day course on cardiorespiratory and gastrointestinal anatomical systems was presented at the Lee Kong Chian School of Medicine in Singapore using its key pedagogies, that is, multimodal practical and team-based learning. Ninety preuniversity students from 21 preuniversity institutions in Singapore participated in this 2-day course, and their experiences were evaluated using a 4-point Likert scale and open-ended survey questions. Free-text comments were analyzed using inductive thematic analysis. Results: The survey using the 4-point Likert scale was completed by 81 (92%) of the 88 participants. Most students felt that the course materials were adequate (mean 3.57, SD 0.57) and met the learning objectives (mean 3.73, SD 0.52). The students felt that the instructors were clear (mean 3.73, SD 0.52) and effective (mean 3.70, SD 0.53). They liked the organization of the outreach session (mean 3.64, SD 0.48) and were highly motivated to study medicine or allied/biomedical sciences (mean 3.69, SD 0.54). Practical and team-based learning were regarded as exceedingly satisfactory (mean 3.63, SD 0.53 and mean 3.58, SD 0.54, respectively). All the respondents said that they would recommend this course to peers. Thematic analysis revealed that the participants gained a new perspective of the human body structure and function, they liked the unique learning settings, they were motivated to pursue a career in health care, they were satisfied with the sessions, and interactions with the facilitators increased their understanding of the human anatomy and physiology. Conclusions: Structured health outreach activities provide students with unique opportunities to experience a preclinical learning environment in a medical school, deepen their understanding of human body structure and function, and increase their motivation and interest in science. Further, outreach programs may lay the foundations for potential students aiming to pursue health profession education. %M 39133908 %R 10.2196/52533 %U https://formative.jmir.org/2024/1/e52533 %U https://doi.org/10.2196/52533 %U http://www.ncbi.nlm.nih.gov/pubmed/39133908 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e50667 %T Identifying Learning Preferences and Strategies in Health Data Science Courses: Systematic Review %A Rohani,Narjes %A Sowa,Stephen %A Manataki,Areti %+ Usher Institute, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, United Kingdom, 44 131 650 3, Narjes.rohani@ed.ac.uk %K health data science %K bioinformatics %K learning approach %K learning preference %K learning tactic %K learning strategy %K interdisciplinary %K systematic review %K medical education %D 2024 %7 12.8.2024 %9 Review %J JMIR Med Educ %G English %X 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. %M 39133909 %R 10.2196/50667 %U https://mededu.jmir.org/2024/1/e50667 %U https://doi.org/10.2196/50667 %U http://www.ncbi.nlm.nih.gov/pubmed/39133909 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e51740 %T How to Develop an Online Video for Teaching Health Procedural Skills: Tutorial for Health Educators New to Video Production %A Srinivasa,Komal %A Charlton,Amanda %A Moir,Fiona %A Goodyear-Smith,Felicity %+ Department of General Practice & Primary Health Care, The University of Auckland, Private Bag 92019, Auckland, 1010, New Zealand, 64 9 923 1975, komal.srinivasa@auckland.ac.nz %K online video %K developing video %K procedural video %K medical education %K clinician educator %K health education %D 2024 %7 7.8.2024 %9 Tutorial %J JMIR Med Educ %G English %X Background: Clinician educators are experts in procedural skills that students need to learn. Some clinician educators are interested in creating their own procedural videos but are typically not experts in video production, and there is limited information on this topic in the clinical education literature. Therefore, we present a tutorial for clinician educators to develop a procedural video. Objective: We describe the steps needed to develop a medical procedural video from the perspective of a clinician educator new to creating videos, informed by best practices as evidenced by the literature. We also produce a checklist of elements that ensure a quality video. Finally, we identify the barriers and facilitators to making such a video. Methods: We used the example of processing a piece of skeletal muscle in a pathology laboratory to make a video. We developed the video by dividing it into 3 phases: preproduction, production, and postproduction. After writing the learning outcomes, we created a storyboard and script, which were validated by subject matter and audiovisual experts. Photos and videos were captured on a digital camera mounted on a monopod. Video editing software was used to sequence the video clips and photos, insert text and audio narration, and generate closed captions. The finished video was uploaded to YouTube (Google) and then inserted into open-source authoring software to enable an interactive quiz. Results: The final video was 4 minutes and 4 seconds long and took 70 hours to create. The final video included audio narration, closed captioning, bookmarks, and an interactive quiz. We identified that an effective video has six key factors: (1) clear learning outcomes, (2) being engaging, (3) being learner-centric, (4) incorporating principles of multimedia learning, (5) incorporating adult learning theories, and (6) being of high audiovisual quality. To ensure educational quality, we developed a checklist of elements that educators can use to develop a video. One of the barriers to creating procedural videos for a clinician educator who is new to making videos is the significant time commitment to build videography and editing skills. The facilitators for developing an online video include creating a community of practice and repeated skill-building rehearsals using simulations. Conclusions: We outlined the steps in procedural video production and developed a checklist of quality elements. These steps and the checklist can guide a clinician educator in creating a quality video while recognizing the time, technical, and cognitive requirements. %M 39110488 %R 10.2196/51740 %U https://mededu.jmir.org/2024/1/e51740 %U https://doi.org/10.2196/51740 %U http://www.ncbi.nlm.nih.gov/pubmed/39110488 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 12 %N %P e40545 %T Variation in Experiences and Attainment in Surgery Between Ethnicities of UK Medical Students and Doctors (ATTAIN): Protocol for a Cross-Sectional Study %A Babiker,Samar %A Ogunmwonyi,Innocent %A Georgi,Maria W %A Tan,Lawrence %A Haque,Sharmi %A Mullins,William %A Singh,Prisca %A Ang,Nadya %A Fu,Howell %A Patel,Krunal %A Khera,Jevan %A Fricker,Monty %A Fleming,Simon %A Giwa-Brown,Lolade %A A Brennan,Peter %A Irune,Ekpemi %A Vig,Stella %A Nathan,Arjun %+ University College London Medical School, Goodge Street, London, WC1E 6BT, United Kingdom, 44 07578636123, maria.georgi@icloud.com %K diversity in surgery %K Black and Minority Ethnic %K BME in surgery %K differential attainment %K diversity %K surgery %K health care system %K surgical training %K disparity %K ethnic disparity %K ethnicity %K medical student %K doctor %K training experience %K surgical placements %K physician %K health care provider %K experience %K perception %K cross-sectional %K doctor in training %K resident %K fellow %K fellowship %K questionnaire %K survey %K Everyday Discrimination Scale %K Maslach Burnout Inventory %K Higher Education %K ethnicities %D 2023 %7 16.6.2023 %9 Protocol %J JMIR Res Protoc %G English %X Background: The unequal distribution of academic and professional outcomes between different minority groups is a pervasive issue in many fields, including surgery. The implications of differential attainment remain significant, not only for the individuals affected but also for the wider health care system. An inclusive health care system is crucial in meeting the needs of an increasingly diverse patient population, thereby leading to better outcomes. One barrier to diversifying the workforce is the differential attainment in educational outcomes between Black and Minority Ethnic (BME) and White medical students and doctors in the United Kingdom. BME trainees are known to have lower performance rates in medical examinations, including undergraduate and postgraduate exams, Annual Review of Competence Progression, as well as training and consultant job applications. Studies have shown that BME candidates have a higher likelihood of failing both parts of the Membership of the Royal Colleges of Surgeons exams and are 10% less likely to be considered suitable for core surgical training. Several contributing factors have been identified; however, there has been limited evidence investigating surgical training experiences and their relationship to differential attainment. To understand the nature of differential attainment in surgery and to develop effective strategies to address it, it is essential to examine the underlying causes and contributing factors. The Variation in Experiences and Attainment in Surgery Between Ethnicities of UK Medical Students and Doctors (ATTAIN) study aims to describe and compare the factors and outcomes of attainment between different ethnicities of doctors and medical students. Objective: The primary aim will be to compare the effect of experiences and perceptions of surgical education of students and doctors of different ethnicities. Methods: This protocol describes a nationwide cross-sectional study of medical students and nonconsultant grade doctors in the United Kingdom. Participants will complete a web-based questionnaire collecting data on experiences and perceptions of surgical placements as well as self-reported academic attainment data. A comprehensive data collection strategy will be used to collect a representative sample of the population. A set of surrogate markers relevant to surgical training will be used to establish a primary outcome to determine variations in attainment. Regression analyses will be used to identify potential causes for the variation in attainment. Results: Data collected between February 2022 and September 2022 yielded 1603 respondents. Data analysis is yet to be competed. The protocol was approved by the University College London Research Ethics Committee on September 16, 2021 (ethics approval reference 19071/004). The findings will be disseminated through peer-reviewed publications and conference presentations. Conclusions: Drawing upon the conclusions of this study, we aim to make recommendations on educational policy reforms. Additionally, the creation of a large, comprehensive data set can be used for further research. International Registered Report Identifier (IRRID): DERR1-10.2196/40545 %M 37327055 %R 10.2196/40545 %U https://www.researchprotocols.org/2023/1/e40545 %U https://doi.org/10.2196/40545 %U http://www.ncbi.nlm.nih.gov/pubmed/37327055 %0 Journal Article %@ 1929-073X %I JMIR Publications %V 12 %N %P e42060 %T Intervention for Intraoperative Teaching in Anesthesiology Using Weekly Keyword Program: Development and Usability Study %A Tewfik,George %A Naftalovich,Rotem %A Rodriguez-Aponte,Carlos %A Ezzat,Bishoy %+ Rutgers New Jersey Medical School, 185 South Orange Ave, Newark, NJ, 07103, United States, 1 908 868 4292, glt31@njms.rutgers.edu %K resident teaching %K intraoperative teaching %K educational strategies %K teaching %K anesthesiology %K education %K efficacy %K survey %K electronic %K medical residents %K operation %D 2023 %7 18.5.2023 %9 Original Paper %J Interact J Med Res %G English %X Background: Learning in the operating room (OR) for residents in anesthesiology is difficult but essential for successful resident education. Numerous approaches have been attempted in the past to varying degrees of success, with efficacy often judged afterward using surveys distributed to participants. The OR presents a particularly complex set of challenges for academic faculty due to the pressures required by concurrent patient care, production pressures, and a noisy environment. Often, educational reviews in ORs are personnel specific, and instruction may or may not take place in this setting, as it is left to the discretion of the parties without regular direction. Objective: This study aims to determine if a structured intraoperative keyword training program could be used to implement a curriculum to improve teaching in the OR and to facilitate impactful discussion between residents and faculty. A structured curriculum was chosen to allow for the standardization of the educational material to be studied and reviewed by faculty and trainees. Given the reality that educational reviews in the OR tend to be personnel specific and are often focused on the clinical cases of the day, this initiative sought to increase both the time and efficiency of learning interactions between learners and teachers in the stressful environment of the OR. Methods: The American Board of Anesthesiology keywords from the Open Anesthesia website were used to construct a weekly intraoperative didactic curriculum, which was distributed by email to all residents and faculty. A weekly worksheet from this curriculum included 5 keywords with associated questions for discussion. The residents and faculty were instructed to complete these questions on a weekly basis. After 2 years, an electronic survey was distributed to the residents to evaluate the efficacy of the keyword program. Results: A total of 19 teaching descriptors were polled for participants prior to and following the use of the intraoperative keyword program to assess the efficacy of the structured curriculum. The survey results showed no improvement in intraoperative teaching based on respondent perception, despite a slight improvement in teaching time, though this was statistically insignificant. The respondents reported some favorable aspects of the program, including the use of a set curriculum, suggesting that greater structure may be beneficial to facilitate more effective intraoperative teaching in anesthesiology. Conclusions: Although learning is difficult in the OR for residents, the use of a formalized didactic curriculum, centered on daily keywords, does not appear to be a useful solution for residents and faculty. Further efforts are required to improve intraoperative teaching, which is well known to be a difficult endeavor for both teachers and trainees. A structured curriculum may be used to augment other educational modalities to improve the overall intraoperative teaching for anesthesia residents. %M 37200082 %R 10.2196/42060 %U https://www.i-jmr.org/2023/1/e42060 %U https://doi.org/10.2196/42060 %U http://www.ncbi.nlm.nih.gov/pubmed/37200082 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e43190 %T Feasibility and Acceptability of a US National Telemedicine Curriculum for Medical Students and Residents: Multi-institutional Cross-sectional Study %A Bajra,Rika %A Frazier,Winfred %A Graves,Lisa %A Jacobson,Katherine %A Rodriguez,Andres %A Theobald,Mary %A Lin,Steven %+ Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, 211 Quarry Road, Suite 405, MC 5985, Palo Alto, CA, 94304, United States, 1 650 725 7966, stevenlin@stanford.edu %K curriculum %K distance education %K graduate medical education %K telemedicine %K undergraduate medical education %D 2023 %7 8.5.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: Telemedicine use increased as a response to health care delivery changes necessitated by the COVID-19 pandemic. However, lack of standardized curricular content creates gaps and inconsistencies in effectively integrating telemedicine training at both the undergraduate medical education and graduate medical education levels. Objective: This study evaluated the feasibility and acceptability of a web-based national telemedicine curriculum developed by the Society of Teachers of Family Medicine for medical students and family medicine (FM) residents. Based on the Association of American Medical Colleges telehealth competencies, the asynchronous curriculum featured 5 self-paced modules; covered topics include evidence-based telehealth uses, best practices in communication and remote physical examinations, technology requirements and documentation, access and equity in telehealth delivery, and the promise and potential perils of emerging technologies. Methods: A total of 17 medical schools and 17 FM residency programs implemented the curriculum between September 1 and December 31, 2021. Participating sites represented 25 states in all 4 US census regions with balanced urban, suburban, and rural settings. A total of 1203 learners, including 844 (70%) medical students and 359 (30%) FM residents, participated. Outcomes were measured through self-reported 5-point Likert scale responses. Results: A total of 92% (1101/1203) of learners completed the entire curriculum. Across the modules, 78% (SD 3%) of participants agreed or strongly agreed that they gained new knowledge, skills, or attitudes that will help them in their training or career; 87% (SD 4%) reported that the information presented was at the right level for them; 80% (SD 2%) reported that the structure of the modules was effective; and 78% (SD 3%) agreed or strongly agreed that they were satisfied. Overall experience using the national telemedicine curriculum did not differ significantly between medical students and FM residents on binary analysis. No consistent statistically significant relationships were found between participants’ responses and their institution’s geographic region, setting, or previous experience with a telemedicine curriculum. Conclusions: Both undergraduate medical education and graduate medical education learners, represented by diverse geographic regions and institutions, indicated that the curriculum was broadly acceptable and effective. %M 37155241 %R 10.2196/43190 %U https://mededu.jmir.org/2023/1/e43190 %U https://doi.org/10.2196/43190 %U http://www.ncbi.nlm.nih.gov/pubmed/37155241 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e38377 %T A Web Tool to Help Counter the Spread of Misinformation and Fake News: Pre-Post Study Among Medical Students to Increase Digital Health Literacy %A Moretti,Valentina %A Brunelli,Laura %A Conte,Alessandro %A Valdi,Giulia %A Guelfi,Maria Renza %A Masoni,Marco %A Anelli,Filippo %A Arnoldo,Luca %+ Dipartimento di Area Medica, Università degli Studi di Udine, via Colugna 50, Udine, 33100, Italy, 39 0432554768, laura.brunelli@uniud.it %K infodemic %K fake news %K education %K digital health literacy %K medical education %K medical student %K health information %K social media %K health literacy %K online learning %K digital education %K COVID-19 %D 2023 %7 18.4.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: The COVID-19 pandemic was accompanied by the spread of uncontrolled health information and fake news, which also quickly became an infodemic. Emergency communication is a challenge for public health institutions to engage the public during disease outbreaks. Health professionals need a high level of digital health literacy (DHL) to cope with difficulties; therefore, efforts should be made to address this issue starting from undergraduate medical students. Objective: The aim of this study was to investigate the DHL skills of Italian medical students and the effectiveness of an informatics course offered by the University of Florence (Italy). This course focuses on assessing the quality of medical information using the “dottoremaeveroche” (DMEVC) web resource offered by the Italian National Federation of Orders of Surgeons and Dentists, and on health information management. Methods: A pre-post study was conducted at the University of Florence between November and December 2020. First-year medical students participated in a web-based survey before and after attending the informatics course. The DHL level was self-assessed using the eHealth Literacy Scale for Italy (IT-eHEALS) tool and questions about the features and quality of the resources. All responses were rated on a 5-point Likert scale. Change in the perception of skills was assessed using the Wilcoxon test. Results: A total of 341 students participated in the survey at the beginning of the informatics course (women: n=211, 61.9%; mean age 19.8, SD 2.0) and 217 of them (64.2%) completed the survey at the end of the course. At the first assessment, the DHL level was moderate, with a mean total score of the IT-eHEALS of 2.9 (SD 0.9). Students felt confident about finding health-related information on the internet (mean score of 3.4, SD 1.1), whereas they doubted the usefulness of the information they received (mean score of 2.0, SD 1.0). All scores improved significantly in the second assessment. The overall mean score of the IT-eHEALS significantly increased (P<.001) to 4.2 (SD 0.6). The item with the highest score related to recognizing the quality of health information (mean score of 4.5, SD 0.7), whereas confidence in the practical application of the information received remained the lowest (mean of 3.7, SD 1.1) despite improvement. Almost all students (94.5%) valued the DMEVC as an educational tool. Conclusions: The DMEVC tool was effective in improving medical students’ DHL skills. Effective tools and resources such as the DMEVC website should be used in public health communication to facilitate access to validated evidence and understanding of health recommendations. %M 36996010 %R 10.2196/38377 %U https://mededu.jmir.org/2023/1/e38377 %U https://doi.org/10.2196/38377 %U http://www.ncbi.nlm.nih.gov/pubmed/36996010 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 4 %P e37730 %T Google Images Search Results as a Resource in the Anatomy Laboratory: Rating of Educational Value %A Wink,Alexandra Elisabeth %A Telfer,Amanda N %A Pascoe,Michael A %+ Division of Translational Anatomy, Department of Radiology, UMass Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, United States, 1 508 856 6920, alexandra.wink@umassmed.edu %K anatomy laboratory %K information literacy %K internet search %K anatomical images %K scoring rubric %K Google %K images %K educational value %K literacy information %K medical education %K medical students %K anatomy %D 2022 %7 21.10.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: Preclinical medical learners are embedded in technology-rich environments, allowing them rapid access to a large volume of information. The anatomy laboratory is an environment in which faculty can assess the development of professional skills such as information literacy in preclinical medical learners. In the anatomy laboratory, many students use Google Images searches in addition to or in place of other course materials as a resource to locate and identify anatomical structures. However, the most frequent sources as well as the educational quality of these images are unknown. Objective: This study was designed to assess the sources and educational value of Google Images search results for commonly searched anatomical structures. Methods: The top 10 Google Images search results were collected for 39 anatomical structures. Image source websites were recorded and categorized based on the purpose and target audience of the site publishing the image. Educational value was determined through assessment of relevance (is the searched structure depicted in the image?), accuracy (does the image contain errors?), and usefulness (will the image assist a learner in locating the structure on an anatomical donor?). A reliable scoring rubric was developed to assess an image’s usefulness. Results: A total of 390 images were analyzed. Most often, images were sourced from websites targeting health care professionals and health care professions students (38% of images), while Wikipedia was the most frequent single source of image results (62/390 results). Of the 390 total images, 363 (93.1%) depicted the searched structure and were therefore considered relevant. However, only 43.0% (156/363) of relevant images met the threshold to be deemed useful in identifying the searched structure in an anatomical donor. The usefulness of images did not significantly differ across source categories. Conclusions: Anatomy faculty may use these results to develop interventions for gaps in information literacy in preclinical medical learners in the context of image searches in the anatomy laboratory. %M 36269663 %R 10.2196/37730 %U https://mededu.jmir.org/2022/4/e37730 %U https://doi.org/10.2196/37730 %U http://www.ncbi.nlm.nih.gov/pubmed/36269663 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 24 %N 5 %P e38508 %T A Short Intervention and an Interactive e-Learning Module to Motivate Medical and Dental Students to Enlist as First Responders: Implementation Study %A Taramarcaz,Victor %A Herren,Tara %A Golay,Eric %A Regard,Simon %A Martin-Achard,Sébastien %A Mach,Francois %A Schnetzler,Nicolas %A Ricci,Gaëtan %A Zamberg,Ido %A Larribau,Robert %A Niquille,Marc %A Suppan,Mélanie %A Schiffer,Eduardo %A Suppan,Laurent %+ Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, Geneva, 1211, Switzerland, 41 223723311, laurent.suppan@hcuge.ch %K basic life support %K cardiopulmonary resuscitation %K first responder %K undergraduate medical education %K out-of-hospital cardiac arrest %K medical education %K e-learning %K digital education %K medical student %K blended learning %D 2022 %7 18.5.2022 %9 Original Paper %J J Med Internet Res %G English %X 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 %M 35583927 %R 10.2196/38508 %U https://www.jmir.org/2022/5/e38508 %U https://doi.org/10.2196/38508 %U http://www.ncbi.nlm.nih.gov/pubmed/35583927 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 2 %P e34042 %T Digital Health and Learning in Speech-Language Pathology, Phoniatrics, and Otolaryngology: Survey Study for Designing a Digital Learning Toolbox App %A Lin,Yuchen %A Lemos,Martin %A Neuschaefer-Rube,Christiane %+ Clinic for Phoniatrics, Pedaudiology & Communication Disorders, University Hospital and Medical Faculty, Rheinisch-Westfaelische Technische Hochschule Aachen, Pauwelsstrasse 30, Aachen, 52074, Germany, 49 241 80 88954, yuchen.lin@rwth-aachen.de %K digital learning %K mLearning %K mHealth %K speech-language pathology %K phoniatrics %K otolaryngology %K communication disorders %K mobile phone %D 2022 %7 27.4.2022 %9 Original Paper %J JMIR Med Educ %G English %X 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: Logopäd*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. %M 35475980 %R 10.2196/34042 %U https://mededu.jmir.org/2022/2/e34042 %U https://doi.org/10.2196/34042 %U http://www.ncbi.nlm.nih.gov/pubmed/35475980 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 10 %N 12 %P e33695 %T Harnessing Innovative Technologies to Train Nurses in Suicide Safety Planning With Hospitalized Patients: Protocol for Formative and Pilot Feasibility Research %A Darnell,Doyanne %A Areán,Patricia A %A Dorsey,Shannon %A Atkins,David C %A Tanana,Michael J %A Hirsch,Tad %A Mooney,Sean D %A Boudreaux,Edwin D %A Comtois,Katherine Anne %+ Department of Psychiatry & Behavioral Sciences, University of Washington, 325 Ninth Avenue, Box 359911, Seattle, WA, 98104, United States, 1 206 744 9108, darnelld@uw.edu %K suicide prevention %K hospital %K training %K e-learning %K artificial intelligence %K implementation science %K user-centered design %K task-shifting %K quality assessment %K fidelity %D 2021 %7 15.12.2021 %9 Protocol %J JMIR Res Protoc %G English %X Background: Suicide is the 10th leading cause of death in the United States, with >47,000 deaths in 2019. Most people who died by suicide had contact with the health care system in the year before their death. Health care provider training is a top research priority identified by the National Action Alliance for Suicide Prevention; however, evidence-based approaches that target skill-building are resource intensive and difficult to implement. Advances in artificial intelligence technology hold promise for improving the scalability and sustainability of training methods, as it is now possible for computers to assess the intervention delivery skills of trainees and provide feedback to guide skill improvements. Much remains to be known about how best to integrate these novel technologies into continuing education for health care providers. Objective: In Project WISE (Workplace Integrated Support and Education), we aim to develop e-learning training in suicide safety planning, enhanced with novel skill-building technologies that can be integrated into the routine workflow of nurses serving patients hospitalized for medical or surgical reasons or traumatic injury. The research aims include identifying strategies for the implementation and workflow integration of both the training and safety planning with patients, adapting 2 existing technologies to enhance general counseling skills for use in suicide safety planning (a conversational agent and an artificial intelligence–based feedback system), observing training acceptability and nurse engagement with the training components, and assessing the feasibility of recruitment, retention, and collection of longitudinal self-report and electronic health record data for patients identified as at risk of suicide. Methods: Our developmental research includes qualitative and observational methods to explore the implementation context and technology usability, formative evaluation of the training paradigm, and pilot research to assess the feasibility of conducting a future cluster randomized pragmatic trial. The trial will examine whether patients hospitalized for medical or surgical reasons or traumatic injury who are at risk of suicide have better suicide-related postdischarge outcomes when admitted to a unit with nurses trained using the skill-building technology than those admitted to a unit with untrained nurses. The research takes place at a level 1 trauma center, which is also a safety-net hospital and academic medical center. Results: Project WISE was funded in July 2019. As of September 2021, we have completed focus groups and usability testing with 27 acute care and 3 acute and intensive care nurses. We began data collection for research aims 3 and 4 in November 2021. All research has been approved by the University of Washington institutional review board. Conclusions: Project WISE aims to further the national agenda to improve suicide prevention in health care settings by training nurses in suicide prevention with medically hospitalized patients using novel e-learning technologies. International Registered Report Identifier (IRRID): DERR1-10.2196/33695 %M 34914618 %R 10.2196/33695 %U https://www.researchprotocols.org/2021/12/e33695 %U https://doi.org/10.2196/33695 %U http://www.ncbi.nlm.nih.gov/pubmed/34914618 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 4 %P e31043 %T Artificial Intelligence Education Programs for Health Care Professionals: Scoping Review %A Charow,Rebecca %A Jeyakumar,Tharshini %A Younus,Sarah %A Dolatabadi,Elham %A Salhia,Mohammad %A Al-Mouaswas,Dalia %A Anderson,Melanie %A Balakumar,Sarmini %A Clare,Megan %A Dhalla,Azra %A Gillan,Caitlin %A Haghzare,Shabnam %A Jackson,Ethan %A Lalani,Nadim %A Mattson,Jane %A Peteanu,Wanda %A Tripp,Tim %A Waldorf,Jacqueline %A Williams,Spencer %A Tavares,Walter %A Wiljer,David %+ University Health Network, 190 Elizabeth Street, R. Fraser Elliott Building RFE 3S-441, Toronto, ON, M5G 2C4, Canada, 1 416 340 4800 ext 6322, david.wiljer@uhn.ca %K machine learning %K deep learning %K health care providers %K education %K learning %K patient care %D 2021 %7 13.12.2021 %9 Review %J JMIR Med Educ %G English %X Background: As the adoption of artificial intelligence (AI) in health care increases, it will become increasingly crucial to involve health care professionals (HCPs) in developing, validating, and implementing AI-enabled technologies. However, because of a lack of AI literacy, most HCPs are not adequately prepared for this revolution. This is a significant barrier to adopting and implementing AI that will affect patients. In addition, the limited existing AI education programs face barriers to development and implementation at various levels of medical education. Objective: With a view to informing future AI education programs for HCPs, this scoping review aims to provide an overview of the types of current or past AI education programs that pertains to the programs’ curricular content, modes of delivery, critical implementation factors for education delivery, and outcomes used to assess the programs’ effectiveness. Methods: After the creation of a search strategy and keyword searches, a 2-stage screening process was conducted by 2 independent reviewers to determine study eligibility. When consensus was not reached, the conflict was resolved by consulting a third reviewer. This process consisted of a title and abstract scan and a full-text review. The articles were included if they discussed an actual training program or educational intervention, or a potential training program or educational intervention and the desired content to be covered, focused on AI, and were designed or intended for HCPs (at any stage of their career). Results: Of the 10,094 unique citations scanned, 41 (0.41%) studies relevant to our eligibility criteria were identified. Among the 41 included studies, 10 (24%) described 13 unique programs and 31 (76%) discussed recommended curricular content. The curricular content of the unique programs ranged from AI use, AI interpretation, and cultivating skills to explain results derived from AI algorithms. The curricular topics were categorized into three main domains: cognitive, psychomotor, and affective. Conclusions: This review provides an overview of the current landscape of AI in medical education and highlights the skills and competencies required by HCPs to effectively use AI in enhancing the quality of care and optimizing patient outcomes. Future education efforts should focus on the development of regulatory strategies, a multidisciplinary approach to curriculum redesign, a competency-based curriculum, and patient-clinician interaction. %M 34898458 %R 10.2196/31043 %U https://mededu.jmir.org/2021/4/e31043 %U https://doi.org/10.2196/31043 %U http://www.ncbi.nlm.nih.gov/pubmed/34898458 %0 Journal Article %@ 2292-9495 %I JMIR Publications %V 8 %N 4 %P e27171 %T Communicating Guideline Recommendations Using Graphic Narrative Versus Text-Based Broadcast Screensavers: Design and Implementation Study %A Sinnenberg,Lauren %A Umscheid,Craig A %A Shofer,Frances S %A Leri,Damien %A Meisel,Zachary F %+ Center for Emergency Care Policy and Research, University of Pennsylvania, Ravdin Ground, 3400 Spruce Street, Philadelphia, PA, 19104, United States, 1 215 746 5618, zfm@pennmedicine.upenn.edu %K medical informatics %K screensaver %K guideline dissemination %K graphic narratives %K health communication %K workstation %K clinical workstation %K guidelines %K medical education %K education %D 2021 %7 13.12.2021 %9 Original Paper %J JMIR Hum Factors %G English %X Background: The use of graphic narratives, defined as stories that use images for narration, is growing in health communication. Objective: The aim of this study was to describe the design and implementation of a graphic narrative screensaver (GNS) to communicate a guideline recommendation (ie, avoiding low-value acid suppressive therapy [AST] use in hospital inpatients) and examine the comparative effectiveness of the GNS versus a text-based screensaver (TBS) on clinical practice (ie, low-value AST prescriptions) and clinician recall. Methods: During a 2-year period, the GNS and the TBS were displayed on inpatient clinical workstations. The numbers of new AST prescriptions were examined in the four quarters before, the three quarters during, and the one quarter after screensavers were implemented. Additionally, an electronic survey was sent to resident physicians 1 year after the intervention to assess screensaver recall. Results: Designing an aesthetically engaging graphic that could be rapidly understood was critical in the development of the GNS. The odds of receiving an AST prescription on medicine and medicine subspecialty services after the screensavers were implemented were lower for all four quarters (ie, GNS and TBS broadcast together, only TBS broadcast, only GNS broadcast, and no AST screensavers broadcast) compared to the quarter prior to implementation (odds ratio [OR] 0.85, 95% CI 0.78-0.92; OR 0.89, 95% CI 0.82-0.97; OR 0.87, 95% CI 0.80-0.95; and OR 0.81, 95% CI 0.75-0.89, respectively; P<.001 for all comparisons). There were no statistically significant decreases for other high-volume services, such as the surgical services. These declines appear to have begun prior to screensaver implementation. When surveyed about the screensaver content 1 year later, resident physicians recalled both the GNS and TBS (43/70, 61%, vs 54/70, 77%; P=.07) and those who recalled the screensaver were more likely to recall the main message of the GNS compared to the TBS (30/43, 70%, vs 1/54, 2%; P<.001). Conclusions: It is feasible to use a graphic narrative embedded in a broadcast screensaver to communicate a guideline recommendation, but further study is needed to determine the impact of graphic narratives on clinical practice. %M 34264197 %R 10.2196/27171 %U https://humanfactors.jmir.org/2021/4/e27171 %U https://doi.org/10.2196/27171 %U http://www.ncbi.nlm.nih.gov/pubmed/34264197 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 5 %N 12 %P e29748 %T Integration of Web Analytics Into Graduate Medical Education: Usability Study %A Massanelli,Jackson %A Sexton,Kevin W %A Lesher,Chris T %A Jensen,Hanna K %A Kimbrough,Mary K %A Privratsky,Anna %A Taylor,John R %A Bhavaraju,Avi %+ Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, United States, 1 501 320 7233, avi99@uams.edu %K graduate medical education %K website analysis %K residency recruitment %K medical education %K website %K analytics %K usage %K usability %K user engagement %K user-centered design %K website design %D 2021 %7 13.12.2021 %9 Original Paper %J JMIR Form Res %G English %X Background: Web analytics is the measurement, collection, analysis, and reporting of website and web application usage data. While common in the e-commerce arena, web analytics is underutilized in graduate medical education (GME). Objective: The University of Arkansas for Medical Sciences Department of Surgery website was revamped with input from in-house surgeons in August 2017. This study investigated the use of web analytics to gauge the impact of our department’s website redesign project. Methods: Google Analytics software was used to measure website performance before and after implementation of the new website. Eight-month matched periods were compared. Factors tracked included total users, new users, total sessions, sessions per user, pages per session, average session duration, total page views, and bounce rate (the percentage of visitors who visit a site and then leave [ie, bounce] without continuing to another page on the same site). Results: Analysis using a nonpaired Student t test demonstrated a statistically significant increase for total page views (before vs after: 33,065 vs 81,852; P<.001) and decrease for bounce rate (before vs after: 50.70% vs 0.23%; P<.001). Total users, new users, total sessions, sessions per user, and pages per session showed improvement. The average session duration was unchanged. Subgroup analysis showed that after the main page, the next 3 most frequently visited pages were related to GME programs in our department. Conclusions: Web analytics is a practical measure of a website’s efficacy. Our data suggest that a modern website significantly improves user engagement. An up-to-date website is essential for contemporary GME recruitment, will likely enhance engagement of residency applicants with GME programs, and warrants further investigation. %M 34898459 %R 10.2196/29748 %U https://formative.jmir.org/2021/12/e29748 %U https://doi.org/10.2196/29748 %U http://www.ncbi.nlm.nih.gov/pubmed/34898459 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 4 %P e32356 %T Assessment of Entrustable Professional Activities Using a Web-Based Simulation Platform During Transition to Emergency Medicine Residency: Mixed Methods Pilot Study %A Peng,Cynthia R %A Schertzer,Kimberly A %A Caretta-Weyer,Holly A %A Sebok-Syer,Stefanie S %A Lu,William %A Tansomboon,Charissa %A Gisondi,Michael A %+ Department of Emergency Medicine, Stanford University School of Medicine, 900 Welch Rd, Palo Alto, CA, 94304-1805, United States, 1 6507235111, crp34@cornell.edu %K simulation %K graduate medical education %K assessment %K gamification %K entrustable professional activities %K emergency medicine %K undergraduate medical education %D 2021 %7 17.11.2021 %9 Original Paper %J JMIR Med Educ %G English %X 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. %M 34787582 %R 10.2196/32356 %U https://mededu.jmir.org/2021/4/e32356 %U https://doi.org/10.2196/32356 %U http://www.ncbi.nlm.nih.gov/pubmed/34787582 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 23 %N 10 %P e19915 %T Comparative Effectiveness of Enhanced Patient Instructions for Bowel Preparation Before Colonoscopy: Network Meta-analysis of 23 Randomized Controlled Trials %A Tian,Xu %A Yi,Li-Juan %A Han,Yang %A Chen,Hui %A Liu,Xiao-Ling %A Chen,Wei-Qing %A Jiménez-Herrera,Maria F %+ Nursing Department, Universitat Rovira i Virgili, Avinguda Catalunya, 35, Tarragona, 43002, Spain, 34 977299426, maria.jimenez@urv.cat %K colonoscopy %K bowel preparation %K patient instruction %K systematic review %K network meta-analysis %D 2021 %7 25.10.2021 %9 Review %J J Med Internet Res %G English %X Background: Various enhanced patient instructions (EPIs) have been used for bowel preparation (BP) and our previous meta-analysis also demonstrated the efficacy of EPIs in increasing the colonic polyp and adenoma detection rates; however, the optimal method for adequate BP has not yet been developed. Objective: We performed a network meta-analysis to determine the optimal instructions. Methods: We searched for randomized controlled trials (RCTs) comparing the effectiveness of EPIs with each other or standard patient instructions (SPIs) for BP. We performed direct and Bayesian network meta-analyses for all instructions and used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria to appraise the quality of evidence. Results: We included 23 RCTs (7969 patients) comparing 10 different instructions. In direct meta-analyses, most of the EPIs, except visual aids and mobile apps, increased the adequate preparation rate (APR). Network meta-analyses showed that additional explanations were superior to visual aids (odds ratio [OR] 0.35, 95% CI 0.19-0.59), telephone calls (OR 0.62, 95% CI 0.37-0.99), educational videos (OR 0.79, 95% CI 0.5-0.77), and mobile apps (OR 0.33, 95% CI 0.14-0.68) with low-to-high-quality evidence; newly designed booklets (OR 3.28, 95% CI 1.59-6.16), SMS text messaging (OR 2.33, 95% CI 1.28-3.91), telephone calls (OR 1.86, 95% CI 1.03-1.78), educational videos (OR 2.33, 95% CI 1.40-3.65), and social media applications (OR 2.42, 95% CI 1.4-3.93) were superior to visual aids and mobile apps with low-to-high-quality evidence. SMS text messaging, telephone calls, and social media applications increase adherence to and satisfaction with the BP regime. Social media applications reduce the risk of adverse events (AEs). Telephone calls and social media applications increase the polyp detection rate (PDR). Conclusions: Newly designed booklets, telephone calls, educational videos, and social media applications can improve the quality of BP. Telephone calls and social media applications improve adherence to and satisfaction with the BP regime, reduce the risk of AEs, and increase the PDR. Trial Registration: INPLASY (International Platform of Registered Systematic Review and Meta-analysis Protocols) INPLASY2020120103; https://inplasy.com/inplasy-2020-12-0103/ %M 34694227 %R 10.2196/19915 %U https://www.jmir.org/2021/10/e19915 %U https://doi.org/10.2196/19915 %U http://www.ncbi.nlm.nih.gov/pubmed/34694227 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 10 %N 9 %P e29707 %T Analyzing Evidence on Interventions to Strengthen the Clinical Support for Midwifery Students in Clinical Placements: Protocol for a Systematic Scoping Review %A Amod,Hafaza %A Mkhize,Sipho Wellington %A Muraraneza,Claudine %+ Discipline of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, 238 Masizi Kunene Road, Glenwood, Durban, 4041, South Africa, 27 742347394, amodh@ukzn.ac.za %K midwifery students %K registered midwives %K clinical support interventions %K midwives %K midwifery %K students %K mentorship %K clinical supervision %K collaboration %K clinician attitudes %D 2021 %7 21.9.2021 %9 Protocol %J JMIR Res Protoc %G English %X Background: The benefits of clinical support are evident in various mentorship, preceptorship, or clinical supervision models. Poor collaboration between lecturers and clinical staff, lack of confidence about student support, large student intakes coupled with core demands create negative attitudes toward student supervision, and this poses a huge challenge to midwifery students who are expected to become competent in the process. Objective: This study aims to identify and analyze interventions, strategies, and/or mechanisms in order to strengthen the clinical support for midwifery students in clinical practice areas from a global perspective. Methods: This review will follow the Arksey and O’Malley framework (2005). The search strategy will include primary studies searched for in electronic databases such as EBSCOhost (CINAHL, MEDLINE, and Health Source: Nursing/Academic edition), PubMed, Google, and Google Scholar. Keywords such as “midwifery students,” “midwifery education,” and “clinical support” will be used to search for related articles. The search will include articles from the cited by search, as well as citations from the reference list of included articles. All title-screened articles will be exported to an EndNote library, and duplicate studies will be removed. Two independent reviewers will concurrently carry out the abstract and full-text article screening according to the eligibility criteria. Extracted data will highlight the aims, geographical setting, and level of training; intervention outcomes; and the most relevant and most significant findings. This review will also include a mixed methods quality appraisal check. A narrative summary of data extracted will be analyzed using content analysis. Results: Interventions to strengthen the clinical support for midwifery students in practice will be extracted from this review, and data will be analyzed and extracted to develop a comprehensive guide or framework for clinical mentorship. As of August 2021, the electronic search, the data extraction, and the analysis have been completed. The results paper is expected to be published within the next 6 months. Conclusions: It is expected that this review will contribute to midwifery education by identifying quality evidence on clinical support interventions available to midwifery students globally, as well as best practice methods, procedures, or interventions that can be used to develop a midwifery mentorship training program. International Registered Report Identifier (IRRID): DERR1-10.2196/29707 %M 34546180 %R 10.2196/29707 %U https://www.researchprotocols.org/2021/9/e29707 %U https://doi.org/10.2196/29707 %U http://www.ncbi.nlm.nih.gov/pubmed/34546180 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 10 %N 7 %P e28671 %T Virtual Interactive Surgical Skills Classroom: Protocol for a Parallel-Group, Noninferiority, Adjudicator-Blinded, Randomized Controlled Trial (VIRTUAL) %A Nathan,Arjun %A Fricker,Monty %A Patel,Sonam %A Georgi,Maria %A Hang,Man Kien %A Asif,Aqua %A Sinha,Amil %A Mullins,William %A Shea,Jessie %A Hanna,Nancy %A Lamb,Benjamin %A Kelly,John %A Sridhar,Ashwin %A Collins,Justin %+ University College London, Gower Street, London, WC1E 6BT, United Kingdom, 44 7595189982, arjun.nathan.11@ucl.ac.uk %K digital education %K digital health %K education %K surgery %K surgical skills %K surgical training %K surgical %K suturing %K telemedicine %K virtual classroom %K virtual training %D 2021 %7 22.7.2021 %9 Protocol %J JMIR Res Protoc %G English %X Background: Traditional face-to-face training (FFT) for basic surgical skills is inaccessible and resource-intensive. Noninteractive computer-based learning is more economical but less educationally beneficial. Virtual classroom training (VCT) is a novel method that permits distanced interactive expert instruction. VCT may optimize resources and increase accessibility. Objective: We aim to investigate whether VCT is superior to computer-based learning and noninferior to FFT in improving proficiency in basic surgical skills. Methods: This is a protocol for a parallel-group, noninferiority, randomized controlled trial. A sample of 72 undergraduates will be recruited from 5 medical schools in London. Participants will be stratified by subjective and objective suturing experience level and allocated to 3 intervention groups at a 1:1:1 ratio. VCT will be delivered using the BARCO weConnect software, and FFT will be provided by expert instructors. Optimal student-to-teacher ratios of 12:1 for VCT and 4:1 for FFT will be maintained. The assessed task will be interrupted suturing with hand-tied knots. Results: The primary outcome will be the postintervention Objective Structured Assessment of Technical Skills score, adjudicated by 2 experts blinded to the study and adjusted for baseline proficiency. The noninferiority margin (δ) will be defined using historical data. Conclusions: This study will serve as a comprehensive appraisal of the suitability of virtual basic surgical skills classroom training as an alternative to FFT. Our findings will assist the development and implementation of further resource-efficient, accessible, virtual basic surgical skills training programs during the COVID-19 pandemic and in the future. Trial Registration: International Standard Randomized Controlled Trial Number ISRCTN12448098; https://www.isrctn.com/ISRCTN12448098 International Registered Report Identifier (IRRID): PRR1-10.2196/28671 %M 34292162 %R 10.2196/28671 %U https://www.researchprotocols.org/2021/7/e28671 %U https://doi.org/10.2196/28671 %U http://www.ncbi.nlm.nih.gov/pubmed/34292162 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 10 %N 7 %P e27239 %T Career Development of Academic Staff in Faculties of Dentistry by Means of Mentorship Programs: Protocol for a Scoping Review %A Amosun,Seyi %A Kimmie-Dhansay,Faheema %A Geerts,Greta %A Basson,Reneda %+ Faculty of Dentistry, University of the Western Cape, Private Bag X17, Bellville 7535, Cape Town, 7535, South Africa, 27 21 937 3000, samosun@uwc.ac.za %K scoping review protocol %K academic staff development %K mentorship %K capacity development %K dental education %K dentistry %K dental educators %D 2021 %7 21.7.2021 %9 Protocol %J JMIR Res Protoc %G English %X Background: Globally, the demands on dental educators continue to diversify and expand. Due to their importance and value, mentoring programs have been acknowledged as a means of recruiting, developing, and retaining academics in dental education. Objective: This protocol is for a scoping review that aims to identify the goals of mentoring programs for academic staff in dental faculties and determine how these programs were structured, delivered, and evaluated. Methods: The review will be performed in accordance with the Joanna Briggs Institute’s methodology for scoping reviews, which covers both qualitative and quantitative scientific literature as well as grey literature written in English and published between 2000 and 2020. The databases will include PubMed, Ovid, the Educational Resources Information Center database, Science Direct, Scopus, Google Scholar, Trove, Web of Science, Openthesis.org, and the website of the American Dental Education Association. A manual search will also be conducted by using the reference lists of included studies to identify additional articles. Working independently, the authors will participate iteratively in literature screening, paper selection, and data extraction. Disagreements between the reviewers will be resolved by discussion until a consensus is reached or after consultation with the research team. Key information that is relevant to the review questions will be extracted from the selected articles and imported into a Microsoft Excel file. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) will be used to guide the reporting of this protocol. Results: The search for appropriate literature has commenced, and we aim to present the results before the end of the 2021 academic year. Conclusions: The development of formal mentorship programs for academics in dental education will enhance the retention of academic staff. International Registered Report Identifier (IRRID): PRR1-10.2196/27239 %M 34287219 %R 10.2196/27239 %U https://www.researchprotocols.org/2021/7/e27239 %U https://doi.org/10.2196/27239 %U http://www.ncbi.nlm.nih.gov/pubmed/34287219 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 10 %N 6 %P e24697 %T Supporting Clinicians to Use Technology to Deliver Highly Personalized and Measurement-Based Mental Health Care to Young People: Protocol for an Evaluation Study %A Dohnt,Henriette C %A Dowling,Mitchell J %A Davenport,Tracey A %A Lee,Grace %A Cross,Shane P %A Scott,Elizabeth M %A Song,Yun Ju C %A Hamilton,Blake %A Hockey,Samuel J %A Rohleder,Cathrin %A LaMonica,Haley M %A Hickie,Ian B %+ Brain and Mind Centre, University of Sydney, 94 Mallett St, Camperdown, 2050, Australia, 61 02 9114 4100, mitch.dowling@sydney.edu.au %K mental health service delivery %K youth mental health %K model of care coordination %K transdiagnostic %K health information technology %K education %K training %K adoption into clinical practice %K Kirkpatrick evaluation %D 2021 %7 14.6.2021 %9 Protocol %J JMIR Res Protoc %G English %X Background: Australia’s mental health care system has long been fragmented and under-resourced, with services falling well short of demand. In response, the World Economic Forum has recently called for the rapid deployment of smarter, digitally enhanced health services to facilitate effective care coordination and address issues of demand. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution that incorporates 2 components: a highly personalized and measurement-based (data-driven) model of youth mental health care and a health information technology (HIT) registered on the Australian Register of Therapeutic Goods. Importantly, research into implementation of such solutions considers education and training of clinicians to be essential to adoption and optimization of use in standard clinical practice. The BMC’s Youth Mental Health and Technology Program has subsequently developed a comprehensive education and training program to accompany implementation of the digital health solution. Objective: This paper describes the protocol for an evaluation study to assess the effectiveness of the education and training program on the adoption and optimization of use of the digital health solution in service delivery. It also describes the proposed tools to assess the impact of training on knowledge and skills of mental health clinicians. Methods: The evaluation study will use the Kirkpatrick Evaluation Model as a framework with 4 levels of analysis: Reaction (to education and training), Learning (knowledge acquired), Behavior (practice change), and Results (client outcomes). Quantitative and qualitative data will be collected using a variety of tools, including evaluation forms, pre- and postknowledge questionnaires, skill development and behavior change scales, as well as a real-time clinical practice audit. Results: This project is funded by philanthropic funding from Future Generation Global. Ethics approval has been granted via Sydney Local Health District’s Human Research Ethics Committee. At the time of this publication, clinicians and their services were being recruited to this study. The first results are expected to be submitted for publication in 2021. Conclusions: The education and training program teaches clinicians the necessary knowledge and skills to assess, monitor, and manage complex needs; mood and psychotic syndromes; and trajectories of youth mental ill-health using a HIT that facilitates a highly personalized and measurement-based model of care. The digital health solution may therefore guide clinicians to help young people recover low functioning associated with subthreshold diagnostic presentations and prevent progression to more serious mental ill-health. International Registered Report Identifier (IRRID): PRR1-10.2196/24697 %M 34125074 %R 10.2196/24697 %U https://www.researchprotocols.org/2021/6/e24697 %U https://doi.org/10.2196/24697 %U http://www.ncbi.nlm.nih.gov/pubmed/34125074 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 6 %N 2 %P e23668 %T The Quality of Instructional YouTube Videos for the Administration of Intranasal Spray: Observational Study %A Peters-Geven,Marije M %A Rollema,Corine %A Metting,Esther I %A van Roon,Eric N %A de Vries,Tjalling W %+ Department of Clinical Pharmacy and Pharmacology, Medical Centre Leeuwarden, Henri Dunantweg 2, PO Box 888, Leeuwarden, 8901 BR, Netherlands, 31 58 286 3385, corine.rollema@mcl.nl %K allergic rhinitis %K administration %K intranasal spray %K instruction videos %K nasal %K YouTube %K educational video %K corticosteroid %K allergic %K intranasal %K allergy %D 2020 %7 30.12.2020 %9 Original Paper %J JMIR Med Educ %G English %X Background: Allergic rhinitis is a common disorder affecting both children and adults. Recommended treatment consists of intranasal corticosteroid spray administration, but only few patients administer the nasal spray in the correct technical manner. A wrong administration technique may result in side effects and affect the efficacy and adherence, thus making accurate administration instructions indispensable. Unfortunately, information about intranasal drug administration is generally not explained accurately, thereby leading to confusion among patients and inaccuracy in the self-administration of drugs. Objective: In this study, we analyzed instructional videos available on YouTube for the administration of nasal sprays for allergic rhinitis. Our aim was to determine if the videos provided instructions in accordance with the standardized nationwide patient protocol in the Netherlands for intranasal spray administration. Methods: Instructional videos for the administration of aqueous formulations of nasal spray for allergic rhinitis were found on YouTube. All videos were reviewed by 2 researchers and scored using the instructions from the Dutch standardized protocol. Correct instructions were given a score of 1, while incorrect or missing instructions were given a score of 0. The interrater reliability using Cohen ĸ was used to determine the differences in the scores between the researchers. Results: We identified 33 YouTube videos made by different health care professionals and pharmaceutical companies around the world. None of the videos displayed all the steps correctly, while 5 of the 33 (15%) videos displayed over 75% of the steps correctly. The median score of the correctly displayed steps was 11 out of 19 (range 2-17, IQR 6). The interrater reliability using Cohen ĸ was statistically significant (range 0.872-1.00, P<.001). The steps “neutral position of the head,” “breathing out through the mouth,” and “periodically cleaning with water” scored the lowest and were incorrectly displayed in 28 (85%), 28 (85%), and 30 (91%) of the 33 videos, respectively. Conclusions: The findings of our study revealed that only few instructional videos on YouTube provided correct instructions for the administration of nasal sprays to patients. The inaccuracy of the instructions for nasal spray administration in the majority of the videos may lead to confusion in patients and incorrect use of nasal sprays. In the future, it is important to make evidence-based instructional videos that show patients the correct technique of nasal spray administration. Trial Registration: Not applicable %M 33377873 %R 10.2196/23668 %U http://mededu.jmir.org/2020/2/e23668/ %U https://doi.org/10.2196/23668 %U http://www.ncbi.nlm.nih.gov/pubmed/33377873