%0 Journal Article %@ 2561-326X %I JMIR Publications %V 9 %N %P e58940 %T Impact of a “Digital Health” Curriculum on Students’ Perception About Competence and Relevance of Digital Health Topics for Future Professional Challenges: Prospective Pilot Study %A Kröplin,Juliane %A Maier,Leonie %A Lenz,Jan-Hendrik %A Romeike,Bernd %K education %K gamification %K robotics %K telemedicine %K wearable electronic devices %K artificial intelligence %D 2025 %7 12.5.2025 %9 %J JMIR Form Res %G English %X Background: The rapid integration of digital technologies in health care has emphasized the need to ensure that medical students are well-equipped with the knowledge and competencies related to digital health. Objective: This study aimed to evaluate the impact of the “Digital Health” curriculum at our university on the perceptions of medical students regarding the relevance of digital health topics for their future professions and their self-assessed competence in these areas. Methods: The “Digital Health” curriculum was introduced at a German university for 2 consecutive semesters. The perceived relevance of topics for their future careers and their subjective competence were evaluated before and after the curriculum using a Likert scale. Furthermore, the practical gamification-based teaching part of the robotics teaching unit was evaluated. In total, 6 months after completing the last semester, a follow-up analysis was performed with questions on the significance of the completed curriculum for current and future professional challenges regarding digital health and suggestions for improvement for innovative teaching. The study was meticulously planned and supported by an approved ethics vote of the local ethics committee to ensure that all ethical guidelines were adhered to (A 2022-0137). Results: A total of 20 students participated, with 13 (65%) being women. In particular, data protection and information security were considered the most relevant topics both before and after the curriculum. Significant increases in perceived importance were observed for messenger apps (mean increase of 0.8 [SD 1.2]; P<.01). Regarding self-assessed competence, significant development was observed on almost all topics. The greatest development was observed in robotics (mean increase of 1.8 [SD 1.2]; P<.001), open educational resources (mean increase of 1.7 [SD 1.5]; P<.001), and simulation-training (mean increase of 1.6 [SD 1.3]; P<.001). The gamification-based, robot-related teaching was predominantly rated suitable and very enjoyable for the students. Conclusions: The results highlight the potential to integrate more innovative teaching techniques, such as gamification, augmented reality, virtual reality, and simulation training, into a technologically advanced health care environment. Finally, the overarching importance of artificial intelligence and digital health applications signals the need to further integrate them, given their potential in remote and personalized medicine. %R 10.2196/58940 %U https://formative.jmir.org/2025/1/e58940 %U https://doi.org/10.2196/58940 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 11 %N %P e63018 %T Recruiting Medical, Dental, and Biomedical Students as First Responders in the Immediate Aftermath of the COVID-19 Pandemic: Prospective Follow-Up Study %A Schnetzler,Nicolas %A Taramarcaz,Victor %A Herren,Tara %A Golay,Eric %A Regard,Simon %A Mach,François %A Nasution,Amanta %A Larribau,Robert %A Suppan,Melanie %A Schiffer,Eduardo %A Suppan,Laurent %K basic life support %K out-of-hospital cardiac arrest %K cardiopulmonary resuscitation %K e-learning %K blended learning %K first responder %K undergraduate medical education %K student motivation %K motivational strategies %K medical student %K COVID-19 %K pandemic %K life support %K survival prognosis %K biomedical students %K dental students %K motivational interventions %D 2025 %7 24.4.2025 %9 %J JMIR Med Educ %G English %X Background: Basic life support improves survival prognosis after out-of-hospital cardiac arrest, but is too rarely provided before the arrival of professional rescue services. First responder networks have been developed in many regions of the world to decrease the delay between collapse and initiation of resuscitation maneuvers. Their efficiency depends on the number of first responders available and many networks lack potential rescuers. Medical, dental, and biomedical students represent an almost untapped source of potential first responders, and a first study, carried out during the COVID-19 pandemic, led to the recruitment of many of these future professionals even though many restrictions were still in effect. Objective: The objective of this study was to determine the impact of an enhanced strategy on the recruitment of medical, dental, and biomedical students as first responders in the immediate aftermath of the COVID-19 pandemic. Methods: This was a prospective follow-up study, conducted between November 2021 and March 2022 at the University of Geneva Faculty of Medicine, Geneva, Switzerland. A web-based study platform was used to manage consent, registrations, and certificates. A first motivational intervention was held early in the academic year and targeted all first-year medical, dental, and biomedical students. Participants first answered a questionnaire designed to assess their initial basic life support knowledge before following an e-learning module. Those who completed the module were able to register for a face-to-face training session held by senior medical students. A course certificate was awarded to those who completed these sessions, enabling them to register as first responders on the Save a Life first responder network. Since the number of students who had enlisted as first responders 2 months after the motivational intervention was markedly lower than expected, a second, unplanned motivational intervention was held in an attempt to recruit more students. Results: Out of a total of 674 first-year students, 19 (2.5%) students had registered as first responders after the first motivational intervention. This was significantly less than the proportion achieved through the initial study (48/529, 9.1%; P<.001). The second motivational intervention led to the enrollment of 7 more students (26/674, 3.9%), a figure still significantly lower than that of the original study (P<.001). At the end of the study, 76 (11.3%) students had been awarded a certificate of competence. Conclusions: Contrary to expectations, an earlier presentation during the academic year outside the COVID restriction period did not increase the recruitment of medical, dental, and biomedical students as first responders in the immediate aftermath of the COVID-19 pandemic. The reasons underlying this drop in motivation should be explored to enable the design of focused motivational interventions. %R 10.2196/63018 %U https://mededu.jmir.org/2025/1/e63018 %U https://doi.org/10.2196/63018 %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 %@ 1438-8871 %I JMIR Publications %V 27 %N %P e60630 %T Impact of Mobile Phone Usage on Sleep Quality Among Medical Students Across Latin America: Multicenter Cross-Sectional Study %A Izquierdo-Condoy,Juan S %A Paz,Clara %A Nati-Castillo,H A %A Gollini-Mihalopoulos,Ricardo %A Aveiro-Róbalo,Telmo Raul %A Valeriano Paucar,Jhino Renson %A Laura Mamami,Sandra Erika %A Caicedo,Juan Felipe %A Loaiza-Guevara,Valentina %A Mejía,Diana Camila %A Salazar-Santoliva,Camila %A Villavicencio-Gomezjurado,Melissa %A Hall,Cougar %A Ortiz-Prado,Esteban %+ One Health Research Group, Universidad de las Américas, Calle de los Colimes, Quito, 170137, Ecuador, 593 0995760693, e.ortizprado@gmail.com %K mobile phone %K addiction behavior %K sleep quality %K medical students %K Latin America %D 2025 %7 10.2.2025 %9 Original Paper %J J Med Internet Res %G English %X Background: The ubiquitous use of mobile phones among medical students has been linked to potential health consequences, including poor sleep quality. Objective: This study investigates the prevalence of mobile phone addiction and its association with sleep quality among medical students across 6 Latin American countries. Methods: A descriptive, cross-sectional, multicenter study was conducted between December 2023 and March 2024 using a self-administered online survey. The survey incorporated the Mobile Phone Addiction Scale and the Pittsburgh Sleep Quality Index to evaluate mobile phone addiction and sleep quality among 1677 medical students. A multiple regression model was applied to analyze the relationship between mobile phone addiction and poor sleep quality, adjusting for sex, age, and educational level to ensure robust results. Results: Mobile phone addiction was identified in 32.5% (545/1677) of participants, with significant differences across countries. The overall mean Pittsburgh Sleep Quality Index score was 7.26, indicating poor sleep quality. Multiple regression analysis revealed a strong association between mobile phone addiction and poor sleep, controlled for demographic variables (β=1.4, 95% CI 1.05-1.74). Conclusions: This study underscores a significant prevalence of mobile phone addiction among medical students and its detrimental association with sleep quality in Latin America. The findings advocate for the need to address mobile phone usage to mitigate its negative implications on student health and academic performance. Strategies to enhance digital literacy and promote healthier usage habits could benefit medical education and student well-being. %M 39928921 %R 10.2196/60630 %U https://www.jmir.org/2025/1/e60630 %U https://doi.org/10.2196/60630 %U http://www.ncbi.nlm.nih.gov/pubmed/39928921 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 11 %N %P e57634 %T Comparison of Learning Outcomes Among Medical Students in Thailand to Determine the Right Time to Teach Forensic Medicine: Retrospective Study %A Chudoung,Ubon %A Saengon,Wilaipon %A Peonim,Vichan %A Worasuwannarak,Wisarn %K multiple-choice question %K MCQ %K forensic medicine %K preclinic %K clinic %K medical student %D 2025 %7 10.2.2025 %9 %J JMIR Med Educ %G English %X Background: Forensic medicine requires background medical knowledge and the ability to apply it to legal cases. Medical students have different levels of medical knowledge and are therefore likely to perform differently when learning forensic medicine. However, different medical curricula in Thailand deliver forensic medicine courses at different stages of medical study; most curricula deliver these courses in the clinical years, while others offer them in the preclinical years. This raises questions about the differences in learning effectiveness. Objective: We aimed to compare the learning outcomes of medical students in curricula that either teach forensic medicine at the clinical level or teach it at the preclinical level. Methods: This was a 5-year retrospective study that compared multiple-choice question (MCQ) scores in a forensic medicine course for fifth- and third-year medical students. The fifth-year students’ program was different from that of the third-year students, but both programs were offered by Mahidol University. The students were taught forensic medicine by the same instructors, used similar content, and were evaluated via examinations of similar difficulty. Of the 1063 medical students included in this study, 782 were fifth-year clinical students, and 281 were third-year preclinical students. Results: The average scores of the fifth- and third-year medical students were 76.09% (SD 6.75%) and 62.94% (SD 8.33%), respectively. The difference was statistically significant (Kruskal-Wallis test: P<.001). Additionally, the average score of fifth-year medical students was significantly higher than that of third-year students in every academic year (all P values were <.001). Conclusions: Teaching forensic medicine during the preclinical years may be too early, and preclinical students may not understand the clinical content sufficiently. Attention should be paid to ensuring that students have the adequate clinical background before teaching subjects that require clinical applications, especially in forensic medicine. %R 10.2196/57634 %U https://mededu.jmir.org/2025/1/e57634 %U https://doi.org/10.2196/57634 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 11 %N %P e68743 %T Understanding Community Health Care Through Problem-Based Learning With Real-Patient Videos: Single-Arm Pre-Post Mixed Methods Study %A Shikino,Kiyoshi %A Yamauchi,Kazuyo %A Araki,Nobuyuki %A Shimizu,Ikuo %A Kasai,Hajime %A Tsukamoto,Tomoko %A Tajima,Hiroshi %A Li,Yu %A Onodera,Misaki %A Ito,Shoichi %+ Chiba University Graduate School of Medicine, Community-Oriented Medical Education, 1-8-1, Inohana, Chu-ou-ku, Chiba, 2608670, Japan, 81 43 222 7171, kshikino@gmail.com %K community health care %K community-oriented medical education %K mixed method %K problem-based learning %K real-patient video %D 2025 %7 31.1.2025 %9 Original Paper %J JMIR Med Educ %G English %X Background: Japan faces a health care delivery challenge due to physician maldistribution, with insufficient physicians practicing in rural areas. This issue impacts health care access in remote areas and affects patient outcomes. Educational interventions targeting students’ career decision-making can potentially address this problem by promoting interest in rural medicine. We hypothesized that community-based problem-based learning (PBL) using real-patient videos could foster students’ understanding of community health care and encourage positive attitudes toward rural health care. Objective: This study investigated the impact of community-based PBL on medical students’ understanding and engagement with rural health care, focusing on their knowledge, skills, and career orientation. Methods: Participants were 113 fourth-year medical students from Chiba University, engaged in a transition course between preclinical and clinical clerkships from October 24 to November 2, 2023. The students were randomly divided into 16 groups (7-8 participants per group). Each group participated in two 3-hour PBL sessions per week over 2 consecutive weeks. Quantitative data were collected using pre- and postintervention questionnaires, comprehension tests, and tutor-assessed rubrics. Self-assessment questionnaires evaluated the students’ interest in community health care and their ability to envision community health care settings before and after the intervention. Qualitative data from the students’ semistructured interviews after the PBL sessions assessed the influence of PBL experience on clinical clerkship in community hospitals. Statistical analysis included median (IQR), effect sizes, and P values for quantitative outcomes. Thematic analysis was used for qualitative data. Results: Of the 113 participants, 71 (62.8%) were male and 42 (37.2%) female. The total comprehension test scores improved significantly (pretest: median 4.0, IQR 2.5-5.0; posttest: median 5, IQR 4-5; P<.001; effect size r=0.528). Rubric-based assessments showed increased knowledge application (pretest: median 8, IQR 7-9; posttest: median 8, IQR 8-8; P<.001; r=0.494) and self-directed learning (pretest: median 8, IQR 7-9; posttest: median 8, IQR 8-8; P<.001; r=0.553). Self-assessment questionnaires revealed significant improvements in the students’ interest in community health care (median 3, IQR 3-4 to median 4, IQR 3-4; P<.001) and their ability to envision community health care settings (median 3, IQR 3-4 to median 4, IQR 3-4; P<.001). Thematic analysis revealed key themes, such as “empathy in patient care,” “challenges in home health care,” and “professional identity formation.” Conclusions: Community-based PBL with real-patient videos effectively enhances medical students’ understanding of rural health care settings, clinician roles, and the social needs of rural patients. This approach holds potential as an educational strategy to address physician maldistribution. Although this study suggests potential for fostering positive attitudes toward rural health care, further research is needed to assess its long-term impact on students’ career trajectories. %M 39889290 %R 10.2196/68743 %U https://mededu.jmir.org/2025/1/e68743 %U https://doi.org/10.2196/68743 %U http://www.ncbi.nlm.nih.gov/pubmed/39889290 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 14 %N %P e58037 %T Evaluating the Effectiveness of a Multimodal Psychotherapy Training Program for Medical Students in China: Protocol for a Randomized Controlled Trial %A Pei,Tao %A Ding,Yinan %A Tang,Jinsong %A Liao,Yanhui %+ Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, 310000, China, 86 18814898844, liaoyanhui@zju.edu.cn %K multimodal teaching %K psychotherapy training %K Chinese medical students %K randomized controlled trial %D 2025 %7 3.1.2025 %9 Protocol %J JMIR Res Protoc %G English %X Background: Psychotherapy is central to the treatment of mental disorders, highlighting the importance of medical students and residents developing competencies in this area. Chinese medical residents have expressed a strong need for psychotherapy training, yet they are generally dissatisfied with the current offerings. This paper presents the protocol for an evidence-based, well-structured psychotherapy teaching program aimed at medical students and residents. Objective: This study involves a randomized controlled trial of a 2-day multimodal intensive educational intervention designed to evaluate the effectiveness of a new psychotherapy teaching program for medical students and residents in China. The primary outcomes include participants’ knowledge and utilization of psychotherapy, training program acceptability, self-reported self-efficacy, and motivation to apply psychotherapy. Methods: This 2-arm randomized controlled trial was conducted at Sir Run Run Shaw Hospital. The study aimed to recruit approximately 160 medical students and residents, with about 80 participants in the intervention group and 80 in the control group. Both groups completed a baseline survey before participation, reporting their psychotherapy knowledge, utilization of psychotherapy, self-efficacy, and self-motivation. The intervention group received a 2-day multimodal intensive educational intervention (supervision-based online teaching), while the waitlist control group did not receive any intervention during this period. Both groups were followed up for 8 weeks, completing the same survey administered at baseline. At the end of the study, the control group received the intervention. The primary outcome measure was the change in trainees’ psychotherapy knowledge before and after the intervention training. Secondary outcome measures included changes in the trainees’ utilization of psychotherapy, self-reported self-efficacy, and self-reported motivation for psychotherapy. Additionally, training program acceptability was assessed. Analysis of covariance was used to analyze the primary outcomes. Pearson correlations and regression analysis explored factors associated with the knowledge score at baseline. The secondary outcomes, including participants’ psychotherapy utilization, confidence, and motivation, were analyzed using the same methods as for knowledge. All tests were 2-tailed, with a significance level set at P<.05. Results: A total of 160 participants were recruited and randomized between January 4 and 12, 2024. Baseline assessments were conducted from January 28 to February 1, 2024. The psychotherapy training program for the intervention group took place on February 3 and 4, 2024. Posttraining assessments were conducted starting April 1, 2024. Due to withdrawals, incomplete surveys, and data loss, we had a total of 113 participants: 57 in the intervention group and 56 in the control group. The amount of data varied across measures. The data analysis was finished in August 2024. Conclusions: This study aims to evaluate the effectiveness of the multimodal psychotherapy training program for medical students in China. If this brief, cognitive behavioral therapy–based psychotherapy skill training proves effective, the potential mental health impact of its nationwide expansion could be significant. Trial Registration: ClinicalTrials.gov NCT06258460; https://clinicaltrials.gov/ct2/show/NCT06258460 International Registered Report Identifier (IRRID): DERR1-10.2196/58037 %M 39752191 %R 10.2196/58037 %U https://www.researchprotocols.org/2025/1/e58037 %U https://doi.org/10.2196/58037 %U http://www.ncbi.nlm.nih.gov/pubmed/39752191 %0 Journal Article %@ 1929-073X %I JMIR Publications %V 13 %N %P e60223 %T Personality Types of Medical Students in Terms of Their Choice of Medical Specialty: Cross-Sectional Study %A Tobiaszewska,Małgorzata %A Koweszko,Tytus %A Jurek,Jonasz %A Mikołap,Karolina %A Gierus,Jacek %A Mikulski,Jantoni %A Waszkiewicz,Napoleon %+ Department of Psychiatry, Faculty of Health Sciences, Medical University of Warsaw, ul. Partyzantów 2/4, Pruszków 05-802, Warsaw, Poland, 48 22 739 13 02, malgorzata.tobiaszewska@gmail.com %K personality type %K characteristics %K traits %K psychology %K psychometric %K medical students %K university %K burnout %K gender %K preferences %K professional %K job %K career %K specialty %K survey %K questionnaire %D 2024 %7 31.12.2024 %9 Original Paper %J Interact J Med Res %G English %X Background: Research on personality types among doctors reveals its impact on medical specialty choices, suggesting that considering personality in career planning may enhance work satisfaction and reduce burnout risks. Objective: This study, encompassing 2104 medical students, explores how personality types, traits, and gender relate to specialty preferences. Methods: Participants of this study were medical students from various universities in Poland. The study surveyed 2104 participants. Each participant completed a general questionnaire and a NERIS Type Explorer personality test, based on the Myers-Briggs Type Indicator inventory and the “Big Five” personality traits concept. The questionnaire was distributed on social media groups for medical students from all Polish universities. An exploratory statistical analysis was performed to find relationships. For each tested relationship a Fisher exact test was conducted and the significance level was P<.05. Each test resulted in a P value and odds ratio (OR) with a CI. To ensure we included undecided students and obtained meaningful data, we allowed participants to select up to three medical specialties from the 77 available in Poland at the time of the study. Results: The findings unveil significant relationships between gender, personality types, traits, and specialty preferences. Women tended to favor Neonatology (OR 9.15, 95% CI 3.02-45.46), while men leaned toward Orthopedics and traumatology of the locomotor system (OR 7.53, 95% CI 4.87-11.94). Extroverted, Intuitive, Feeling, Prospecting, and Turbulent students showed a heightened interest in Psychiatry (OR 2.23, 95% CI 1.64-3.01), whereas Introverted, Observant, Feeling, Judging, and Turbulent types favored Family Medicine (OR 2.98, 95% CI 2.08-4.24) and Pediatrics (OR 2.13, 95% CI 1.51-2.99). Conclusions: In conclusion, this research establishes a link between personality and medical specialty selection. Taking into account the significant role of personality traits, it should be considered to integrate them into the process of selecting a medical career or designing a medical curriculum. This approach may allow for the customization of programs to match students’ traits, thereby cultivating improved clinical communication skills, fostering interprofessional collaboration and ultimately enhancing treatment outcomes and professional fulfillment among physicians. The main limitation of this study is that it was conducted on medical students, who lack the full knowledge of the work as a specific specialist. A study surveying medical doctors with longer internships across different wards could be conducted to check for any variabilities. Moreover, there are other significant factors that influence one’s medical specialty choice. Certainly, this area could be further explored. %M 39740218 %R 10.2196/60223 %U https://www.i-jmr.org/2024/1/e60223 %U https://doi.org/10.2196/60223 %U http://www.ncbi.nlm.nih.gov/pubmed/39740218 %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 %@ 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 %@ 1929-0748 %I JMIR Publications %V 13 %N %P e62810 %T Development of Leadership Skills in Medical Education: Protocol for a Scoping Review %A Chubaci,Eliana Fazuoli %A Costa,Carlos Dario da Silva %A Santos Neto,Martins Fideles dos %A dos Santos,Emerson Roberto %A Engel,Ana Maria Rita Pedroso Vilela Torres de Carvalho %A Costa,Ana Caroline dos Santos %A Silva,Taisa Morete da %A Cristóvão,Helena Landin Gonçalves %A Quitério,Alex Bertolazzo %A Lima,Alba Regina de Abreu %A Brienze,Vânia Maria Sabadoto %A Fácio Jr,Fernando Nestor %A André,Júlio César %+ Center for Studies and Development of Health Education, Faculdade de Medicina de São José do Rio Preto, Av. Brg. Faria Lima, 5416, São José do Rio Preto, São Paulo, 15090-000, Brazil, 55 17997171651, li_chubaci@hotmail.com %K leadership skills %K medical education %K undergraduate curriculum %K health care management %K professional development %K scoping review protocol %D 2024 %7 22.10.2024 %9 Protocol %J JMIR Res Protoc %G English %X Background: Leadership is recognized as an essential competency in health care and science, being central for professionals to face health challenges. Few physicians feel prepared to serve as leaders in the health care environment, and few receive training in the leadership skills needed to be successful. Teaching leadership skills together with extensive, longitudinal, clinical education in an authentic and nurturing environment can effectively develop students for leadership in medicine. Studies on the subject still do not show the best way to implement it in medical education, and an updated review is necessary. Objective: The aim of this study is to identify the types of available evidence on the teaching of leadership skills in undergraduate courses in the health area, analyze them, determine knowledge gaps, and disseminate the research results. Methods: This is a scoping review that will consider studies on leadership skills in medical and health undergraduate courses. Primary studies published in English, Spanish, and Portuguese since 2019 will be considered. The search will be performed in 8 databases, and reference lists will be searched for additional studies. Duplicates will be removed, and 2 independent reviewers will examine the titles, abstracts, and full texts of the selected studies. Data extraction will be performed using a tool developed by the researchers. Results: The scoping review is currently in progress. The preliminary database search has been completed, yielding a total of 1213 articles across multiple databases. The next stages, including deduplication, title and abstract screening, and full-text review, are scheduled to be completed by December 2024. Data extraction and analysis are expected to be finalized by March 2025, with the final report anticipated to be ready for submission by June 2025. Conclusions: This scoping review on leadership in the medical curriculum can significantly contribute to the literature by organizing and synthesizing the available evidence on teaching leadership skills in undergraduate courses in the health area. Furthermore, by analyzing evidence and identifying knowledge gaps, the study can provide valuable insights to develop more efficient and comprehensive medical education programs, thus preparing students to take on leadership roles in the complex environment of health care. Trial Registration: Open Science Framework YEXKB; https://osf.io/yexkb International Registered Report Identifier (IRRID): PRR1-10.2196/62810 %M 39436686 %R 10.2196/62810 %U https://www.researchprotocols.org/2024/1/e62810 %U https://doi.org/10.2196/62810 %U http://www.ncbi.nlm.nih.gov/pubmed/39436686 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e57760 %T Spaced Digital Education for Health Professionals: Systematic Review and Meta-Analysis %A Martinengo,Laura %A Ng,Matthew Song Peng %A Ng,Tony De Rong %A Ang,Yi-Ian %A Jabir,Ahmad Ishqi %A Kyaw,Bhone Myint %A Tudor Car,Lorainne %+ Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Rd, Level 18, Clinical Sciences Builiding, Singapore, 308232, Singapore, 65 69041258, l.tudor.car@imperial.ac.uk %K digital education %K e-learning %K spaced education %K spaced learning %K spaced digital education %K spaced simulation %K health care professionals %K continuous medical education %K systematic review %K meta-analysis %D 2024 %7 10.10.2024 %9 Review %J J Med Internet Res %G English %X Background: Spaced digital education applies digital tools to deliver educational content via multiple, repeated learning sessions separated by prespecified time intervals. Spaced digital education appears to promote acquisition and long-term retention of knowledge, skills, and change in clinical behavior. Objective: The aim of this review was to assess the effectiveness of spaced digital education in improving pre- and postregistration health care professionals’ knowledge, skills, attitudes, satisfaction, and change in clinical behavior. Methods: This review followed Cochrane’s methodology and PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) reporting guidelines. We searched MEDLINE, Embase, Web of Science, ERIC, PsycINFO, CINAHL, CENTRAL, and ProQuest Dissertation and Theses databases from January 1990 to February 2023. We included randomized controlled trials (RCTs), cluster RCTs, and quasi-RCTs comparing spaced digital education with nonspaced education, spaced nondigital education, traditional learning, or no intervention for pre- or postregistration health care professionals. Study selection, data extraction, study quality, and certainty of evidence were assessed by 2 independent reviewers. Meta-analyses were conducted using random effect models. Results: We included 23 studies evaluating spaced online education (n=17, 74%) or spaced digital simulation (n=6, 26%) interventions. Most studies assessed 1 or 2 outcomes, including knowledge (n=15, 65%), skills (n=9, 39%), attitudes (n=8, 35%), clinical behavior change (n=8, 35%), and satisfaction (n=7, 30%). Most studies had an unclear or a high risk of bias (n=19, 83%). Spaced online education was superior to massed online education for postintervention knowledge (n=9, 39%; standardized mean difference [SMD] 0.32, 95% CI 0.13-0.51, I2=66%, moderate certainty of evidence). Spaced online education (n=3, 13%) was superior to massed online education (n=2, 9%) and no intervention (n=1, 4%; SMD 0.67, 95% CI 0.43-0.91, I2=5%, moderate certainty of evidence) for postintervention clinical behavior change. Spaced digital simulation was superior to massed simulation for postintervention surgical skills (n=2, 9%; SMD 1.15, 95% CI 0.34-1.96, I2=74%, low certainty of evidence). Spaced digital education positively impacted confidence and satisfaction with the intervention. Conclusions: Spaced digital education is effective in improving knowledge, particularly in substantially improving surgical skills and promoting clinical behavior change in pre- and postregistration health care professionals. Our findings support the use of spaced digital education interventions in undergraduate and postgraduate health profession education. Trial Registration: PROSPERO CRD42021241969; Trial Registration: PROSPERO CRD42021241969; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=241969 %M 39388234 %R 10.2196/57760 %U https://www.jmir.org/2024/1/e57760 %U https://doi.org/10.2196/57760 %U http://www.ncbi.nlm.nih.gov/pubmed/39388234 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e57772 %T Knowledge Mapping and Global Trends in the Field of the Objective Structured Clinical Examination: Bibliometric and Visual Analysis (2004-2023) %A Ba,Hongjun %A Zhang,Lili %A He,Xiufang %A Li,Shujuan %+ Department of Pediatric Cardiology, First Affiliated Hospital of Sun Yat-sen University, 58# Zhongshan Road 2, Guangzhou, 510080, China, 86 13430329103, lishuj2@mail.sysu.edu.cn %K Objective Structured Clinical Examination %K OSCE %K medical education assessment %K bibliometric analysis %K academic collaboration %K health care professional training %K medical education %K medical knowledge %K medical training %K medical student %D 2024 %7 30.9.2024 %9 Original Paper %J JMIR Med Educ %G English %X Background: The Objective Structured Clinical Examination (OSCE) is a pivotal tool for assessing health care professionals and plays an integral role in medical education. Objective: This study aims to map the bibliometric landscape of OSCE research, highlighting trends and key influencers. Methods: A comprehensive literature search was conducted for materials related to OSCE from January 2004 to December 2023, using the Web of Science Core Collection database. Bibliometric analysis and visualization were performed with VOSviewer and CiteSpace software tools. Results: Our analysis indicates a consistent increase in OSCE-related publications over the study period, with a notable surge after 2019, culminating in a peak of activity in 2021. The United States emerged as a significant contributor, responsible for 30.86% (1626/5268) of total publications and amassing 44,051 citations. Coauthorship network analysis highlighted robust collaborations, particularly between the United States and the United Kingdom. Leading journals in this domain—BMC Medical Education, Medical Education, Academic Medicine, and Medical Teacher—featured the highest volume of papers, while The Lancet garnered substantial citations, reflecting its high impact factor (to be verified for accuracy). Prominent authors in the field include Sondra Zabar, Debra Pugh, Timothy J Wood, and Susan Humphrey-Murto, with Ronaldo M Harden, Brian D Hodges, and George E Miller being the most cited. The analysis of key research terms revealed a focus on “education,” “performance,” “competence,” and “skills,” indicating these are central themes in OSCE research. Conclusions: The study underscores a dynamic expansion in OSCE research and international collaboration, spotlighting influential countries, institutions, authors, and journals. These elements are instrumental in steering the evolution of medical education assessment practices and suggest a trajectory for future research endeavors. Future work should consider the implications of these findings for medical education and the potential areas for further investigation, particularly in underrepresented regions or emerging competencies in health care training. %M 39348890 %R 10.2196/57772 %U https://mededu.jmir.org/2024/1/e57772 %U https://doi.org/10.2196/57772 %U http://www.ncbi.nlm.nih.gov/pubmed/39348890 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e50128 %T Live Streaming of the Professor’s Ward Rounds in Undergraduate Neurology Education: Usability Study %A Sekiguchi,Kenji %A Kawano,Seiji %A Chihara,Norio %A Satomi-Kobayashi,Seimi %A Maeda,Eiichi %A Matsumoto,Riki %+ Division of Neurology, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho, Chuo-ku, Kobe, 6500017, Japan, 81 783825885, sekiguch@med.kobe-u.ac.jp %K live streaming %K ward round %K web conferencing software %K neurological examination %K undergraduate education %K medical student %K medical education %K rounds %K remote education %K video-conferencing %K residents %K live-stream %K neurology %K neuroscience %K web conferencing %K distance education %K technology enhanced learning %K mobile phone %D 2024 %7 22.8.2024 %9 Original Paper %J JMIR Form Res %G English %X Background: Although neurology department ward rounds are among the most important medical education exercises in Japan, they have several issues. Patients may find it unpleasant to undergo repeated neurological tests, especially when in the presence of several students. Only the front row of students can closely observe the examination findings; moreover, students were prohibited from contacting patients altogether during the COVID-19 pandemic. One possible solution is to use commercial videoconferencing systems. However, Japanese patients are reluctant to have their medical information or video footage of them sent outside of the hospital via the internet. Objective: The study aimed to confirm the feasibility of conducting remote teaching rounds using an in-house web conferencing system in which the patients’ personal data are securely protected. This study also explored whether using remote rounds alongside face-to-face participation would enhance learning. Methods: We created an on-premises videoconferencing system using an open-source app. To perform video ward rounds, the professor wore a wireless microphone while leading routine in-person rounds and the attending physician carried a tablet device linked to a web conference, allowing students in another room to watch the rounds on a live stream. In total, 112 of 5th-year students who entered their 1-week neurology rotation between 2021 and 2022 were instructed to participate in 1-hour in-person and remote rounds. Students were given questionnaires to evaluate their satisfaction and the educational effects of the remote rounds. Results: The remote ward rounds were conducted easily with no interference with the in-person rounds, nor any complaints from the patients. Each examination technique was explained by another teacher to the students who participated in remote rounds in the conference room. Characteristic neurological findings, such as plantar reflexes (Babinski sign), which are usually seen only by close observers during in-person rounds, could be visualized under magnification by all students. The postexperience survey (82/112, 73% response rate) showed that the mean score of participants’ satisfaction was 3.94 (SD 0.83; excellent 5 and poor 1). No participant scoring 1 was noted. The proportion of students who observed 6 representative abnormal neurological findings (Babinski sign, hyperreflexia, cerebellar ataxia, involuntary movement, muscular weakness, and abnormality in sensory examination) increased by 22% (18/82, range 13-24) compared to in-person rounds alone. When self-rating the learning value, 43% (35/82) of the students answered that remote rounds are equally as valuable as in-person rounds, while 32% (26/82) preferred remote rounds. Conclusions: Live-streaming of neurology ward rounds using a secure in-house web conferencing system provides additional learning experience without concerns regarding leakage of patient information. This initiative could enhance neurology learning before entering a clinical clerkship. %M 39172503 %R 10.2196/50128 %U https://formative.jmir.org/2024/1/e50128 %U https://doi.org/10.2196/50128 %U http://www.ncbi.nlm.nih.gov/pubmed/39172503 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e56415 %T Global Rate of Willingness to Volunteer Among Medical and Health Students During Pandemic: Systemic Review and Meta-Analysis %A Mahsusi,Mahsusi %A Hudaa,Syihaabul %A Nuryani,Nuryani %A Fahmi,Mustofa %A Tsurayya,Ghina %A Iqhrammullah,Muhammad %+ Department of Islamic Education Management, Faculty of Tarbiyah and Teacher Training, Universitas Islam Negeri Syarif Hidayatullah Jakarta, Jl Ir H Djuanda No 95, Tangerang Selatan, 15412, Indonesia, 62 83806254803, mahsusi@uinjkt.ac.id %K COVID-19 %K education %K health crisis %K human resource management %K volunteer %D 2024 %7 15.4.2024 %9 Review %J JMIR Med Educ %G English %X Background: During health crises such as the COVID-19 pandemic, shortages of health care workers often occur. Recruiting students as volunteers could be an option, but it is uncertain whether the idea is well-accepted. Objective: This study aims to estimate the global rate of willingness to volunteer among medical and health students in response to the COVID-19 pandemic. Methods: A systematic search was conducted on PubMed, Embase, Scopus, and Google Scholar for studies reporting the number of health students willing to volunteer during COVID-19 from 2019 to November 17, 2023. The meta-analysis was performed using a restricted maximum-likelihood model with logit transformation. Results: A total of 21 studies involving 26,056 health students were included in the meta-analysis. The pooled estimate of the willingness-to-volunteer rate among health students across multiple countries was 66.13%, with an I2 of 98.99% and P value of heterogeneity (P-Het)<.001. Removing a study with the highest influence led to the rate being 64.34%. Our stratified analyses indicated that those with older age, being first-year students, and being female were more willing to volunteer (P<.001). From highest to lowest, the rates were 77.38%, 77.03%, 65.48%, 64.11%, 62.71%, and 55.23% in Africa, Western Europe, East and Southeast Asia, Middle East, and Eastern Europe, respectively. Because of the high heterogeneity, the evidence from this study has moderate strength. Conclusions: The majority of students are willing to volunteer during COVID-19, suggesting that volunteer recruitment is well-accepted. %M 38621233 %R 10.2196/56415 %U https://mededu.jmir.org/2024/1/e56415 %U https://doi.org/10.2196/56415 %U http://www.ncbi.nlm.nih.gov/pubmed/38621233 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e49616 %T Comparison of Blended Learning With Traditional Dermatology Learning for Medical Students: Prospective Evaluation Study %A Silva,Cristiana Silveira %A Vasconcellos,Cidia %A Souza,Murilo Barreto %A Fernandes,Juliana Dumet %A Rego,Vitoria Regina Pedreira de Almeida %+ Department of Dermatology, Federal University of Bahia, Av. Milton Santos, s/nº - Ondina, Salvador, BA, 40170-110, Brazil, 55 7133362850, silveira.cristiana@gmail.com %K dermatology %K distance education %K distance learning %K e-learning %K medical education %K undergraduate medical education %D 2024 %7 1.2.2024 %9 Original Paper %J JMIR Form Res %G English %X Background: Novel internet-based applications and associated technologies have influenced all aspects of society, ranging from commerce and business to entertainment and health care, and education is no exception. In this context, this study was designed to evaluate the impact of a dermatology e-learning program on the academic performance of medical students in dermatology. Objective: The aim of this study is to develop a dermatology blended-learning course for undergraduate medical students, evaluate the knowledge gained by students exposed to this course, and compare the results to those of traditional teaching methods. Methods: In this prospective study, we evaluated the performance of fourth-semester medical students at the Federal University of Bahia, Brazil. Students who had been in their second year of the medical course in 2019 were considered the control group, while students in their second year in 2020 were considered the blended or hybrid group. The first group attended traditional classes, using printed material (books and handouts), while the second group used our web-based course and e-book as a supplement in a hybrid web-plus-traditional fashion. Neither participants nor evaluators were blinded. The students in both groups were subjected to the same pre- and postcourse face-to-face, multiple-choice, paper-based evaluations, and we compared their performances. The content of the classes was the same for both groups. All didactic activities were developed by a team of certified dermatologists and professors from the university. Results: A total of 129 students were selected and divided into 2 groups: the control group (n=57) and the hybrid group (n=72). The precourse tests did not indicate any difference between the control group (mean score 2.74, SD 1.25) and the hybrid group (mean score 3.2, SD 1.22 SD; P>.05). The hybrid group had better final-term grades (mean 8.18, SD 1.26) than the traditional group (mean 7.11, SD 1.04). This difference was statistically significant (P<.05). Conclusions: This study explores pedagogical possibilities in the field of dermatology teaching for medical school students. The results suggest that the performance of undergraduate students who attended the course with additional e-learning material was superior when compared to the performance of those who participated in the traditional course alone. %M 38300698 %R 10.2196/49616 %U https://formative.jmir.org/2024/1/e49616 %U https://doi.org/10.2196/49616 %U http://www.ncbi.nlm.nih.gov/pubmed/38300698 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e52711 %T Challenges for Medical Students in Applying Ethical Principles to Allocate Life-Saving Medical Devices During the COVID-19 Pandemic: Content Analysis %A Hsieh,Hsing-yen %A Lin,Chyi-her %A Huang,Ruyi %A Lin,Guan-chun %A Lin,Jhen-Yu %A Aldana,Clydie %+ School of Medicine for International Students, College of Medicine, I-Shou University, 8 Yida Rd, Yanchao District, Kaohsiung, 82445, Taiwan, 886 7 615 0011 ext 2547, ruyi@mail.harvard.edu %K virtual patient %K virtual patients %K medical resources distribution %K medical ethical education %K COVID-19 pandemic %K ethics %K medical student %K medical students %K medical ethics %K decision-making %K ethical dilemna %K simulation %K reasoning %K decision support %K medical guideline %K medical guidelines %K medical devices %K medical device %K life-saving %K thematic analysis %K virtual platform %D 2024 %7 5.1.2024 %9 Original Paper %J JMIR Med Educ %G English %X Background: The emergence of the COVID-19 pandemic has posed a significant ethical dilemma in the allocation of scarce, life-saving medical equipment to critically ill patients. It remains uncertain whether medical students are equipped to navigate this complex ethical process. Objective: This study aimed to assess the ability and confidence of medical students to apply principles of medical ethics in allocating critical medical devices through the scenario of virtual patients. Methods: The study recruited third- and fourth-year medical students during clinical rotation. We facilitated interactions between medical students and virtual patients experiencing respiratory failure due to COVID-19 infection. We assessed the students’ ability to ethically allocate life-saving resources. Subsequently, we analyzed their written reports using thematic analysis to identify the ethical principles guiding their decision-making. Results: We enrolled a cohort of 67 out of 71 medical students with a mean age of 34 (SD 4.7) years, 60% (n=40) of whom were female students. The principle of justice was cited by 73% (n=49) of students while analyzing this scenario. A majority of them expressed hesitancy in determining which patient should receive life-saving resources, with 46% (n=31) citing the principle of nonmaleficence, 31% (n=21) advocating for a first-come-first-served approach, and 25% (n=17) emphasizing respect for patient autonomy as key influencers in their decisions. Notably, medical students exhibited a lack of confidence in making ethical decisions concerning the distribution of medical resources. A minority, comprising 12% (n=8), proposed the exploration of legal alternatives, while 4% (n=3) suggested medical guidelines and collective decision-making as potential substitutes for individual ethical choices to alleviate the stress associated with personal decision-making. Conclusions: This study highlights the importance of improving ethical reasoning under time constraints using virtual platforms. More than 70% of medical students identified justice as the predominant principle in allocating limited medical resources to critically ill patients. However, they exhibited a lack of confidence in making ethical determinations and leaned toward principles such as nonmaleficence, patient autonomy, adherence to legal and medical standards, and collective decision-making to mitigate the pressure associated with such decisions. %M 38050366 %R 10.2196/52711 %U https://mededu.jmir.org/2024/1/e52711 %U https://doi.org/10.2196/52711 %U http://www.ncbi.nlm.nih.gov/pubmed/38050366 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e42354 %T Distance Electronic Learning Strategy in Medical Teaching During the COVID-19 Pandemic: Cross-Sectional Survey Study %A Alkuran,Oqba %A Al-Mehaisen,Lama %A Abu Mahfouz,Ismaiel %A Al-Kuran,Lena %A Asali,Fida %A Khamees,Almu’atasim %A AL-Shatanawi,Tariq %A Jaber,Hatim %+ Medical School, Al-Balqa Applied University, PO box 206, Assalt, Amman, 19117, Jordan, 962 799051387, hjabber@bau.edu.jo %K COVID-19 %K distant electronic learning %K medical %K medicine %K school %K medical school %K medical education %K clinical skill %K teaching hospital %K questionnaire %K distance learning %K distance education %K web-based education %K web-based learning %K medical student %D 2023 %7 5.12.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: Teaching hospitals have been regarded as the primary settings where doctors teach and practice high-quality medicine, as well as where medical students learn the profession and acquire their initial clinical skills. A percentage of instruction is now done over the internet or via electronic techniques. The present COVID-19 epidemic has pushed distance electronic learning (DEL) to the forefront of education at all levels, including medical institutions. Objective: This study aimed to observe how late-stage medical students felt about DEL, which was put in place during the recent COVID-19 shutdown in Jordan. Methods: We conducted a prospective, cross-sectional, web-based, questionnaire-based research study during the COVID-19 pandemic lockdown between March 15 and May 1, 2020. During this period, all medical schools in Jordan shifted to DEL. Results: A total of 380 students responded to a request to fill out the questionnaire, of which 256 completed the questionnaire. The data analysis showed that 43.6% (n=112) of respondents had no DEL experience, and 53.1% (n=136)of respondents perceived the DEL method as user-friendly. On the other hand, 64.1% (n=164) of students strongly believed that DEL cannot substitute traditional clinical teaching. There was a significant positive correlation between the perception of user-friendliness and the clarity of the images and texts used. Moreover, there was a strong positive correlation between the perception of sound audibility and confidence in applying knowledge gained through DEL to clinical practice. Conclusions: DEL is a necessary and important tool in modern medical education, but it should be used as an auxiliary approach in the clinical setting since it cannot replace conventional personal instruction. %M 38051556 %R 10.2196/42354 %U https://mededu.jmir.org/2023/1/e42354 %U https://doi.org/10.2196/42354 %U http://www.ncbi.nlm.nih.gov/pubmed/38051556 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e45372 %T Exploring the Use of YouTube as a Pathology Learning Tool and Its Relationship With Pathology Scores Among Medical Students: Cross-Sectional Study %A Alzoubi,Hiba %A Karasneh,Reema %A Irshaidat,Sara %A Abuelhaija,Yussuf %A Abuorouq,Saleh %A Omeish,Haya %A Daromar,Shrouq %A Makhadmeh,Naheda %A Alqudah,Mohammad %A Abuawwad,Mohammad T %A Taha,Mohammad J J %A Baniamer,Ansam %A Abu Serhan,Hashem %+ Department of Ophthalmology, Hamad Medical Corporations, Al Rayyan St. Al Sadd, Doha, 3050, Qatar, 974 77912335, HAbuserhan@hamad.qa %K pathology %K medical students %K YouTube %K social media %K medical education %K online resources %D 2023 %7 24.11.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: YouTube is considered one of the most popular sources of information among college students. Objective: This study aimed to explore the use of YouTube as a pathology learning tool and its relationship with pathology scores among medical students at Jordanian public universities. Methods: This cross-sectional, questionnaire-based study included second-year to sixth-year medical students from 6 schools of medicine in Jordan. The questionnaire was distributed among the students using social platforms over a period of 2 months extending from August 2022 to October 2022. The questionnaire included 6 attributes. The first section collected demographic data, and the second section investigated the general use of YouTube and recorded material. The remaining 4 sections targeted the participants who used YouTube to learn pathology including using YouTube for pathology-related content. Results: As of October 2022, 699 students were enrolled in the study. More than 60% (422/699, 60.4%) of the participants were women, and approximately 50% (354/699, 50.6%) were second-year students. The results showed that 96.5% (675/699) of medical students in Jordan were using YouTube in general and 89.1% (623/699) were using it as a source of general information. YouTube use was associated with good and very good scores among the users. In addition, 82.3% (575/699) of medical students in Jordan used YouTube as a learning tool for pathology in particular. These students achieved high scores, with 428 of 699 (61.2%) students scoring above 70%. Most participants (484/699, 69.2%) reported that lectures on YouTube were more interesting than classic teaching and the lectures could enhance the quality of learning (533/699, 76.3%). Studying via YouTube videos was associated with higher odds (odds ratio [OR] 3.86, 95% CI 1.33-11.18) and lower odds (OR 0.27, 95% CI 0.09-0.8) of achieving higher scores in the central nervous system and peripheral nervous system courses, respectively. Watching pathology lectures on YouTube was related to a better chance of attaining higher scores (OR 1.96, 95% CI 1.08-3.57). Surprisingly, spending more time watching pathology videos on YouTube while studying for examinations corresponded with lower performance, with an OR of 0.46 (95% CI 0.26-0.82). Conclusions: YouTube may play a role in enhancing pathology learning, and aiding in understanding, memorization, recalling information, and obtaining higher scores. Many medical students in Jordan have positive attitudes toward using YouTube as a supplementary pathology learning tool. Based on this, it is recommended that pathology instructors should explore the use of YouTube and other emerging educational tools as potential supplementary learning resources. %R 10.2196/45372 %U https://mededu.jmir.org/2023/1/e45372/ %U https://doi.org/10.2196/45372 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e48765 %T Adaptive Peer Tutoring and Insights From a Neurooncology Course %A Ozkara,Burak Berksu %A Karabacak,Mert %A Ozcan,Zeynep %A Bisdas,Sotirios %+ Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, 8‑11 Queen Square, London, WC1N 3BG, United Kingdom, 44 203 448 3446, s.bisdas@ucl.ac.uk %K COVID-19 %K distance learning %K medical education %K mentoring %K peer teaching %K web-based tutoring %D 2023 %7 6.10.2023 %9 Viewpoint %J JMIR Med Educ %G English %X Peer teaching in medicine is a valuable educational approach that benefits students and tutors alike. The COVID-19 pandemic has significantly impacted the advancement of remote education in the medical field. In response, the Cerrahpasa Neuroscience Society organized a web-based, volunteer-based peer tutoring program to introduce students to central nervous system tumors. This viewpoint examines our peer mentoring experience in medical education. We discussed how we shaped the course, its positive effects, and the flexible nature of the course, which brought medical students from different regions together. In addition to evaluating academic results, we examined the social relations made possible by this unique teaching method by analyzing student feedback and test scores. Finally, we discussed the promise of global web-based mentoring, highlighting its significance in the dynamic and global context of medicine. %M 37801350 %R 10.2196/48765 %U https://mededu.jmir.org/2023/1/e48765 %U https://doi.org/10.2196/48765 %U http://www.ncbi.nlm.nih.gov/pubmed/37801350 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e50902 %T Authors’ Response to the Validity of Cortisol and Galvanic Skin Responses for Measuring Student Stress During Training %A Toohey,Shannon %A Wray,Alisa %A Hunter,John %A Saadat,Soheil %A Boysen-Osborn,Megan %A Smart,Jonathan %A Wiechmann,Warren %A Pressman,Sarah D %+ Department of Emergency Medicine, University of California, Irvine, 3800 Chapman Avenue, Suite 3200, Orange, CA, 92868, United States, 1 8055019674, stoohey@hs.uci.edu %K augmented reality %K AR %K salivary cortisol %K galvanic skin conductance %K medical simulation %K medical education %D 2023 %7 18.8.2023 %9 Letter to the Editor %J JMIR Med Educ %G English %X %M 37594800 %R 10.2196/50902 %U https://mededu.jmir.org/2023/1/e50902 %U https://doi.org/10.2196/50902 %U http://www.ncbi.nlm.nih.gov/pubmed/37594800 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e45340 %T How Valid Are Cortisol and Galvanic Skin Responses in Measuring Student Stress During Training? Comment on the Psychological Effects of Simulation Training %A Sonawane,Urvi %A Kasetti,Pragna %+ Imperial College London, Exhibition Road, South Kensington, London, SW7 2BX, United Kingdom, 44 020 7589 5111, urvi.sonawane13@gmail.com %K augmented reality %K AR %K salivary cortisol %K galvanic skin conductance %K medical simulation %K medical education %D 2023 %7 18.8.2023 %9 Letter to the Editor %J JMIR Med Educ %G English %X %M 37594784 %R 10.2196/45340 %U https://mededu.jmir.org/2023/1/e45340 %U https://doi.org/10.2196/45340 %U http://www.ncbi.nlm.nih.gov/pubmed/37594784 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e50109 %T Authors’ Reply to: Additional Considerations for US Residency Selection After Pass/Fail USMLE Step 1. Comment on “The US Residency Selection Process After the United States Medical Licensing Examination Step 1 Pass/Fail Change: Overview for Applicants and Educators” %A Ozair,Ahmad %A Bhat,Vivek %A Detchou,Donald K E %+ Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, United States, 1 410 516 8070, aozair1@jh.edu %K admission %K assessment %K postgraduate training %K selection %K standardized testing %K graduate medical education %K medical education %D 2023 %7 17.8.2023 %9 Letter to the Editor %J JMIR Med Educ %G English %X %M 37590044 %R 10.2196/50109 %U https://mededu.jmir.org/2023/1/e50109 %U https://doi.org/10.2196/50109 %U http://www.ncbi.nlm.nih.gov/pubmed/37590044 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e47763 %T Additional Considerations for US Residency Selection After Pass/Fail USMLE Step 1. Comment on “The US Residency Selection Process After the United States Medical Licensing Examination Step 1 Pass/Fail Change: Overview for Applicants and Educators” %A Sow,Yacine %A Gangal,Ameya %A Yeung,Howa %A Blalock,Travis %A Stoff,Benjamin %+ Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA, 30310, United States, 1 678 900 3441, yacinenellysow@gmail.com %K admission %K assessment %K postgraduate training %K selection %K standardized testing %K USMLE %K medical school %K medical students %K residency application %K research training %D 2023 %7 17.8.2023 %9 Letter to the Editor %J JMIR Med Educ %G English %X %M 37590047 %R 10.2196/47763 %U https://mededu.jmir.org/2023/1/e47763 %U https://doi.org/10.2196/47763 %U http://www.ncbi.nlm.nih.gov/pubmed/37590047 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e43231 %T Selected Skill Sets as Building Blocks for High School-to-Medical School Bridge: Longitudinal Study Among Undergraduate Medical Students %A Alsuwaidi,Laila %A Otaki,Farah %A Hassan Khamis,Amar %A AlGurg,Reem %A Lakhtakia,Ritu %+ College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Building 14, Dubai Healthcare City, Dubai, PO box 505055, United Arab Emirates, 971 43838708, laila.alsuwaidi@mbru.ac.ae %K transition %K undergraduate %K medical %K education %K academic performance %K self-regulated learning %D 2023 %7 4.7.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: The high school–to–medical school education transition is a significant milestone in the students’ academic journey, which is characterized by multiple stressors. Although this crucial transition has been repetitively explored, the concept of proactively intervening to support this transition is still novel. Objective: In this study, we investigated the efficacy of a web-based multidimensional resilience building intervention in developing selected soft skills that are believed to drive the learner’s success in any learning setting. The association between the students' academic performance over time and their proficiency in selected modules addressing skill sets, including Time Management, Memory and Study, Listening and Taking Notes, and College Transition, was also assessed to test the impact of the intervention on the students’ learning. Methods: A longitudinal study was conducted on 1 cohort of students of a Bachelor of Medicine, Bachelor of Surgery program (MBBS). The medical students were offered a learning intervention around 4 skill sets during the first year of the 6-year program. Quantitative analyses were conducted using deidentified data, relating to the students' proficiency in the 4 skill sets and to the students’ academic performance: grade point average (GPA). Descriptive analyses constituted computing an overall score of skill sets’ proficiency (of all 4 selected skill sets). The mean and SD (and percentage of the mean) were also calculated for each skill set component, independently, and for the overall score of skill sets’ proficiency. Bivariate Pearson correlations were used to assess the extent to which the academic performance of the students can be explained by the corresponding students’ level of proficiency in each skill set component and by all 4 sets together. Results: Out of the 63 admitted students, 28 participated in the offered intervention. The means and SDs of the annual GPA of the students for years 1 and 2 (GPA range 1-4) were 2.83 (SD 0.74) and 2.83 (SD 0.99), respectively. The mean and SD of the cumulative GPA toward the end of year 2 was 2.92 (SD 0.70). Correlation analysis showed that the overall score of skill sets proficiency was significantly associated with the annual GPA of year 1 (r=0.44; P=.02) but was not associated with their annual GPA of year 2. The cumulative GPA (toward the end of year 2) appeared to be significantly associated with the overall score (r=0.438; P=.02). Conclusions: Developing purposefully selected skill sets among medical students holds the potential of facilitating the high school–to–medical school education transition and is likely to improve their academic performance. As the medical student progresses, the acquired skills need to be continuously reinforced and effectively built upon. %M 37402145 %R 10.2196/43231 %U https://mededu.jmir.org/2023/1/e43231 %U https://doi.org/10.2196/43231 %U http://www.ncbi.nlm.nih.gov/pubmed/37402145 %0 Journal Article %@ 1929-073X %I JMIR Publications %V 12 %N %P e46075 %T Development of a Pilot Introductory Advanced Cardiovascular Resuscitation Course for Senior Medical Students in Switzerland: Student-Driven Implementation Study %A Herren,Tara %A Fivaz,Loris %A Dufeil,Eva %A Golay,Eric %A Braun,Ely %A Straub,Emilie %A Nidegger,Philippe %A Grosgurin,Olivier %A Gartner,Birgit Andrea %A Suppan,Mélanie %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 advanced cardiovascular life support %K undergraduate medical education %K cardiopulmonary resuscitation %K CPR %K medical education %K resuscitation %K web-based questionnaire %K collaborative design %K implementation %K medical course %K curriculum %K student %K life support %K training %K cardiac arrest %K medical student %D 2023 %7 27.6.2023 %9 Original Paper %J Interact J Med Res %G English %X Background: Cardiac arrest is the most time-critical emergency medical students and junior physicians may face in their personal or professional life. However, many studies have shown that most of them lack the necessary knowledge and skills to efficiently perform resuscitation. This could be related to the fact that advanced cardiovascular resuscitation courses are not always part of the undergraduate medical curriculum. Objective: The aim of this study was to describe the development, pilot implementation, and assessment of an advanced cardiovascular resuscitation course designed to enable senior medical students to manage the initial resuscitation phase in case of cardiac arrest. Methods: An introductory advanced cardiovascular resuscitation course was developed on the initiative of fifth-year medical students, in collaboration with the prehospital emergency medical service team of the Geneva University Hospitals. The 60 slots available to the 157 members of the fifth-year promotion of the University of Geneva Faculty of Medicine were filled in less than 8 hours. This unexpected success prompted the creation of a first questionnaire, which was sent to all fifth-year students to determine the overall proportion of students interested in attending an advanced cardiovascular resuscitation course. This questionnaire was also used to assess basic life support education and experience among course participants. A postcourse questionnaire was used to gather feedback regarding the course and to assess student confidence regarding the resuscitation skills they had been taught. Results: Out of 157 fifth-year medical students, 73 (46%) completed the first questionnaire. Most thought that the current curriculum did not provide them with enough knowledge and skills regarding resuscitation and 85% (62/73) wished to attend an introductory advanced cardiovascular resuscitation course. All the participants who would have wanted to follow the full Advanced Cardiovascular Life Support course before graduating were set back by its cost (10/10, 100%). Of the 60 students who had registered for the training sessions, 56 (93%) actually attended. The postcourse questionnaire was completed by 42 (87%) students (out of 48 who had registered on the platform). They unanimously answered that an advanced cardiovascular resuscitation course should be part of the standard curriculum. Conclusions: This study demonstrates the interest of senior medical students in an advanced cardiovascular resuscitation course and their willingness to see such a course integrated as a part of their regular curriculum. %M 37231610 %R 10.2196/46075 %U https://www.i-jmr.org/2023/1/e46075 %U https://doi.org/10.2196/46075 %U http://www.ncbi.nlm.nih.gov/pubmed/37231610 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 12 %N %P e45992 %T Ascertaining the Career Intentions of Medical Students (AIMS) in the United Kingdom Post Graduation: Protocol for a Mixed Methods Study %A Ferreira,Tomas %A Collins,Alexander M %A Horvath,Rita %+ School of Clinical Medicine, University of Cambridge, Cambridge Centre For Brain Repair, Ed Adrian Building, Cambridge, CB2 0PY, Cambridge, United Kingdom, 44 7887382199, tf385@cam.ac.uk %K medical students %K NHS %K National Health Service %K career intent %K attitude %K opinion %K workforce %K workforce planning %K medical education %K career %K doctor %K medical training %K medical graduate %K cross-sectional %K thematic analysis %K degree %K rotation %D 2023 %7 19.6.2023 %9 Protocol %J JMIR Res Protoc %G English %X Background: Among doctors in the United Kingdom, there is growing sentiment regarding delaying specialist training, emigrating to practice medicine abroad, or leaving the profession altogether. This trend may have substantial implications for the future of the profession in the United Kingdom. The extent to which this sentiment is also present in the medical student population is not well understood. Objective: Our primary outcome is to determine current medical students’ career intentions after graduation and upon completing the foundation program and to establish the motivations behind these intentions. Secondary outcomes include determining which, if any, demographic factors alter the propensity to pursue different career paths available to a medical graduate, determining which specialties medical students plan on pursuing, and understanding current views on the prospect of working in the National Health Service (NHS). Methods: The Ascertaining the Career Intentions of Medical Students (AIMS) study is a national, multi-institution, and cross-sectional study in which all medical students at all medical schools in the United Kingdom are eligible to participate. It was administered via a novel, mixed methods, and web-based questionnaire and disseminated through a collaborative network of approximately 200 students recruited for this purpose. Both quantitative and thematic analyses will be performed. Results: The study was launched nationally on January 16, 2023. Data collection was closed on March 27, 2023, and data analysis has commenced. The results are expected to be available later in the year. Conclusions: Doctors’ career satisfaction within the NHS is a well-researched topic; however, there is a shortage of high-powered studies that are able to offer insight into medical students’ outlook on their future careers. It is anticipated that the results of this study will bring clarity to this issue. Identified areas of improvement in medical training or within the NHS could be targeted to improve doctors’ working conditions and help retain medical graduates. Results may also aid future workforce-planning efforts. International Registered Report Identifier (IRRID): DERR1-10.2196/45992 %M 37335615 %R 10.2196/45992 %U https://www.researchprotocols.org/2023/1/e45992 %U https://doi.org/10.2196/45992 %U http://www.ncbi.nlm.nih.gov/pubmed/37335615 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e46428 %T Artificial Intelligence Teaching as Part of Medical Education: Qualitative Analysis of Expert Interviews %A Weidener,Lukas %A Fischer,Michael %+ Research Unit for Quality and Ethics in Health Care, UMIT TIROL – Private University for Health Sciences and Health Technology, Eduard-Wallnöfer-Zentrum 1, Hall in Tirol, 6060, Austria, 43 17670491594, lukas.weidener@edu.umit-tirol.at %K AI technology %K artificial intelligence %K clinical context %K expert interviews %K health care %K medical curriculum %K medical education %K medical school %K medical student %K medicine %D 2023 %7 24.4.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: The use of artificial intelligence (AI) in medicine is expected to increase significantly in the upcoming years. Advancements in AI technology have the potential to revolutionize health care, from aiding in the diagnosis of certain diseases to helping with treatment decisions. Current literature suggests the integration of the subject of AI in medicine as part of the medical curriculum to prepare medical students for the opportunities and challenges related to the use of the technology within the clinical context. Objective: We aimed to explore the relevant knowledge and understanding of the subject of AI in medicine and specify curricula teaching content within medical education. Methods: For this research, we conducted 12 guideline-based expert interviews. Experts were defined as individuals who have been engaged in full-time academic research, development, or teaching in the field of AI in medicine for at least 5 years. As part of the data analysis, we recorded, transcribed, and analyzed the interviews using qualitative content analysis. We used the software QCAmap and inductive category formation to analyze the data. Results: The qualitative content analysis led to the formation of three main categories (“Knowledge,” “Interpretation,” and “Application”) with a total of 9 associated subcategories. The experts interviewed cited knowledge and an understanding of the fundamentals of AI, statistics, ethics, and privacy and regulation as necessary basic knowledge that should be part of medical education. The analysis also showed that medical students need to be able to interpret as well as critically reflect on the results provided by AI, taking into account the associated risks and data basis. To enable the application of AI in medicine, medical education should promote the acquisition of practical skills, including the need for basic technological skills, as well as the development of confidence in the technology and one’s related competencies. Conclusions: The analyzed expert interviews’ results suggest that medical curricula should include the topic of AI in medicine to develop the knowledge, understanding, and confidence needed to use AI in the clinical context. The results further imply an imminent need for standardization of the definition of AI as the foundation to identify, define, and teach respective content on AI within medical curricula. %M 36946094 %R 10.2196/46428 %U https://mededu.jmir.org/2023/1/e46428 %U https://doi.org/10.2196/46428 %U http://www.ncbi.nlm.nih.gov/pubmed/36946094 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e43792 %T Use of Multiple-Select Multiple-Choice Items in a Dental Undergraduate Curriculum: Retrospective Study Involving the Application of Different Scoring Methods %A Kanzow,Philipp %A Schmidt,Dennis %A Herrmann,Manfred %A Wassmann,Torsten %A Wiegand,Annette %A Raupach,Tobias %+ Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str 40, Göttingen, 37075, Germany, 49 551 3960870, philipp.kanzow@med.uni-goettingen.de %K dental education %K education system %K educational assessment %K educational measurement %K examination %K k of n %K Kprim %K K’ %K MTF %K Multiple-True-False %K Pick-N %K scoring %K scoring system %K Type X %K undergraduate %K undergraduate curriculum %K undergraduate education %D 2023 %7 27.3.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: Scoring and awarding credit are more complex for multiple-select items than for single-choice items. Forty-one different scoring methods were retrospectively applied to 2 multiple-select multiple-choice item types (Pick-N and Multiple-True-False [MTF]) from existing examination data. Objective: This study aimed to calculate and compare the mean scores for both item types by applying different scoring methods, and to investigate the effect of item quality on mean raw scores and the likelihood of resulting scores at or above the pass level (≥0.6). Methods: Items and responses from examinees (ie, marking events) were retrieved from previous examinations. Different scoring methods were retrospectively applied to the existing examination data to calculate corresponding examination scores. In addition, item quality was assessed using a validated checklist. Statistical analysis was performed using the Kruskal-Wallis test, Wilcoxon rank-sum test, and multiple logistic regression analysis (P<.05). Results: We analyzed 1931 marking events of 48 Pick-N items and 828 marking events of 18 MTF items. For both item types, scoring results widely differed between scoring methods (minimum: 0.02, maximum: 0.98; P<.001). Both the use of an inappropriate item type (34 items) and the presence of cues (30 items) impacted the scoring results. Inappropriately used Pick-N items resulted in lower mean raw scores (0.88 vs 0.93; P<.001), while inappropriately used MTF items resulted in higher mean raw scores (0.88 vs 0.85; P=.001). Mean raw scores were higher for MTF items with cues than for those without cues (0.91 vs 0.8; P<.001), while mean raw scores for Pick-N items with and without cues did not differ (0.89 vs 0.90; P=.09). Item quality also impacted the likelihood of resulting scores at or above the pass level (odds ratio ≤6.977). Conclusions: Educators should pay attention when using multiple-select multiple-choice items and select the most appropriate item type. Different item types, different scoring methods, and presence of cues are likely to impact examinees’ scores and overall examination results. %M 36841970 %R 10.2196/43792 %U https://mededu.jmir.org/2023/1/e43792 %U https://doi.org/10.2196/43792 %U http://www.ncbi.nlm.nih.gov/pubmed/36841970 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e45631 %T Understanding Prospective Physicians’ Intention to Use Artificial Intelligence in Their Future Medical Practice: Configurational Analysis %A Wagner,Gerit %A Raymond,Louis %A Paré,Guy %+ Faculty Information Systems and Applied Computer Sciences, University of Bamberg, An der Weberei 5, Bamberg, 96047, Germany, 49 0951863 ext 27834, gerit.wagner@uni-bamberg.de %K artificial intelligence %K medical education %K attitudes and beliefs %K knowledge and experience %K behavioral intentions %K fuzzy-set qualitative comparative analysis %K fsQCA %D 2023 %7 22.3.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: Prospective physicians are expected to find artificial intelligence (AI) to be a key technology in their future practice. This transformative change has caught the attention of scientists, educators, and policy makers alike, with substantive efforts dedicated to the selection and delivery of AI topics and competencies in the medical curriculum. Less is known about the behavioral perspective or the necessary and sufficient preconditions for medical students’ intention to use AI in the first place. Objective: Our study focused on medical students’ knowledge, experience, attitude, and beliefs related to AI and aimed to understand whether they are necessary conditions and form sufficient configurations of conditions associated with behavioral intentions to use AI in their future medical practice. Methods: We administered a 2-staged questionnaire operationalizing the variables of interest (ie, knowledge, experience, attitude, and beliefs related to AI, as well as intention to use AI) and recorded 184 responses at t0 (February 2020, before the COVID-19 pandemic) and 138 responses at t1 (January 2021, during the COVID-19 pandemic). Following established guidelines, we applied necessary condition analysis and fuzzy-set qualitative comparative analysis to analyze the data. Results: Findings from the fuzzy-set qualitative comparative analysis show that the intention to use AI is only observed when students have a strong belief in the role of AI (individually necessary condition); certain AI profiles, that is, combinations of knowledge and experience, attitudes and beliefs, and academic level and gender, are always associated with high intentions to use AI (equifinal and sufficient configurations); and profiles associated with nonhigh intentions cannot be inferred from profiles associated with high intentions (causal asymmetry). Conclusions: Our work contributes to prior knowledge by showing that a strong belief in the role of AI in the future of medical professions is a necessary condition for behavioral intentions to use AI. Moreover, we suggest that the preparation of medical students should go beyond teaching AI competencies and that educators need to account for the different AI profiles associated with high or nonhigh intentions to adopt AI. %M 36947121 %R 10.2196/45631 %U https://mededu.jmir.org/2023/1/e45631 %U https://doi.org/10.2196/45631 %U http://www.ncbi.nlm.nih.gov/pubmed/36947121 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e43415 %T Changes in Radiology Due to Artificial Intelligence That Can Attract Medical Students to the Specialty %A Liu,David Shalom %A Abu-Shaban,Kamil %A Halabi,Safwan S %A Cook,Tessa Sundaram %+ University of Toledo College of Medicine and Life Sciences, 2801 W Bancroft, Toledo, OH, 43606, United States, 1 4016628518, david.liu@utoledo.edu %K artificial intelligence %K AI %K radiology %K medical students %K residency %K medical education %K students %K automated %K clinical informatics %K patient %K care %K innovation %K radiologist %D 2023 %7 20.3.2023 %9 Viewpoint %J JMIR Med Educ %G English %X The role of artificial intelligence (AI) in radiology has grown exponentially in the recent years. One of the primary worries by medical students is that AI will cause the roles of a radiologist to become automated and thus obsolete. Therefore, there is a greater hesitancy by medical students to choose radiology as a specialty. However, it is in this time of change that the specialty needs new thinkers and leaders. In this succinct viewpoint, 2 medical students involved in AI and 2 radiologists specializing in AI or clinical informatics posit that not only are these fears false, but the field of radiology will be transformed in such a way due to AI that there will be novel reasons to choose radiology. These new factors include greater impact on patient care, new space for innovation, interdisciplinary collaboration, increased patient contact, becoming master diagnosticians, and greater opportunity for global health initiatives, among others. Finally, since medical students view mentorship as a critical resource when deciding their career path, medical educators must also be cognizant of these changes and not give much credence to the prevalent fearmongering. As the field and practice of radiology continue to undergo significant change due to AI, it is urgent and necessary for the conversation to expand from expert to expert to expert to student. Medical students should be encouraged to choose radiology specifically because of the changes brought on by AI rather than being deterred by it. %M 36939823 %R 10.2196/43415 %U https://mededu.jmir.org/2023/1/e43415 %U https://doi.org/10.2196/43415 %U http://www.ncbi.nlm.nih.gov/pubmed/36939823 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e42364 %T Implementation of a Biopsychosocial History and Physical Exam Template in the Electronic Health Record: Mixed Methods Study %A Rieger,Erin Y %A Anderson,Irsk J %A Press,Valerie G %A Cui,Michael X %A Arora,Vineet M %A Williams,Brent C %A Tang,Joyce W %+ Department of Medicine, University of Chicago, 5841 S Maryland Avenue, Chicago, IL, 60637, United States, 1 773 702 1111, jtang@bsd.uchicago.edu %K medical education %K electronic health record %K hospital medicine %K psychosocial factors %K chronic condition %K chronic %K disease %K management %K prevention %K clinical %K engagement %D 2023 %7 21.2.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: Patients’ perspectives and social contexts are critical for prevention of hospital readmissions; however, neither is routinely assessed using the traditional history and physical (H&P) examination nor commonly documented in the electronic health record (EHR). The H&P 360 is a revised H&P template that integrates routine assessment of patient perspectives and goals, mental health, and an expanded social history (behavioral health, social support, living environment and resources, function). Although the H&P 360 has shown promise in increasing psychosocial documentation in focused teaching contexts, its uptake and impact in routine clinical settings are unknown. Objective: The aim of this study was to assess the feasibility, acceptability, and impact on care planning of implementing an inpatient H&P 360 template in the EHR for use by fourth-year medical students. Methods: A mixed methods study design was used. Fourth-year medical students on internal medicine subinternship (subI) services were given a brief training on the H&P 360 and access to EHR-based H&P 360 templates. Students not working in the intensive care unit (ICU) were asked to use the templates at least once per call cycle, whereas use by ICU students was elective. An EHR query was used to identify all H&P 360 and traditional H&P admission notes authored by non-ICU students at University of Chicago (UC) Medicine. Of these notes, all H&P 360 notes and a sample of traditional H&P notes were reviewed by two researchers for the presence of H&P 360 domains and impact on patient care. A postcourse survey was administered to query all students for their perspectives on the H&P 360. Results: Of the 13 non-ICU subIs at UC Medicine, 6 (46%) used the H&P 360 templates at least once, which accounted for 14%-92% of their authored admission notes (median 56%). Content analysis was performed with 45 H&P 360 notes and 54 traditional H&P notes. Psychosocial documentation across all H&P 360 domains (patient perspectives and goals, mental health, expanded social history elements) was more common in H&P 360 compared with traditional notes. Related to impact on patient care, H&P 360 notes more commonly identified needs (20% H&P 360; 9% H&P) and described interdisciplinary coordination (78% H&P 360; 41% H&P). Of the 11 subIs completing surveys, the vast majority (n=10, 91%) felt the H&P 360 helped them understand patient goals and improved the patient-provider relationship. Most students (n=8, 73%) felt the H&P 360 took an appropriate amount of time. Conclusions: Students who applied the H&P 360 using templated notes in the EHR found it feasible and helpful. These students wrote notes reflecting enhanced assessment of goals and perspectives for patient-engaged care and contextual factors important to preventing rehospitalization. Reasons some students did not use the templated H&P 360 should be examined in future studies. Uptake may be enhanced through earlier and repeated exposure and greater engagement by residents and attendings. Larger-scale implementation studies can help further elucidate the complexities of implementing nonbiomedical information within EHRs. %M 36802337 %R 10.2196/42364 %U https://mededu.jmir.org/2023/1/e42364 %U https://doi.org/10.2196/42364 %U http://www.ncbi.nlm.nih.gov/pubmed/36802337 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e37069 %T The US Residency Selection Process After the United States Medical Licensing Examination Step 1 Pass/Fail Change: Overview for Applicants and Educators %A Ozair,Ahmad %A Bhat,Vivek %A Detchou,Donald K E %+ St John's Medical College, Sarjapur Main Road, Bangalore, 560034, India, 91 5712720044, email.vivekbhat@gmail.com %K admission %K assessment %K postgraduate training %K selection %K standardized testing %D 2023 %7 6.1.2023 %9 Viewpoint %J JMIR Med Educ %G English %X The United States Medical Licensing Examination (USMLE) Step 1, arguably the most significant assessment in the USMLE examination series, changed from a 3-digit score to a pass/fail outcome in January 2022. Given the rapidly evolving body of literature on this subject, this paper aims to provide a comprehensive review of the historical context and impact of this change on various stakeholders involved in residency selection. For this, relevant keyword-based searches were performed in PubMed, Google Scholar, and Scopus to identify relevant literature. Given the unique history of USMLE Step 1 in the US residency selection process and the score’s correlation with future performance in board-certifying examinations in different specialties, this scoring change is predicted to significantly impact US Doctor of Medicine students, US Doctor of Osteopathic Medicine students, international medical graduates, and residency program directors, among others. The significance and the rationale of the pass/fail change along with the implications for both residency applicants and educators are also summarized in this paper. Although medical programs, academic institutions, and residency organizing bodies across the United States have swiftly stepped up to ensure a seamless transition and have attempted to ensure equity for all, the conversion process carries considerable uncertainty for residency applicants. For educators, the increasing number of applications conflicts with holistic application screening, leading to the expected greater use of objective measures, with USMLE Step 2 Clinical Knowledge likely becoming the preferred screening tool in lieu of Step 1. %M 36607718 %R 10.2196/37069 %U https://mededu.jmir.org/2023/1/e37069 %U https://doi.org/10.2196/37069 %U http://www.ncbi.nlm.nih.gov/pubmed/36607718 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 6 %N 9 %P e37252 %T Extracurricular Humanism in Medicine Initiative and Medical Student Wellness: Retrospective Study %A Auckley,Elizabeth Diane %A Barbee,Jeff %A Verbeck,Nicole %A McCambridge,Tracie %A Stone,Linda %A Garvin,Jennifer %+ The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, United States, 1 4402926035, elizabeth.auckley@osumc.edu %K humanism %K extracurricular %K stress %K burnout %K medical student %K student %K academic success %K wellness %D 2022 %7 16.9.2022 %9 Original Paper %J JMIR Form Res %G English %X Background: Humanism in Medicine Initiative (HIMI), an extracurricular program at Ohio State University College of Medicine (OSUCOM) with 27 subgroups, fosters the humanities. Stress and burnout among first- and second-year medical students are prevalent across the United States. Solutions for stress among first- and second-year medical students have been proposed, but no gold standard exists. The relationship of humanism with stress and burnout has yet to be described in the literature. Objective: This study investigates the relationship between participation in the HIMI and stress, burnout, and academic success among first- and second-year medical students. Methods: First- and second-year medical students enrolled at OSUCOM between August 2018 and August 2019 were recruited. Attendance in the HIMI and membership records were used to measure their participation. Curricular examination scores and those on Step 1 of United States Medical Licensing Examination (USMLE) were used to measure academic success. Stress and burnout were measured using the Maslach Burnout Inventory and the Perceived Stress Scale. Results: In total, 412 students were enrolled with 362 (87%) students participating in HIMI. Those with high participation were more often Black, Asian, female, or with a humanities undergraduate major compared to the overall study population. There were significant relationships between Gold Humanism Honors Society (GHHS) induction and participation of first- and second-year medical students in service- (χ21=5.8, P<.05) or leadership-focused (χ21=19.3, P<.001) HIMI groups. Medium levels of participation in the HIMI were associated with significantly higher stress. Performance on the Step 1 USMLE was not significantly associated with participation levels in the HIMI (low=233.7 vs high=238.0; P=.10). Conclusions: The HIMI is an extracurricular program vastly utilized by first- and second-year medical students at OSUCOM and did not impact Step 1 USMLE scores. Medium participation in the HIMI was associated with higher stress, and service- and leadership-focused HIMI participation was associated with a higher level of induction to the GHHS. This study identifies areas for future studies to understand the relationship of the HIMI with stress and academic success. %M 36112401 %R 10.2196/37252 %U https://formative.jmir.org/2022/9/e37252 %U https://doi.org/10.2196/37252 %U http://www.ncbi.nlm.nih.gov/pubmed/36112401 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 3 %P e36447 %T Comparing the Psychological Effects of Manikin-Based and Augmented Reality–Based Simulation Training: Within-Subjects Crossover Study %A Toohey,Shannon %A Wray,Alisa %A Hunter,John %A Waldrop,Ian %A Saadat,Soheil %A Boysen-Osborn,Megan %A Sudario,Gabriel %A Smart,Jonathan %A Wiechmann,Warren %A Pressman,Sarah D %+ Department of Emergency Medicine, University of California, Irvine, City Tower, Ste 640, Rt 128-01, Orange, CA, 92868, United States, 1 805 501 9674, stoohey@hs.uci.edu %K augmented reality %K AR %K salivary cortisol %K galvanic skin conductance %K medical simulation %K medical education %D 2022 %7 1.8.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: Patient simulators are an increasingly important part of medical training. They have been shown to be effective in teaching procedural skills, medical knowledge, and clinical decision-making. Recently, virtual and augmented reality simulators are being produced, but there is no research on whether these more realistic experiences cause problematic and greater stress responses as compared to standard manikin simulators. Objective: The purpose of this research is to examine the psychological and physiological effects of augmented reality (AR) in medical simulation training as compared to traditional manikin simulations. Methods: A within-subjects experimental design was used to assess the responses of medical students (N=89) as they completed simulated (using either manikin or AR) pediatric resuscitations. Baseline measures of psychological well-being, salivary cortisol, and galvanic skin response (GSR) were taken before the simulations began. Continuous GSR assessments throughout and after the simulations were captured along with follow-up measures of emotion and cortisol. Participants also wrote freely about their experience with each simulation, and narratives were coded for emotional word use. Results: Of the total 86 medical students who participated, 37 (43%) were male and 49 (57%) were female, with a mean age of 25.2 (SD 2.09, range 22-30) years and 24.7 (SD 2.08, range 23-36) years, respectively. GSR was higher in the manikin group adjusted for day, sex, and medications taken by the participants (AR-manikin: –0.11, 95% CI –0.18 to –0.03; P=.009). The difference in negative affect between simulation types was not statistically significant (AR-manikin: 0.41, 95% CI –0.72 to 1.53; P=.48). There was no statistically significant difference between simulation types in self-reported stress (AR-manikin: 0.53, 95% CI –2.35 to 3.42; P=.71) or simulation stress (AR-manikin: –2.17, 95% CI –6.94 to 2.59; P=.37). The difference in percentage of positive emotion words used to describe the experience was not statistically significant between simulation types, which were adjusted for day of experiment, sex of the participants, and total number of words used (AR-manikin: –4.0, 95% CI –0.91 to 0.10; P=.12). There was no statistically significant difference between simulation types in terms of the percentage of negative emotion words used to describe the experience (AR-manikin: –0.33, 95% CI –1.12 to 0.46; P=.41), simulation sickness (AR-manikin: 0.17, 95% CI –0.29 to 0.62; P=.47), or salivary cortisol (AR-manikin: 0.04, 95% CI –0.05 to 0.13; P=.41). Finally, preexisting levels of posttraumatic stress disorder, perceived stress, and reported depression were not tied to physiological responses to AR. Conclusions: AR simulators elicited similar stress responses to currently used manikin-based simulators, and we did not find any evidence of AR simulators causing excessive stress to participants. Therefore, AR simulators are a promising tool to be used in medical training, which can provide more emotionally realistic scenarios without the risk of additional harm. %M 35916706 %R 10.2196/36447 %U https://mededu.jmir.org/2022/3/e36447 %U https://doi.org/10.2196/36447 %U http://www.ncbi.nlm.nih.gov/pubmed/35916706 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 3 %P e32185 %T The Role of Metacognitive Beliefs in Predicting Academic Procrastination Among Students in Iran: Cross-sectional Study %A Safari,Yahya %A Yousefpoor,Nasrin %+ Department of General Paramedicine, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Dolatabad Street, Kermanshah, 6719875131, Iran, 98 9188349360, n_yousefpoor@yahoo.com %K procrastination %K metacognitive awareness %K medical students %K academic training %D 2022 %7 28.7.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: Academic procrastination is a challenge that many students face. Metacognitive beliefs are the main cause of academic procrastination because they are one of the main reasons for students' academic failure or progress. Objective: This study aimed to determine whether and to what extent academic procrastination could be predicted based on students’ metacognitive beliefs. Methods: This descriptive cross-sectional study involved 300 students selected via stratified random sampling. Data were collected using the Procrastination Assessment Scale for Students and the Metacognition Questionnaire-30. The data analysis was done using the Pearson correlation coefficient and regression analysis to estimate the correlation coefficient and predictability of academic procrastination based on metacognitive beliefs. Results: A significant negative correlation was observed between the subscale of positive beliefs of concern and academic procrastination (r=–0.16; P<.001). In addition, the metacognitive beliefs of the participants predicted 10% of academic procrastination. The component of positive metacognitive beliefs with the β value of 0.45 negatively and significantly predicted the students’ academic procrastination (P<.001), whereas the component of negative metacognitive beliefs with the β value of .39 positively and significantly predicted the students’ academic procrastination (P<.001). Conclusions: Metacognitive beliefs can predict students' academic procrastination. Therefore, the modification of metacognitive beliefs to reduce procrastination is suggested. %M 35900821 %R 10.2196/32185 %U https://mededu.jmir.org/2022/3/e32185 %U https://doi.org/10.2196/32185 %U http://www.ncbi.nlm.nih.gov/pubmed/35900821 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 3 %P e37081 %T Opioid Use Disorder Education for Students and the Future of Opioid Overdose Treatment %A Balapal,Neha %A Ankem,Amala %A Shyamsundar,Saishravan %A He,Shuhan %+ City University of New York School of Medicine, 160 Convent Avenue, New York, NY, 10031, United States, 1 845 536 0837, nbalapa000@csom.cuny.edu %K opioid use disorder %K students %K buprenorphine %K education %K public health %K opioid %K health care providers %K healthcare providers %K medication-assisted treatment %K youth %K substance use %K opioid agonist %K overdose %D 2022 %7 18.7.2022 %9 Viewpoint %J JMIR Med Educ %G English %X Opioid use disorder (OUD) is a major public health concern in the United States. The opioid crisis has taken hundreds of thousands of lives in the past 20 years, and it is predicted to take millions more. With the rising death tolls, it is essential that health care providers are able to use proper tools to treat OUD efficiently and effectively through medication-assisted treatment (MAT), particularly buprenorphine. Despite changes to buprenorphine regulations making it more accessible, clinicians have been slow to use buprenorphine to treat OUD. We believe that training student clinicians in evidence-based MAT and buprenorphine practices will address the training and competence barriers that hinder clinicians from prescribing buprenorphine to treat OUD. Students are in an ideal position to receive and benefit from this training and influence the medical community to better treat OUD. %M 35849432 %R 10.2196/37081 %U https://mededu.jmir.org/2022/3/e37081 %U https://doi.org/10.2196/37081 %U http://www.ncbi.nlm.nih.gov/pubmed/35849432 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 2 %P e37872 %T Evaluation of Online Near-Peer Teaching for Penultimate-Year Objective Structured Clinical Examinations in the COVID-19 Era: Longitudinal Study %A Shah,Savan %+ Barking Havering and Redbridge University Hospitals NHS Trust, Queen's Hospital, 2 Parham Drive, London, IG2 6LZ, United Kingdom, 44 7415057781, savan.shah2012@gmail.com %K near-peer teaching %K peer-assisted learning %K Objective Structured Clinical Examination %K OSCE %K online teaching %K COVID-19 %K medical education %K learning %K medical school %K near-peer teacher %K NPT %K near-peer learner %K NPL %D 2022 %7 26.5.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: The benefits of near-peer learning are well established in several aspects of undergraduate medical education including preparing students for Objective Structured Clinical Examinations (OSCEs). The COVID-19 pandemic has resulted in a paradigm shift to predominantly online teaching. Objective: This study aims to demonstrate the feasibility and benefits of an exclusively online near-peer OSCE teaching program in a time of significant face-to-face and senior-led teaching shortage. Methods: A teaching program was delivered to penultimate-year students by final-year students at Manchester Medical School. Program development involved compiling a list of salient topics and seeking senior faculty approval. Teachers and students were recruited on Facebook. In total, 22 sessions and 42 talks were attended by 72 students and taught by 13 teachers over a 3-month period. Data collection involved anonymous weekly questionnaires and 2 separate anonymous student and teacher postcourse questionnaires including both quantitative and qualitative components. Results: On a scale of 1-10, students rated the quality of the program highly (mean 9.30, SD 1.15) and felt the sessions were highly useful in guiding their revision (mean 8.95, SD 0.94). There was a significant increase in perceived confidence ratings after delivery of the program (P<.001). Teachers felt the program helped them better understand and retain the subject material taught (mean 9.36, SD 0.81) and develop skills to become effective clinical teachers (mean 9.27, SD 0.79). Conclusions: This is the first study demonstrating the efficacy of a near-peer OSCE teaching program delivered exclusively online. This provides an exemplary framework for how similar programs should be encouraged given their efficacy and logistical viability in supplementing the undergraduate curriculum. %M 35617013 %R 10.2196/37872 %U https://mededu.jmir.org/2022/2/e37872 %U https://doi.org/10.2196/37872 %U http://www.ncbi.nlm.nih.gov/pubmed/35617013 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 2 %P e33565 %T An Alternative to Traditional Bedside Teaching During COVID-19: High-Fidelity Simulation-Based Study %A Ajab,Shereen %A Pearson,Emma %A Dumont,Steven %A Mitchell,Alicia %A Kastelik,Jack %A Balaji,Packianathaswamy %A Hepburn,David %+ Hull York Medical School, Hull University Teaching Hospitals NHS Trust, Allam Medical Building, Cottingham Road, Hull, HU6 7RX, United Kingdom, 44 1482875875, shereen.ajab@nhs.net %K simulation %K high fidelity %K low fidelity %K COVID-19 %K bedside teaching %K undergraduate medical education %K fidelity %K medical education %K medical student %K review %K innovation %K risk %K design %K implementation %D 2022 %7 9.5.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: Bedside teaching is integral to medical education and has been highlighted to improve clinical and communication skills, as well as clinical reasoning. Despite the significant advantages of bedside teaching, its usage within medical education has been declining, and COVID-19 has added additional challenges. The pandemic has resulted in a significant reduction in opportunities to deliver bedside teaching due to risk of viral exposure, patients declining student interactions, and ward closures. Educators have therefore been required to be innovative in their teaching methods, leading to the use of online learning, social media platforms, and simulation. Simulation-based education allows for learning in a low-risk environment and affords the opportunity for deliberated repeated practice with case standardization. The results demonstrate that simulation-based training can increase students’ confidence, increase the rates of correct clinical diagnoses, and improve retention of skills and knowledge when compared with traditional teaching methods. Objective: To mitigate the impact of COVID-19 upon bedside teaching for third year students at Hull York Medical School amid closure of the cardiorespiratory wards, a high-fidelity simulation-based model of traditional bedside teaching was designed and implemented. The objectives of the teaching session were to enable students to perform history taking and a focused cardiorespiratory clinical examination in a COVID-19–safe environment using SimMan 3G. Methods: Four clinical teaching fellows with experience of simulation-based medical education scripted histories for 2 common cardiorespiratory cases, which were asthma and aortic stenosis. The simulation sessions were designed for students to take a focused cardiorespiratory history and clinical examination using SimMan 3G. All cases involved dynamic vital signs, and the simulator allowed for auscultation of an ejection systolic murmur and wheezing in accordance with the cases chosen. Key aspects of the pathologies, including epidemiology, differential diagnoses, investigations, and management, were summarized using an interactive PowerPoint presentation, followed by a debriefing session. Results: In total, 12 third year medical students undertook the sessions, and overall feedback was highly positive. Of the 10 students who completed the feedback questionnaires, 90% (n=9) felt more confident in their clinical examination skills following the teaching; 100% (n=10) of the students responded that they would recommend the session to a colleague; and implementation of regular simulation was frequently requested on feedback. These results are in keeping with the current literature. Conclusions: Bedside teaching continues to face ongoing challenges from the COVID-19 pandemic as well as declining patient recruitment and fluctuations in clinical findings. The support for simulation-based medical education is derived from high-quality studies; however, studies describing the use of this technology for bedside teaching in the undergraduate curriculum are limited. The authors describe a highly effective teaching session amid the pandemic, which allowed for maintenance of staff and student safety alongside continued education during a challenging time for educators globally. %M 35404828 %R 10.2196/33565 %U https://mededu.jmir.org/2022/2/e33565 %U https://doi.org/10.2196/33565 %U http://www.ncbi.nlm.nih.gov/pubmed/35404828 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 2 %P e34973 %T Readiness to Embrace Artificial Intelligence Among Medical Doctors and Students: Questionnaire-Based Study %A Boillat,Thomas %A Nawaz,Faisal A %A Rivas,Homero %+ Design Lab, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Healthcare City 14, Dubai, United Arab Emirates, 971 43838759, Thomas.boillat@mbru.ac.ae %K artificial intelligence in medicine %K health care %K questionnaire %K medical doctors %K medical students %D 2022 %7 12.4.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: Similar to understanding how blood pressure is measured by a sphygmomanometer, physicians will soon have to understand how an artificial intelligence–based application has come to the conclusion that a patient has hypertension, diabetes, or cancer. Although there are an increasing number of use cases where artificial intelligence is or can be applied to improve medical outcomes, the extent to which medical doctors and students are ready to work and leverage this paradigm is unclear. Objective: This research aims to capture medical students’ and doctors’ level of familiarity toward artificial intelligence in medicine as well as their challenges, barriers, and potential risks linked to the democratization of this new paradigm. Methods: A web-based questionnaire comprising five dimensions—demographics, concepts and definitions, training and education, implementation, and risks—was systematically designed from a literature search. It was completed by 207 participants in total, of which 105 (50.7%) medical doctors and 102 (49.3%) medical students trained in all continents, with most of them in Europe, the Middle East, Asia, and North America. Results: The results revealed no significant difference in the familiarity of artificial intelligence between medical doctors and students (P=.91), except that medical students perceived artificial intelligence in medicine to lead to higher risks for patients and the field of medicine in general (P<.001). We also identified a rather low level of familiarity with artificial intelligence (medical students=2.11/5; medical doctors=2.06/5) as well as a low attendance to education or training. Only 2.9% (3/105) of medical doctors attended a course on artificial intelligence within the previous year, compared with 9.8% (10/102) of medical students. The complexity of the field of medicine was considered one of the biggest challenges (medical doctors=3.5/5; medical students=3.8/5), whereas the reduction of physicians’ skills was the most important risk (medical doctors=3.3; medical students=3.6; P=.03). Conclusions: The question is not whether artificial intelligence will be used in medicine, but when it will become a standard practice for optimizing health care. The low level of familiarity with artificial intelligence identified in this study calls for the implementation of specific education and training in medical schools and hospitals to ensure that medical professionals can leverage this new paradigm and improve health outcomes. %M 35412463 %R 10.2196/34973 %U https://mededu.jmir.org/2022/2/e34973 %U https://doi.org/10.2196/34973 %U http://www.ncbi.nlm.nih.gov/pubmed/35412463 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 1 %P e32183 %T Technology Literacy in Undergraduate Medical Education: Review and Survey of the US Medical School Innovation and Technology Programs %A Wang,Judy Jiaqi %A Singh,Rishabh K %A Miselis,Heather Hough %A Stapleton,Stephanie Nicole %+ Department of Emergency Medicine, Boston University School of Medicine, Boston Medical Center, 1 Boston Medical Center Place, Boston, MA, 02118, United States, 1 6174144892, snstaple13@gmail.com %K curricular development %K medical innovation %K medical technology %K student engagement %D 2022 %7 31.3.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: Modern innovations, like machine learning, genomics, and digital health, are being integrated into medical practice at a rapid pace. Physicians in training receive little exposure to the implications, drawbacks, and methodologies of upcoming technologies prior to their deployment. As a result, there is an increasing need for the incorporation of innovation and technology (I&T) training, starting in medical school. Objective: We aimed to identify and describe curricular and extracurricular opportunities for innovation in medical technology in US undergraduate medical education to highlight challenges and develop insights for future directions of program development. Methods: A review of publicly available I&T program information on the official websites of US allopathic medical schools was conducted in June 2020. Programs were categorized by structure and implementation. The geographic distribution of these categories across US regions was analyzed. A survey was administered to school-affiliated student organizations with a focus on I&T and publicly available contact information. The data collected included the founding year, thematic focus, target audience, activities offered, and participant turnout rate. Results: A total of 103 I&T opportunities at 69 distinct Liaison Committee on Medical Education–accredited medical schools were identified and characterized into the following six categories: (1) integrative 4-year curricula, (2) facilitated doctor of medicine/master of science dual degree programs in a related field, (3) interdisciplinary collaborations, (4) areas of concentration, (5) preclinical electives, and (6) student-run clubs. The presence of interdisciplinary collaboration is significantly associated with the presence of student-led initiatives (P=.001). “Starting and running a business in healthcare” and “medical devices” were the most popular thematic focuses of student-led I&T groups, representing 87% (13/15) and 80% (12/15) of respondents, respectively. “Career pathways exploration for students” was the only type of activity that was significantly associated with a high event turnout rate of >26 students per event (P=.03). Conclusions: Existing school-led and student-driven opportunities in medical I&T indicate growing national interest and reflect challenges in implementation. The greater visibility of opportunities, collaboration among schools, and development of a centralized network can be considered to better prepare students for the changing landscape of medical practice. %M 35357319 %R 10.2196/32183 %U https://mededu.jmir.org/2022/1/e32183 %U https://doi.org/10.2196/32183 %U http://www.ncbi.nlm.nih.gov/pubmed/35357319 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 1 %P e33612 %T Student-Run Online Journal Club Initiative During a Time of Crisis: Survey Study %A Ozkara,Burak Berksu %A Karabacak,Mert %A Alpaydin,Duygu Demet %+ Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, İstanbul Üniversitesi-Cerrahpaşa Tıp Fakültesi, Kocamustafapaşa Cd. No 53, Istanbul, 34098, Turkey, 90 5542993096, berksuozkara@gmail.com %K online journal club %K medical student %K distance learning %K COVID-19 %K undergraduate education %K student journal club %K online education %K establishment %K initiative %K literature %K research %K publishing %K education %D 2022 %7 7.3.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: Since the closure of university campuses due to COVID-19 in spring 2020 necessitated a quick transition to online courses, medical students were isolated from hospitals and universities, negatively impacting their education. During this time, medical students had no opportunity to participate in academic discussions and were also socially isolated. Furthermore, medical doctors and professors of medical schools were given additional responsibilities during the pandemic because they were the frontliners in the fight against COVID-19. As a result, they did not have enough time to contribute effectively to medical student education. Objective: This paper describes the establishment of the Cerrahpasa Neuroscience Society Journal Clubs, a group of entirely student-run online journal clubs at Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa. Methods: The website, mass emailing, and social media accounts were used to announce the online journal clubs. Only medical students were eligible to apply. Journal clubs included psychiatry, neuroradiology, neurosurgery, neurology, and neuroscience. Following the last journal club meeting, a questionnaire created by the society’s board was distributed to the participants. SPSS Statistics (version 26) was used for statistical analysis. Results: Since March 15, 2021, synchronous online journal club meetings have been held every 2 weeks on a weekday using Google Meet, Microsoft Teams, or Zoom. Meetings of each journal club lasted approximately 1 hour on average. Interstudent interaction across multiple institutions was achieved since a total of 45 students from 11 different universities attended the meetings on a regular basis. Students on the society’s board served as academic mentors for the clubs. The clubs received excellent feedback from participants, with an overall contentment score of 4.32 out of 5. Conclusions: By establishing these clubs, we have created a venue for academic discussions, which helps to reduce the negative impact of the pandemic on education. In addition, we believe it greatly aided students in staying in touch with their peers, thereby reducing the sense of isolation. We realize that traditional journal clubs are run by faculty; however, we believe that this experience demonstrated that medical students could run a journal club on their own since the feedback from participants was excellent. Additionally, as a medical student, being a journal club academic mentor is a challenging responsibility; however, having this responsibility significantly improved our academic mentors’ leadership abilities. %M 35148270 %R 10.2196/33612 %U https://mededu.jmir.org/2022/1/e33612 %U https://doi.org/10.2196/33612 %U http://www.ncbi.nlm.nih.gov/pubmed/35148270 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 1 %P e34751 %T Real-life Evaluation of an Interactive Versus Noninteractive e-Learning Module on Chronic Obstructive Pulmonary Disease for Medical Licentiate Students in Zambia: Web-Based, Mixed Methods Randomized Controlled Trial %A Schnieders,Elena %A Röhr,Freda %A Mbewe,Misho %A Shanzi,Aubrey %A Berner-Rodoreda,Astrid %A Barteit,Sandra %A Louis,Valérie R %A Andreadis,Petros %A Syakantu,Gardner %A Neuhann,Florian %+ Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Im Neuenheimer Feld 672, Heidelberg, 69120, Germany, 49 6221 564904, E.Schnieders@stud.uni-heidelberg.de %K distance education %K randomized controlled trial %K personal satisfaction %K knowledge %K user-centered design %K chronic obstructive pulmonary disease %K interactive %K noninteractive %K low- and middle-income country %K LMIC %K mobile phone %D 2022 %7 24.2.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: e-Learning for health professionals in many low- and middle-income countries (LMICs) is still in its infancy, but with the advent of COVID-19, a significant expansion of digital learning has occurred. Asynchronous e-learning can be grouped into interactive (user-influenceable content) and noninteractive (static material) e-learning. Studies conducted in high-income countries suggest that interactive e-learning is more effective than noninteractive e-learning in increasing learner satisfaction and knowledge; however, there is a gap in our understanding of whether this also holds true in LMICs. Objective: This study aims to validate the hypothesis above in a resource-constrained and real-life setting to understand e-learning quality and delivery by comparing interactive and noninteractive e-learning user satisfaction, usability, and knowledge gain in a new medical university in Zambia. Methods: We conducted a web-based, mixed methods randomized controlled trial at the Levy Mwanawasa Medical University (LMMU) in Lusaka, Zambia, between April and July 2021. We recruited medical licentiate students (second, third, and fourth study years) via email. Participants were randomized to undergo asynchronous e-learning with an interactive or noninteractive module for chronic obstructive pulmonary disease and informally blinded to their group allocation. The interactive module included interactive interfaces, quizzes, and a virtual patient, whereas the noninteractive module consisted of PowerPoint slides. Both modules covered the same content scope. The primary outcome was learner satisfaction. The secondary outcomes were usability, short- and long-term knowledge gain, and barriers to e-learning. The mixed methods study followed an explanatory sequential design in which rating conferences delivered further insights into quantitative findings, which were evaluated through web-based questionnaires. Results: Initially, 94 participants were enrolled in the study, of whom 41 (44%; 18 intervention participants and 23 control participants) remained in the study and were analyzed. There were no significant differences in satisfaction (intervention: median 33.5, first quartile 31.3, second quartile 35; control: median 33, first quartile 30, second quartile 37.5; P=.66), usability, or knowledge gain between the intervention and control groups. Challenges in accessing both e-learning modules led to many dropouts. Qualitative data suggested that the content of the interactive module was more challenging to access because of technical difficulties and individual factors (eg, limited experience with interactive e-learning). Conclusions: We did not observe an increase in user satisfaction with interactive e-learning. However, this finding may not be generalizable to other low-resource settings because the post hoc power was low, and the e-learning system at LMMU has not yet reached its full potential. Consequently, technical and individual barriers to accessing e-learning may have affected the results, mainly because the interactive module was considered more difficult to access and use. Nevertheless, qualitative data showed high motivation and interest in e-learning. Future studies should minimize technical barriers to e-learning to further evaluate interactive e-learning in LMICs. %M 35200149 %R 10.2196/34751 %U https://mededu.jmir.org/2022/1/e34751 %U https://doi.org/10.2196/34751 %U http://www.ncbi.nlm.nih.gov/pubmed/35200149 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 1 %P e22096 %T e-Learning in Medical Education in Sri Lanka: Survey of Medical Undergraduates and New Graduates %A Samarasekara,Keshinie %+ University Medical Unit, National Hospital of Sri Lanka, EW Perera Mawatha, Colombo, 00700, Sri Lanka, 94 779124748, k_samarasekara@yahoo.com %K medical education %K e-learning %K Sri Lanka %K medical students %D 2022 %7 10.2.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: Medical education has undergone drastic changes with the advent of novel technologies that enable e-learning. Medical students are increasingly using e-learning methods, and universities have incorporated them into their curricula. Objective: This study aimed at delineating the pattern of use of e-learning methods among medical undergraduates and new graduates of the Faculty of Medicine, University of Colombo, and identifying the challenges faced by these students in using e-learning methods. Methods: A cross-sectional descriptive study was conducted in the Faculty of Medicine, University of Colombo, in April 2020, with the participation of current undergraduates and pre-intern medical graduates, using a self-administered questionnaire that collected data on sociodemographic details, pattern of use of learning methods, and challenges faced using e-learning methods. Results: There were 778 respondents, with a response rate of 65.1% (778/1195). All the study participants used e-learning resources with varying frequencies, and all of them had at least 1 smart device with access to the internet. Electronic versions of standard textbooks (e-books), nonmedical websites, online lectures, medical websites, and medical phone apps were used by the majority. When comparing the extent of use of different learning methods, it appeared that students preferentially used traditional learning methods. The preference was influenced by the year of study and family income. The 3 most commonly used modalities for learning new study material and revising previously learned content were notes on paper material, textbooks (paper version), and e-books. The majority (98.7% [n=768]) of participants have encountered problems using e-learning resources. The most commonly faced problems were unavailability of free-of-charge access to some e-learning methods, expenses related to internet connection, poor connectivity of mobile internet, distractions while using online resources, and lack of storage space on electronic devices. Conclusions: There is a high uptake of e-learning methods among Sri Lankan medical students. However, when comparing the extent of use of different learning methods, it appeared that students preferentially used traditional learning methods. A majority of the students have encountered problems when using e-learning methods, and most of these problems were related to poor economic status. Universities should take these factors into consideration when developing curricula in medical education. %M 35142626 %R 10.2196/22096 %U https://mededu.jmir.org/2022/1/e22096 %U https://doi.org/10.2196/22096 %U http://www.ncbi.nlm.nih.gov/pubmed/35142626 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 11 %N 2 %P e32992 %T Assessing the Efficacy of an Individualized Psychological Flexibility Skills Training Intervention App for Medical Student Burnout and Well-being: Protocol for a Randomized Controlled Trial %A Ditton,Elizabeth %A Knott,Brendon %A Hodyl,Nicolette %A Horton,Graeme %A Walker,Frederick Rohan %A Nilsson,Michael %+ Centre for Rehab Innovations, University of Newcastle, University Drive, Callaghan, 2308, Australia, 61 2 404 ext 20738, elizabeth.ditton@newcastle.edu.au %K burnout %K psychological %K burnout interventions %K psychological flexibility %K digital intervention %K individualized intervention %K acceptance and commitment therapy %K medical students %K well-being %K mobile phone %D 2022 %7 4.2.2022 %9 Protocol %J JMIR Res Protoc %G English %X Background: Medical student burnout is a prevalent problem with adverse long-term outcomes. Incorporating psychological resource-building interventions into comprehensive burnout prevention approaches during medical training is an identified priority among educators. These interventions could reduce burnout risk by buffering students against nonmodifiable career stressors. However, there is a need for rigorous investigation into optimal intervention targets and methods. Psychological flexibility (PF) is an adaptive behavioral skill set that has demonstrated relationships with medical student burnout and well-being. More broadly, there is evidence that PF mediates burnout and well-being outcomes and may be a protective factor. Efficacy studies assessing the benefits of interventions targeting PF among medical students are needed. Research also supports the need to establish optimal methods for increasing intervention efficacy in the context of individual differences in burnout and PF by using individualized approaches. Objective: This study aims to assess whether an app-delivered PF intervention (Acceptance and Commitment Training) reduces burnout and improves well-being among medical students. We will examine whether changes in burnout and well-being are mediated by changes in PF. The potential benefits of an individualized version of the app versus those of a nonindividualized version will also be evaluated. Methods: In this 3-arm, parallel, randomized controlled study, a sample of medical students will be randomly allocated to 1 of 3 intervention arms (individualized, nonindividualized, and waiting list) by using a 1:1:1 allocation ratio. Participants in the individualized and nonindividualized intervention arms will have 5 weeks to access the app, which includes a PF concepts training session (stage 1) and access to short PF skill activities on demand (stage 2). Stage 2 will be either individualized to meet participants’ identified PF training needs at each log-in or nonindividualized. Results: Burnout, well-being, and PF will be assessed at baseline and after the intervention. Quantitative analyses will include descriptive and inferential statistics. We hypothesize that the Acceptance and Commitment Training intervention app will be effective in improving burnout and well-being and that changes in these outcomes will be mediated by changes in PF. We further hypothesize that participants in the individualized intervention group will demonstrate greater improvements in burnout and well-being outcomes than those in the nonindividualized group. Conclusions: The findings of this study could guide the development of burnout prevention and well-being initiatives for medical students. Identifying PF as a mediating process would provide support for the delivery of preventive intervention programs that train individuals to strengthen this psychological resource before burnout symptoms emerge. This would be an important step in addressing and potentially offsetting the significant costs of burnout among medical students and physicians. Demonstrating the superiority of an individualized version of the app over a nonindividualized version would have implications for enhancing intervention precision and efficacy by using scalable interventions. Trial Registration: Australian New Zealand Clinical Trials Registry ANZCTR 12621000911897; https://www.anzctr.org.au/ACTRN12621000911897.aspx International Registered Report Identifier (IRRID): PRR1-10.2196/32992 %M 35119378 %R 10.2196/32992 %U https://www.researchprotocols.org/2022/2/e32992 %U https://doi.org/10.2196/32992 %U http://www.ncbi.nlm.nih.gov/pubmed/35119378 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 1 %P e31392 %T Preparing Medical Students for the Final Examinations During the COVID-19 Crisis: A Bumpy Ride to the Finishing Line %A Mageswaran,Nanthini %A Ismail,Noor Akmal Shareela %+ Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia, 60 391459552, nasismail@ukm.edu.my %K COVID-19 %K undergraduate medical education %K medical students %K clinical competency %K pandemic %D 2022 %7 3.2.2022 %9 Viewpoint %J JMIR Med Educ %G English %X In this viewpoint, we share and reflect on the experiences of final-year students preparing for a high-stakes examination at the Faculty of Medicine, Universiti Kebangsaan Malaysia during the COVID-19 pandemic. We highlight the new challenges faced during web-based remote learning and major differences in the clinical learning environment at our teaching hospital, which was one of the designated COVID-19 centers in Malaysia. We also document how a face-to-face professional examination was conducted for final-year medical students at our institution despite in times of a global health crisis. The lessons learned throughout this process address the importance of resilience and adaptability in unprecedented times. Further, we recommend appropriate measures that could be applied by medical schools across the world to improve the delivery of quality medical education during a crisis in the years to come. %M 35084354 %R 10.2196/31392 %U https://mededu.jmir.org/2022/1/e31392 %U https://doi.org/10.2196/31392 %U http://www.ncbi.nlm.nih.gov/pubmed/35084354 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 1 %P e34860 %T Virtual Reality in Medical Students’ Education: Scoping Review %A Jiang,Haowen %A Vimalesvaran,Sunitha %A Wang,Jeremy King %A Lim,Kee Boon %A Mogali,Sreenivasulu Reddy %A Car,Lorainne Tudor %+ Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road Singapore, Singapore, 308232, Singapore, 65 69041258, lorainne.tudor.car@ntu.edu.sg %K virtual reality %K medical education %K medical students %K virtual worlds %K digital health education %D 2022 %7 2.2.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: Virtual reality (VR) produces a virtual manifestation of the real world and has been shown to be useful as a digital education modality. As VR encompasses different modalities, tools, and applications, there is a need to explore how VR has been used in medical education. Objective: The objective of this scoping review is to map existing research on the use of VR in undergraduate medical education and to identify areas of future research. Methods: We performed a search of 4 bibliographic databases in December 2020. Data were extracted using a standardized data extraction form. The study was conducted according to the Joanna Briggs Institute methodology for scoping reviews and reported in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Results: Of the 114 included studies, 69 (60.5%) reported the use of commercially available surgical VR simulators. Other VR modalities included 3D models (15/114, 13.2%) and virtual worlds (20/114, 17.5%), which were mainly used for anatomy education. Most of the VR modalities included were semi-immersive (68/114, 59.6%) and were of high interactivity (79/114, 69.3%). There is limited evidence on the use of more novel VR modalities, such as mobile VR and virtual dissection tables (8/114, 7%), as well as the use of VR for nonsurgical and nonpsychomotor skills training (20/114, 17.5%) or in a group setting (16/114, 14%). Only 2.6% (3/114) of the studies reported the use of conceptual frameworks or theories in the design of VR. Conclusions: Despite the extensive research available on VR in medical education, there continue to be important gaps in the evidence. Future studies should explore the use of VR for the development of nonpsychomotor skills and in areas other than surgery and anatomy. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2020-046986 %M 35107421 %R 10.2196/34860 %U https://mededu.jmir.org/2022/1/e34860 %U https://doi.org/10.2196/34860 %U http://www.ncbi.nlm.nih.gov/pubmed/35107421 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 24 %N 2 %P e30082 %T Learning Outcomes of Immersive Technologies in Health Care Student Education: Systematic Review of the Literature %A Ryan,Grace V %A Callaghan,Shauna %A Rafferty,Anthony %A Higgins,Mary F %A Mangina,Eleni %A McAuliffe,Fionnuala %+ Perinatal Research Centre, Obstetrics and Gynaecology, School of Medicine, University College Dublin, The National Maternity Hospital, 65/66 Lower Mount Street Dublin, Dublin, D02 NX40, Ireland, 353 1 6373216, fionnuala.mcauliffe@ucd.ie %K Virtual Reality %K Augmented Reality %K Mixed Reality %K Learning Outcomes %K Medical Education %K Nursing Education %K Midwifery Education %K Systematic Review %D 2022 %7 1.2.2022 %9 Review %J J Med Internet Res %G English %X Background: There is a lack of evidence in the literature regarding the learning outcomes of immersive technologies as educational tools for teaching university-level health care students. Objective: The aim of this review is to assess the learning outcomes of immersive technologies compared with traditional learning modalities with regard to knowledge and the participants’ learning experience in medical, midwifery, and nursing preclinical university education. Methods: A systematic review was conducted according to the Cochrane Collaboration guidelines. Randomized controlled trials comparing traditional learning methods with virtual, augmented, or mixed reality for the education of medicine, nursing, or midwifery students were evaluated. The identified studies were screened by 2 authors independently. Disagreements were discussed with a third reviewer. The quality of evidence was assessed using the Medical Education Research Study Quality Instrument (MERSQI). The review protocol was registered with PROSPERO (International Prospective Register of Systematic Reviews) in April 2020. Results: Of 15,627 studies, 29 (0.19%) randomized controlled trials (N=2722 students) were included and evaluated using the MERSQI tool. Knowledge gain was found to be equal when immersive technologies were compared with traditional learning modalities; however, the learning experience increased with immersive technologies. The mean MERSQI score was 12.64 (SD 1.6), the median was 12.50, and the mode was 13.50. Immersive technology was predominantly used to teach clinical skills (15/29, 52%), and virtual reality (22/29, 76%) was the most commonly used form of immersive technology. Knowledge was the primary outcome in 97% (28/29) of studies. Approximately 66% (19/29) of studies used validated instruments and scales to assess secondary learning outcomes, including satisfaction, self-efficacy, engagement, and perceptions of the learning experience. Of the 29 studies, 19 (66%) included medical students (1706/2722, 62.67%), 8 (28%) included nursing students (727/2722, 26.71%), and 2 (7%) included both medical and nursing students (289/2722, 10.62%). There were no studies involving midwifery students. The studies were based on the following disciplines: anatomy, basic clinical skills and history-taking skills, neurology, respiratory medicine, acute medicine, dermatology, communication skills, internal medicine, and emergency medicine. Conclusions: Virtual, augmented, and mixed reality play an important role in the education of preclinical medical and nursing university students. When compared with traditional educational modalities, the learning gain is equal with immersive technologies. Learning outcomes such as student satisfaction, self-efficacy, and engagement all increase with the use of immersive technology, suggesting that it is an optimal tool for education. %M 35103607 %R 10.2196/30082 %U https://www.jmir.org/2022/2/e30082 %U https://doi.org/10.2196/30082 %U http://www.ncbi.nlm.nih.gov/pubmed/35103607 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 1 %P e33390 %T Health Care Students’ Perspectives on Artificial Intelligence: Countrywide Survey in Canada %A Teng,Minnie %A Singla,Rohit %A Yau,Olivia %A Lamoureux,Daniel %A Gupta,Aurinjoy %A Hu,Zoe %A Hu,Ricky %A Aissiou,Amira %A Eaton,Shane %A Hamm,Camille %A Hu,Sophie %A Kelly,Dayton %A MacMillan,Kathleen M %A Malik,Shamir %A Mazzoli,Vienna %A Teng,Yu-Wen %A Laricheva,Maria %A Jarus,Tal %A Field,Thalia S %+ School of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, 2211 Wesbrook Mall T325, Vancouver, BC, V6T 2B5, Canada, 1 (604) 822 7392, minnie.teng@ubc.ca %K medical education %K artificial intelligence %K allied health education %K medical students %K health care students %K medical curriculum %K education %D 2022 %7 31.1.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: Artificial intelligence (AI) is no longer a futuristic concept; it is increasingly being integrated into health care. As studies on attitudes toward AI have primarily focused on physicians, there is a need to assess the perspectives of students across health care disciplines to inform future curriculum development. Objective: This study aims to explore and identify gaps in the knowledge that Canadian health care students have regarding AI, capture how health care students in different fields differ in their knowledge and perspectives on AI, and present student-identified ways that AI literacy may be incorporated into the health care curriculum. Methods: The survey was developed from a narrative literature review of topics in attitudinal surveys on AI. The final survey comprised 15 items, including multiple-choice questions, pick-group-rank questions, 11-point Likert scale items, slider scale questions, and narrative questions. We used snowball and convenience sampling methods by distributing an email with a description and a link to the web-based survey to representatives from 18 Canadian schools. Results: A total of 2167 students across 10 different health professions from 18 universities across Canada responded to the survey. Overall, 78.77% (1707/2167) predicted that AI technology would affect their careers within the coming decade and 74.5% (1595/2167) reported a positive outlook toward the emerging role of AI in their respective fields. Attitudes toward AI varied by discipline. Students, even those opposed to AI, identified the need to incorporate a basic understanding of AI into their curricula. Conclusions: We performed a nationwide survey of health care students across 10 different health professions in Canada. The findings would inform student-identified topics within AI and their preferred delivery formats, which would advance education across different health care professions. %M 35099397 %R 10.2196/33390 %U https://mededu.jmir.org/2022/1/e33390 %U https://doi.org/10.2196/33390 %U http://www.ncbi.nlm.nih.gov/pubmed/35099397 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 1 %P e34369 %T Trauma Care Training in Vietnam: Narrative Scoping Review %A Nguyen,Ba Tuan %A Phung,Toi Lam %A Khuc,Thi Hong Hanh %A Nguyen,Van Anh Thi %A Blizzard,Christopher Leigh %A Palmer,Andrew %A Nguyen,Huu Tu %A Cong Quyet,Thang %A Nelson,Mark %+ Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, 7000, Australia, 61 460918919, batuan.nguyen@utas.edu.au %K trauma training %K Vietnamese medical education system %K medical curricula %K short course %D 2022 %7 24.1.2022 %9 Review %J JMIR Med Educ %G English %X Background: The model of trauma in Vietnam has changed significantly over the last decade and requires reforming medical education to deal with new circumstances. Our aim is to evaluate this transition regarding the new target by analyzing trauma and the medical training system as a whole. Objective: This study aimed to establish if medical training in the developing country of Vietnam has adapted to the new disease pattern of road trauma emerging in its economy. Methods: A review was performed of Vietnamese medical school, Ministry of Health, and Ministry of Education and Training literature on trauma education. The review process and final review paper were prepared following the guidelines on scoping reviews and using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart. Results: The current trauma training at the undergraduate level is minimal and involves less than 5% of the total credit. At the postgraduate level, only the specialties of surgery and anesthesia have a significant and increasing trauma training component ranging from 8% to 22% in the content. Trauma training, which focuses on practical skills, accounts for 31% and 32% of the training time of orientation courses for young doctors in “basic surgery” and “basic anesthesia,” respectively. Other relevant short course trainings, such as continuing medical education, in trauma are available, but they vary in topics, facilitators, participants, and formats. Conclusions: Medical training in Vietnam has not adapted to the new emerging disease pattern of road trauma. In the interim, the implementation of short courses, such as basic trauma life support and primary trauma care, can be considered as an appropriate method to compensate for the insufficient competency-related trauma care among health care workers while waiting for the effectiveness of medical training reformation. %M 34967756 %R 10.2196/34369 %U https://mededu.jmir.org/2022/1/e34369 %U https://doi.org/10.2196/34369 %U http://www.ncbi.nlm.nih.gov/pubmed/34967756 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 1 %P e32818 %T Social Determinants of Health Screening by Preclinical Medical Students During the COVID-19 Pandemic: Service-Based Learning Case Study %A Herrera,Tara %A Fiori,Kevin P %A Archer-Dyer,Heather %A Lounsbury,David W %A Wylie-Rosett,Judith %+ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1310 Belfer Building, 1300 Morris Park Avenue, Bronx, NY, 10461, United States, 1 516 737 4345, judith.wylie-rosett@einsteinmed.edu %K social determinants of health %K service-based learning %K telehealth %K preclinical education %K screening %K referral %K community health workers %K determinant %K medical student %K case study %K service %K preparation %K pilot %K feasibility %K training %K assessment %K needs %K electronic health record %K questionnaire %D 2022 %7 17.1.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: The inclusion of social determinants of health is mandated for undergraduate medical education. However, little is known about how to prepare preclinical students for real-world screening and referrals for addressing social determinants of health. Objective: This pilot project’s objective was to evaluate the feasibility of using a real-world, service-based learning approach for training preclinical students to assess social needs and make relevant referrals via the electronic medical record during the COVID-19 pandemic (May to June 2020). Methods: This project was designed to address an acute community service need and to teach preclinical, second-year medical student volunteers (n=11) how to assess social needs and make referrals by using the 10-item Social Determinants of Health Screening Questionnaire in the electronic health record (EHR; Epic platform; Epic Systems Corporation). Third-year medical student volunteers (n=3), who had completed 6 clinical rotations, led the 2-hour skills development orientation and were available for ongoing mentoring and peer support. All student-patient communication was conducted by telephone, and bilingual (English and Spanish) students called the patients who preferred to communicate in Spanish. We analyzed EHR data extracted from Epic to evaluate screening and data extracted from REDCap (Research Electronic Data Capture; Vanderbilt University) to evaluate community health workers’ notes. We elicited feedback from the participating preclinical students to evaluate the future use of this community-based service learning approach in our preclinical curriculum. Results: The preclinical students completed 45 screening interviews. Of the 45 screened patients, 20 (44%) screened positive for at least 1 social need. Almost all of these patients (19/20, 95%) were referred to the community health worker. Half (8/16, 50%) of the patients who had consultations with the community health worker were connected with a relevant social service resource. The preclinical students indicated that project participation increased their ability to assess social needs and make needed EHR referrals. Food insecurity was the most common social need. Conclusions: Practical exposure to social needs assessment has the potential to help preclinical medical students develop the ability to address social concerns prior to entering clinical clerkships in their third year of medical school. The students can also become familiar with the EHR prior to entering third-year clerkships. Physicians, who are aware of social needs and have the electronic medical record tools and staff resources needed to act, can create workflows to make social needs assessments and services integral components of health care. Research studies and quality improvement initiatives need to investigate how to integrate screening for social needs and connecting patients to the appropriate social services into routine primary care procedures. %M 35037885 %R 10.2196/32818 %U https://mededu.jmir.org/2022/1/e32818 %U https://doi.org/10.2196/32818 %U http://www.ncbi.nlm.nih.gov/pubmed/35037885 %0 Journal Article %@ 2291-9279 %I JMIR Publications %V 9 %N 4 %P e13124 %T Using a 360° Virtual Reality or 2D Video to Learn History Taking and Physical Examination Skills for Undergraduate Medical Students: Pilot Randomized Controlled Trial %A Chao,Yi-Ping %A Chuang,Hai-Hua %A Hsin,Li-Jen %A Kang,Chung-Jan %A Fang,Tuan-Jen %A Li,Hsueh-Yu %A Huang,Chung-Guei %A Kuo,Terry B J %A Yang,Cheryl C H %A Shyu,Hsin-Yih %A Wang,Shu-Ling %A Shyu,Liang-Yu %A Lee,Li-Ang %+ Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, No 5, Fu-Hsing Street, Guishan District, Taoyuan, 33305, Taiwan, 886 3 328 1200 ext 3972, 5738@cgmh.org.tw %K cognitive load %K heart rate variability %K video learning %K learning outcome %K secondary-task reaction time %K virtual reality %D 2021 %7 22.11.2021 %9 Original Paper %J JMIR Serious Games %G English %X Background: Learning through a 360° virtual reality (VR) or 2D video represents an alternative way to learn a complex medical education task. However, there is currently no consensus on how best to assess the effects of different learning materials on cognitive load estimates, heart rate variability (HRV), outcomes, and experience in learning history taking and physical examination (H&P) skills. Objective: The aim of this study was to investigate how learning materials (ie, VR or 2D video) impact learning outcomes and experience through changes in cognitive load estimates and HRV for learning H&P skills. Methods: This pilot system–design study included 32 undergraduate medical students at an academic teaching hospital. The students were randomly assigned, with a 1:1 allocation, to a 360° VR video group or a 2D video group, matched by age, sex, and cognitive style. The contents of both videos were different with regard to visual angle and self-determination. Learning outcomes were evaluated using the Milestone reporting form. Subjective and objective cognitive loads were estimated using the Paas Cognitive Load Scale, the National Aeronautics and Space Administration Task Load Index, and secondary-task reaction time. Cardiac autonomic function was assessed using HRV measurements. Learning experience was assessed using the AttrakDiff2 questionnaire and qualitative feedback. Statistical significance was accepted at a two-sided P value of <.01. Results: All 32 participants received the intended intervention. The sample consisted of 20 (63%) males and 12 (38%) females, with a median age of 24 (IQR 23-25) years. The 360° VR video group seemed to have a higher Milestone level than the 2D video group (P=.04). The reaction time at the 10th minute in the 360° VR video group was significantly higher than that in the 2D video group (P<.001). Multiple logistic regression models of the overall cohort showed that the 360° VR video module was independently and positively associated with a reaction time at the 10th minute of ≥3.6 seconds (exp B=18.8, 95% CI 3.2-110.8; P=.001) and a Milestone level of ≥3 (exp B=15.0, 95% CI 2.3-99.6; P=.005). However, a reaction time at the 10th minute of ≥3.6 seconds was not related to a Milestone level of ≥3. A low-frequency to high-frequency ratio between the 5th and 10th minute of ≥1.43 seemed to be inversely associated with a hedonic stimulation score of ≥2.0 (exp B=0.14, 95% CI 0.03-0.68; P=.015) after adjusting for video module. The main qualitative feedback indicated that the 360° VR video module was fun but caused mild dizziness, whereas the 2D video module was easy to follow but tedious. Conclusions: Our preliminary results showed that 360° VR video learning may be associated with a better Milestone level than 2D video learning, and that this did not seem to be related to cognitive load estimates or HRV indexes in the novice learners. Of note, an increase in sympathovagal balance may have been associated with a lower hedonic stimulation score, which may have met the learners’ needs and prompted learning through the different video modules. Trial Registration: ClinicalTrials.gov NCT03501641; https://clinicaltrials.gov/ct2/show/NCT03501641 %M 34813485 %R 10.2196/13124 %U https://games.jmir.org/2021/4/e13124 %U https://doi.org/10.2196/13124 %U http://www.ncbi.nlm.nih.gov/pubmed/34813485 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 23 %N 11 %P e25770 %T Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review %A Vukušić Rukavina,Tea %A Viskić,Joško %A Machala Poplašen,Lovela %A Relić,Danko %A Marelić,Marko %A Jokic,Drazen %A Sedak,Kristijan %+ Department of Fixed Prosthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, 10000, Croatia, 385 98769245, viskic@sfzg.hr %K e-professionalism %K social media %K internet %K health care professionals %K physicians %K nurses %K students %K medicine %K dental medicine %K nursing %D 2021 %7 17.11.2021 %9 Review %J J Med Internet Res %G English %X Background: As we are witnessing the evolution of social media (SM) use worldwide among the general population, the popularity of SM has also been embraced by health care professionals (HCPs). In the context of SM evolution and exponential growth of users, this scoping review summarizes recent findings of the e-professionalism of HCPs. Objective: The purpose of this scoping review is to characterize the recent original peer-reviewed research studies published between November 1, 2014, to December 31, 2020, on e-professionalism of HCPs; to assess the quality of the methodologies and approaches used; to explore the impact of SM on e-professionalism of HCPs; to recognize the benefits and dangers of SM; and to provide insights to guide future research in this area. Methods: A search of the literature published from November 1, 2014, to December 31, 2020, was performed in January 2021 using 3 databases (PubMed, CINAHL, and Scopus). The searches were conducted using the following defined search terms: “professionalism” AND “social media” OR “social networks” OR “Internet” OR “Facebook” OR “Twitter” OR “Instagram” OR “TikTok.” The search strategy was limited to studies published in English. This scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Results: Of the 1632 retrieved papers, a total of 88 studies were finally included in this review. Overall, the quality of the studies was satisfactory. Participants in the reviewed studies were from diverse health care professions. Medical health professionals were involved in about three-quarters of the studies. Three key benefits of SM on e-professionalism of HCPs were identified: (1) professional networking and collaboration, (2) professional education and training, and (3) patient education and health promotion. For the selected studies, there were five recognized dangers of SM on e-professionalism of HCPs: (1) loosening accountability, (2) compromising confidentiality, (3) blurred professional boundaries, (4) depiction of unprofessional behavior, and (5) legal issues and disciplinary consequences. This scoping review also recognizes recommendations for changes in educational curricula regarding e-professionalism as opportunities for improvement and barriers that influence HCPs use of SM in the context of e-professionalism. Conclusions: Findings in the reviewed studies indicate the existence of both benefits and dangers of SM on e-professionalism of HCPs. Even though there are some barriers recognized, this review has highlighted existing recommendations for including e-professionalism in the educational curricula of HCPs. Based on all evidence provided, this review provided new insights and guides for future research on this area. There is a clear need for robust research to investigate new emerging SM platforms, the efficiency of guidelines and educational interventions, and the specifics of each profession regarding their SM potential and use. %M 34662284 %R 10.2196/25770 %U https://www.jmir.org/2021/11/e25770 %U https://doi.org/10.2196/25770 %U http://www.ncbi.nlm.nih.gov/pubmed/34662284 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 4 %P e30533 %T Replicating Anatomical Teaching Specimens Using 3D Modeling Embedded Within a Multimodal e-Learning Course: Pre-Post Study Exploring the Impact on Medical Education During COVID-19 %A Stunden,Chelsea %A Zakani,Sima %A Martin,Avery %A Moodley,Shreya %A Jacob,John %+ Department of Pediatrics, University of British Columbia, 2D19 - 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada, 1 604 875 2345 ext 2393, john.jacob@cw.bc.ca %K congenital heart disease %K cardiac anatomy, pathologic anatomy %K education %K learning aids %K 3D models %D 2021 %7 17.11.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: The COVID-19 pandemic has had significant effects on anatomy education. During the pandemic, students have had no access to cadavers, which has been the principal method of learning anatomy. We created and tested a customized congenital heart disease e-learning course for medical students that contained interactive 3D models of anonymized pediatric congenital heart defects. Objective: The aim of this study is to assess whether a multimodal e-learning course contributed to learning outcomes in a cohort of first-year undergraduate medical students studying congenital heart diseases. The secondary aim is to assess student attitudes and experiences associated with multimodal e-learning. Methods: The pre-post study design involved 290 first-year undergraduate medical students. Recruitment was conducted by course instructors. Data were collected before and after using the course. The primary outcome was knowledge acquisition (test scores). The secondary outcomes included attitudes and experiences, time to complete the modules, and browser metadata. Results: A total of 141 students were included in the final analysis. Students’ knowledge significantly improved by an average of 44.6% (63/141) when using the course (SD 1.7%; Z=−10.287; P<.001). Most students (108/122, 88.3%) were highly motivated to learn with the course, and most (114/122, 93.5%) reported positive experiences with the course. There was a strong correlation between attitudes and experiences, which was statistically significant (rs=0.687; P<.001; n=122). No relationships were found between the change in test scores and attitudes (P=.70) or experiences (P=.47). Students most frequently completed the e-learning course with Chrome (109/141, 77.3%) and on Apple macOS (86/141, 61%) or Windows 10 (52/141, 36.9%). Most students (117/141, 83%) had devices with high-definition screens. Most students (83/141, 58.9%) completed the course in <3 hours. Conclusions: Multimodal e-learning could be a viable solution in improving learning outcomes and experiences for undergraduate medical students who do not have access to cadavers. Future research should focus on validating long-term learning outcomes. %M 34787589 %R 10.2196/30533 %U https://mededu.jmir.org/2021/4/e30533 %U https://doi.org/10.2196/30533 %U http://www.ncbi.nlm.nih.gov/pubmed/34787589 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 4 %P e30607 %T Using Instagram to Enhance a Hematology and Oncology Teaching Module During the COVID-19 Pandemic: Cross-sectional Study %A Koenig,Julia Felicitas Leni %A Buentzel,Judith %A Jung,Wolfram %A Truemper,Lorenz %A Wurm-Kuczera,Rebecca Isabel %+ Department of Hematology and Medical Oncology, University Medical Center Goettingen, Robert-Koch-Str. 40, Goettingen, 37075, Germany, 49 152 55139056, Rebecca.wurm@med.uni-goettingen.de %K COVID-19 %K medical education %K distance learning %K undergraduate medical education %K digital medical education %K Instagram %K hematology and medical oncology %D 2021 %7 15.11.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: The COVID-19 pandemic necessitated the rapid expansion of novel tools for digital medical education. At our university medical center, an Instagram account was developed as a tool for medical education and used for the first time as a supplement to the hematology and medical oncology teaching module of 2020/2021. Objective: We aimed to evaluate the acceptance and role of Instagram as a novel teaching format in the education of medical students in hematology and medical oncology in the German medical curriculum. Methods: To investigate the role of Instagram in student education of hematology and medical oncology, an Instagram account was developed as a tie-in for the teaching module of 2020/21. The account was launched at the beginning of the teaching module, and 43 posts were added over the 47 days of the teaching module (at least 1 post per day). Five categories for the post content were established: (1) engagement, (2) self-awareness, (3) everyday clinical life combined with teaching aids, (4) teaching aids, and (5) scientific resources. Student interaction with the posts was measured based on overall subscription, “likes,” comments, and polls. Approval to conduct this retrospective study was obtained from the local ethics commission of the University Medical Center Goettingen. Results: Of 164 medical students, 119 (72.6%) subscribed to the Instagram account, showing high acceptance and interest in the use of Instagram for medical education. The 43 posts generated 325 interactions. The highest number of interactions was observed for the category of engagement (mean 15.17 interactions, SD 5.01), followed by self-awareness (mean 14 interactions, SD 7.79). With an average of 7.3 likes per post, overall interaction was relatively low. However, although the category of scientific resources garnered the fewest likes (mean 1.86, SD 1.81), 66% (27/41) of the student participants who answered the related Instagram poll question were interested in studies and reviews, suggesting that although likes aid the estimation of a general trend of interest, there are facets to interest that cannot be represented by likes. Interaction significantly differed between posting categories (P<.001, Welch analysis of variance). Comparing the first category (engagement) with categories 3 to 5 showed a significant difference (Student t test with the Welch correction; category 1 vs 3, P=.01; category 1 vs 4, P=.01; category 1 vs 5, P=.001). Conclusions: Instagram showed high acceptance among medical students participating in the hematology and oncology teaching curriculum. Students were most interested in posts on routine clinical life, self-care topics, and memory aids. More studies need to be conducted to comprehend the use of Instagram in medical education and to define the role Instagram will play in the future. Furthermore, evaluation guidelines and tools need to be developed. %M 34779777 %R 10.2196/30607 %U https://mededu.jmir.org/2021/4/e30607 %U https://doi.org/10.2196/30607 %U http://www.ncbi.nlm.nih.gov/pubmed/34779777 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 4 %P e33861 %T Adjusting to the Reign of Webinars: Viewpoint %A Karabacak,Mert %A Ozkara,Burak Berksu %A Ozcan,Zeynep %+ Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Kocamustafapaşa Caddesi, No 53, Fatih, Istanbul, 34098, Turkey, 90 5396102138, mertkarabacak@gmail.com %K virtual conference %K student-based organization %K neuroscience conference %K COVID-19 %K medical education %K webinars %K web-based education %D 2021 %7 12.11.2021 %9 Viewpoint %J JMIR Med Educ %G English %X Background: With the integration of COVID-19 into our lives, the way events are organized has changed. The Cerrahpaşa Neuroscience Days held on May 8-9, 2021, was one of the conferences that was affected. The annual conference of the student-based Cerrahpaşa Neuroscience Society transitioned to the internet for the first time and had the premise of going international. Objective: With this study, we aim to both discuss how a virtual conference is organized and perceived, and where our conference stands within the literature as a completely student-organized event. Methods: The conference was planned in accordance with virtual standards and promoted to primarily medical schools. During the execution, there were no major issues. The feedback was collected via a form developed with Google Forms. Results: Out of 2195 registrations, 299 qualified to receive a certificate. The feedback forms revealed a general satisfaction; the overall quality of the event was rated an average of 4.6 out of 5, and the ratings of various Likert scale–based questions were statistically analyzed. Open-ended questions provided improvement suggestions for future events. Conclusions: The virtual Cerrahpaşa Neuroscience Days was a success in organization and received positive feedback from the participants. We aim to ground future events on this experience. %M 34766916 %R 10.2196/33861 %U https://mededu.jmir.org/2021/4/e33861 %U https://doi.org/10.2196/33861 %U http://www.ncbi.nlm.nih.gov/pubmed/34766916 %0 Journal Article %@ 2291-9279 %I JMIR Publications %V 9 %N 4 %P e17670 %T Evidence of Construct Validity of Computer-Based Tests for Clinical Reasoning: Instrument Validation Study %A Zuo,Tianming %A Sun,Baozhi %A Guan,Xu %A Zheng,Bin %A Qu,Bo %+ Institute for International Health Professions Education and Research, China Medical University, No. 77 Puhe Road, Shenyang, 110122, China, 86 189 0091 0198, qubo6666@163.com %K medical education %K assessment %K computer-based test %K clinical reasoning %K validity %D 2021 %7 9.11.2021 %9 Original Paper %J JMIR Serious Games %G English %X Background: Clinical reasoning (CR) is a fundamental skill for all medical students. In our medical education system, however, there are shortcomings in the conventional methods of teaching CR. New technology is needed to enhance our CR teaching, especially as we are facing an influx of new health trainees. China Medical University (CMU), in response to this need, has developed a computer-based CR training system (CMU-CBCRT). Objective: We aimed to find evidence of construct validity of the CMU-CBCRT. Methods: We recruited 385 students from fifth year undergraduates to postgraduate year (PGY) 3 to complete the test on CMU-CBCRT. The known-groups technique was used to evaluate the construct validity of the CBCRT by comparing the test scores among 4 training levels (fifth year MD, PGY-1, PGY-2, and PGY-3). Results: We found that test scores increased with years of training. Significant differences were found in the test scores on information collection, diagnosis, and treatment and total scores among different training years of participants. However, significant results were not found for treatment errors. Conclusions: We provided evidence of construct validity of the CMU-CBCRT, which could determine the CR skills of medical students at varying early stage in their careers. %M 34751658 %R 10.2196/17670 %U https://games.jmir.org/2021/4/e17670 %U https://doi.org/10.2196/17670 %U http://www.ncbi.nlm.nih.gov/pubmed/34751658 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 4 %P e31132 %T Use of an Online Ultrasound Simulator to Teach Basic Psychomotor Skills to Medical Students During the Initial COVID-19 Lockdown: Quality Control Study %A Meuwly,Jean-Yves %A Mandralis,Katerina %A Tenisch,Estelle %A Gullo,Giuseppe %A Frossard,Pierre %A Morend,Laura %+ Department of Radiology, University Hospital of Lausanne, University of Lausanne, Rue du Bugnon 46, Lausanne, 1011, Switzerland, 41 795565334, Jean-Yves.Meuwly@chuv.ch %K anatomy %K computers in anatomical education %K internet application in anatomy %K medical education %K ultrasonography %K ultrasound %K simulation %K simulator %K psychomotor %K motor skills %K medical students %K teaching %D 2021 %7 1.11.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: Teaching medical ultrasound has increased in popularity in medical schools with hands-on workshops as an essential part of teaching. However, the lockdown due to COVID-19 kept medical schools from conducting these workshops. Objective: The aim of this paper is to describe an alternative method used by our medical school to allow our students to acquire the essential psychomotor skills to produce ultrasound images. Methods: Our students took online ultrasound courses. Consequently, they had to practice ultrasound exercises on a virtual simulator, using the mouse of their computer to control a simulated transducer. Our team measured the precision reached at the completion of simulation exercises. Before and after completion of the courses and simulator’s exercises, students had to complete a questionnaire dedicated to psychomotor skills. A general evaluation questionnaire was also submitted. Results: A total of 193 students returned the precourse questionnaire. A total of 184 performed all the simulator exercises and 181 answered the postcourse questionnaire. Of the 180 general evaluation questionnaires that were sent out, 136 (76%) were returned. The average precourse score was 4.23 (SD 2.14). After exercising, the average postcourse score was 6.36 (SD 1.82), with a significant improvement (P<.001). The postcourse score was related to the accuracy with which the simulator exercises were performed (Spearman rho 0.2664; P<.001). Nearly two-thirds (n=84, 62.6%) of the students said they enjoyed working on the simulator. A total of 79 (58.0%) students felt that they had achieved the course’s objective of reproducing ultrasound images. Inadequate connection speed had been a problem for 40.2% (n=54) of students. Conclusions: The integration of an online simulator for the practical learning of ultrasound in remote learning situations has allowed for substantial acquisitions in the psychomotor field of ultrasound diagnosis. Despite the absence of workshops, the students were able to learn and practice how to handle an ultrasound probe to reproduce standard images. This study enhances the value of online programs in medical education, even for practical skills. %M 34723818 %R 10.2196/31132 %U https://mededu.jmir.org/2021/4/e31132 %U https://doi.org/10.2196/31132 %U http://www.ncbi.nlm.nih.gov/pubmed/34723818 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 4 %P e33090 %T Effects of a 2-Week Remote Learning Program on Empathy and Clinical and Communication Skills in Premedical Students: Mixed Methods Evaluation Study %A Srivastava,Ujwal %A Price,Amy %A Chu,Larry F %+ Anesthesia, Informatics and Media Lab, Stanford School of Medicine, 2370 Watson Court, Suite 235, Palo Alto, CA, 94303, United States, 1 650 464 3450, lchu@stanford.edu %K empathy %K clinical skills %K communication skills %K high school %K undergraduate %K summer program %K premedical program %K remote learning %D 2021 %7 27.10.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: Expressing empathy builds trust with patients, increases patient satisfaction, and is associated with better health outcomes. Research shows that expressing empathy to patients improves patient adherence to medications and decreases patient anxiety and the number of malpractice lawsuits. However, there is a dearth of research on teaching empathy to premedical students. The Clinical Science, Technology, and Medicine Summer Internship of Stanford Medicine (also called the Stanford Anesthesia Summer Institute) is a 2-week collaborative medical internship for high school and undergraduate students to inspire learners to be compassionate health care providers. The summer 2020 program was adapted to accomplish these objectives in a fully remote environment because of the COVID-19 global pandemic. Objective: This study aims to measure the change in empathy and competencies of participants in clinical and communication skills before and after program participation. Methods: A total of 41 participants completed only the core track of this program, and 39 participants completed the core + research track of this program. Participants in both tracks received instructions in selected clinical skills and interacted directly with patients to improve their interviewing skills. Research track participants received additional instructions in research methodology. All participants completed web-based pre- and postsurveys containing Knowledge and Skills Assessment (KSA) questions. Participant empathy was assessed using the validated Consultation and Relational Empathy measure. A subset of participants completed optional focus groups to discuss empathy. The pre- and post-KSA and Consultation and Relational Empathy measure scores were compared using paired 2-tailed t tests and a linear regression model. Open-ended focus group answers were then analyzed thematically. Results: Participants in both tracks demonstrated significant improvement in empathy after the 2-week remote learning course (P=.007 in core track; P<.001 in research track). These results remained significant when controlling for gender and age. A lower pretest score was associated with a greater change in empathy. Participants in both tracks demonstrated significant improvement in KSA questions related to surgical skills (P<.001 in core track; P<.001 in research track), epinephrine pen use (P<.001 in core track; P<.001 in research track), x-ray image interpretation (P<.001 in core track; P<.001 in research track), and synthesizing information to solve problems (P<.001 in core track; P=.05 in research track). The core track participants also showed significant improvements in health communication skills (P=.001). Qualitative analysis yielded 3 themes: empathy as action, empathy as a mindset, and empathy in designing health care systems. Conclusions: Summer internships that introduce high school and undergraduate students to the field of health care through hands-on interaction and patient involvement may be an effective way to develop measurable empathy skills when combined with clinical skills training and mentorship. Notably, increases in empathy were observed in a program administered via a remote learning environment. %M 34704956 %R 10.2196/33090 %U https://mededu.jmir.org/2021/4/e33090 %U https://doi.org/10.2196/33090 %U http://www.ncbi.nlm.nih.gov/pubmed/34704956 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 3 %P e22235 %T The Association Between Gaming Practices and Scholastic Performance Among Medical Students in India: Case-Control Study %A Suryawanshi,Deodatt Madhav %A Rajaseharan,Divya %A Venugopal,Raghuram %A Mathew,Madhu %A Joy,Anju %A Goyal,Ramchandra %+ Department of Community Medicine, Trichy SRM Medical College Hospital and Research Centre, Irungular, SRM Nagar, Trichy, Tamil Nadu, 621105, India, 91 8220180486, drdeodattms1983@gmail.com %K gaming %K gaming disorder %K medical students %K gaming addiction %K scholastic performance %K academic performance %K addiction %K smartphones %K mobile phones %K youth %K medical education %D 2021 %7 9.9.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: Gaming is a billion-dollar industry that is expanding at a compound annual growth rate of 9% to 14.3%, with the biggest market in Southeast Asian countries. The availability of low-cost smartphones and the ease at which the internet can be accessed have made gaming popular among youth, who enjoy it as a leisure activity. According to the World Health Organization, excessive indulgence in gaming can lead to gaming disorder. Medical students indulging in excessive gaming can succumb to gaming disorder, which can affect their scholastic performance. Objective: This study aimed to assess the association between gaming practices and scholastic performance among medical students. Methods:  This study used a case-control design, where 448 medical undergraduate students (first year to prefinal) were preliminarily surveyed using universal sampling on their gaming practices in the last 6 months. Out of this sample, the 91 participants who admitted to gaming in the past 6 months were recruited as cases, while participants who never engaged in gaming in the last 6 months were recruited as controls. Both the cases and controls were matched for age and gender in a 1:1 ratio. The internal assessment scores (based on 2 midterms completed in the last 6 months) of cases and controls were compared. The Snedecor F test was used to determine the association between the number of hours spent gaming and internal assessment scores (%), while the Student t test was used to determine significant differences between the internal assessment scores of cases and controls. Odds ratios were calculated to identify the risk of poor scholastic performance among cases compared to the controls. The prevalence of gaming disorder among cases was assessed using the Gaming Addiction Scale (GAS). Results: The frequency of gaming (in hours) was not associated with mean internal assessment scores (P=.13). Male cases reported significantly lower internal assessment scores compared to male controls (P=.005 vs P=.01), whereas no significant differences were observed between the internal assessment scores of female cases and controls (P=.89 vs P=.59). A negative correlation was observed between GAS scores and internal assessment scores (r=–0.02). The prevalence of gaming disorder using the GAS was observed to be 6.3% (28/448) in the study population and 31% (28/91) among cases. The risk of low scores (<50%) among gamers was observed to be 1.9 (95% CI 1.04-3.44, P=.03) times higher in the first midterm and 1.80 (95% CI 0.97-3.36, P=.06) times higher in the second midterm compared to nongamers. Conclusions: The findings suggest that excessive gaming adversely affects the scholastic performance of male participants more than female participants. Awareness about gaming disorder needs to be created among students, parents, and teachers. Treatment services should be made available to medical students with gaming disorders. %M 34340961 %R 10.2196/22235 %U https://mededu.jmir.org/2021/3/e22235 %U https://doi.org/10.2196/22235 %U http://www.ncbi.nlm.nih.gov/pubmed/34340961 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 3 %P e27856 %T Removing Educational Achievement Points From the Foundation Programme Application System: Is This the Right Decision? %A Ganesh Kumar,Abirami %A Kallikas,Georgios %A Hassan,Melihah %A Dev,Indu Kiran %A Basu,Soutrik %+ Department of Medicine, London School of Medicine and Dentistry, Queen Mary University of London Barts, Turner Street, Whitechapel, East London, E12AD, United Kingdom, 44 020 7882 5555, ha161136@qmul.ac.uk %K medical student %K medical education %K research %K academic medicine %K medical school %K United Kingdom %K achievement %K test scores %K transferable skills %D 2021 %7 4.8.2021 %9 Viewpoint %J JMIR Med Educ %G English %X The UK Foundation Programme Office has announced that medical students graduating from 2023 onward will not receive Foundation Programme Application System points for additional degrees or journal publications. In this viewpoint paper, we acknowledge the reasons for this decision, such as socioeconomically advantaged students having greater access to these achievements and the promotion of intercalated degrees for the sake of point accumulation. Additionally, the predictive value of these achievements with regard to junior doctors’ performance has been questioned when compared to that of other Foundation Programme Application System components. Conversely, we also highlight the drawbacks of the UK Foundation Programme Office’s decision, since this might discourage medical students from completing additional degrees and attempting to publish their work, thereby resulting in clinicians with little to no academic experience or interest. Finally, we attempt to provide suggestions for future improvements in this system by analyzing different medical schools’ approaches, such as the BMedSci Honors program offered at Nottingham University. Furthermore, promoting and supporting engagement with academia, especially among socioeconomically disadvantaged students, are the responsibility of all medical schools; such actions are needed in order to produce doctors who are both clinically and academically competent. We conclude that the aforementioned changes should only affect new cohorts in the interest of universities’ transparency and fairness to their students. %M 34346899 %R 10.2196/27856 %U https://mededu.jmir.org/2021/3/e27856 %U https://doi.org/10.2196/27856 %U http://www.ncbi.nlm.nih.gov/pubmed/34346899 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 3 %P e27010 %T Taking a Leap of Faith: A Study of Abruptly Transitioning an Undergraduate Medical Education Program to Distance-Learning Owing to the COVID-19 Pandemic %A Du Plessis,Stefan S %A Otaki,Farah %A Zaher,Shroque %A Zary,Nabil %A Inuwa,Ibrahim %A Lakhtakia,Ritu %+ College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Building 14, Dubai Health Care City, Dubai, 505055, United Arab Emirates, 971 521401101, ritu.lakhtakia@mbru.ac.ae %K action research %K change management %K COVID-19 %K curriculum content %K curriculum delivery %K distance-learning %K learning %K medical education %K pandemic %K teaching %D 2021 %7 23.7.2021 %9 Viewpoint %J JMIR Med Educ %G English %X The COVID-19 pandemic has forced universities worldwide to immediately transition to distance-learning. Although numerous studies have investigated the effect of the COVID-19 pandemic on universities in the Middle East, none have reflected on the process through which medical education programs for health professions underwent this transition. This study aimed to elucidate the rapid transition to distance-learning of an undergraduate medical program at the College of Medicine, Mohammad Bin Rashid University of Medicine and Health Sciences (Dubai, United Arab Emirates), owing to the COVID-19 pandemic. An action research approach constituted the foundation of this collaborative effort that involved investigations, reflections, and improvements of practice, through ongoing cycles of planning, acting, observing, and reflecting. Efforts of transitioning to distance-learning were grouped into four interrelated aspects: supporting faculty members in delivering the program content, managing curriculum changes, engaging with the students to facilitate distance-learning experiences, and conducting web-based assessments. Challenges included the high perceived uncertainty, need for making ad hoc decisions, lack of experiential learning and testing of clinical skills, and blurring of work-life boundaries. Our preliminary findings show the successful generation of a strong existing digital base, future prospects for innovation, and a cohesive team that was key to agility, rapid decision-making, and program implementation. %M 34227994 %R 10.2196/27010 %U https://mededu.jmir.org/2021/3/e27010 %U https://doi.org/10.2196/27010 %U http://www.ncbi.nlm.nih.gov/pubmed/34227994 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 3 %P e25875 %T Medical Students’ Perception and Perceived Value of Peer Learning in Undergraduate Clinical Skill Development and Assessment: Mixed Methods Study %A Alzaabi,Shaikha %A Nasaif,Mohammed %A Khamis,Amar Hassan %A Otaki,Farah %A Zary,Nabil %A Mascarenhas,Sharon %+ Department of Clinical Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Building 14, Dubai Healthcare City, Dubai, 505055, United Arab Emirates, 971 509953515, shaikha.alzaabi@mbru.ac.ae %K peer learning %K assessment %K empowerment %K undergraduate %K medical students %K self-regulated learning %D 2021 %7 13.7.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: The effectiveness of peer learning in clinical skill development is well recognized and researched, given the many benefits gained such as enhanced learning, alleviation of the burden on faculty, and early development of teaching skills for future doctors. However, little is known in terms of its effectiveness as an assessment tool and the extent to which peer assessment can be relied upon in the absence of faculty support. Objective: This study was conducted to assess medical students’ perception toward peer learning, which is based on self-regulated learning as a tool of assessment, and to compare peer evaluation with faculty evaluation of clinical skill performance. Methods: A cohort of 36 third-year medical students were exposed to peer learning (same-level) in clinical skills education for 3 months. A convergent mixed methods approach was adapted to collect data from 3 sources, namely, students’ perception of peer learning, performance scores, and reflective observational analysis. A 5-point Likert-type scale was used to assess students’ (n=28) perception on the value of peer learning. The students were asked to assess their peers by using a preset checklist on clinical skill performance, and scores were compared to faculty assessment scores. Reflective observational data were collected from observing video recordings of some of the peer learning sessions. The findings from all 3 sources were integrated using joint display analysis. Results: Out of 28 students, 25 students completed the survey and 20 students perceived peer learning as valuable in clinical skills education. The mean score of peer assessment was higher than that of faculty assessment. There was a significant difference in student performance between supervised teaching and peer learning groups (P=.003). Most students focused on the mastery of skill with little attention to the technique’s quality. Further, students were unable to appreciate the relevance of the potential clinical findings of physical examination. Conclusions: Peer learning in clinical skills education, based on self-regulated learning, empowers students to develop a more responsible approach toward their education. However, peer assessment is insufficient to evaluate clinical skill performance in the absence of faculty support. Therefore, we recommend that peer learning activities be preceded by supervised faculty-taught sessions. %M 34021539 %R 10.2196/25875 %U https://mededu.jmir.org/2021/3/e25875 %U https://doi.org/10.2196/25875 %U http://www.ncbi.nlm.nih.gov/pubmed/34021539 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 2 %P e28739 %T Knowledge and Attitude Toward Evidence-Based Medicine and Associated Factors Among Medical Interns in Amhara Regional State Teaching Hospitals, Northwest Ethiopia: Cross-sectional Study %A Emwodew,Delelegn %A Melese,Tesfahun %A Takele,Adamu %A Mesfin,Nebiyu %A Tariku,Binyam %+ School of Public Health, Dilla University, Dilla University Hospital, PO Box 419, Dilla, Ethiopia, 251 97 606 1907, delelegn1244@gmail.com %K knowledge %K attitude %K evidence-based medicine %K teaching hospitals %D 2021 %7 24.6.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: Evidence-based medicine (EBM) is widely accepted in medicine. It is necessary to improve the knowledge and attitudes of medical students in the use of evidence. In Ethiopia, little is known about medical students’ knowledge and attitudes toward EBM. Objective: This study aimed to assess the knowledge and attitudes toward EBM and its associated factors among medical interns in teaching hospitals. Methods: A cross-sectional survey was conducted using a random sample of medical interns in teaching hospitals in Ethiopia. Multivariable logistic regression analyses were used to identify the factors associated with the knowledge and attitudes toward EBM. Adjusted odds ratio (AOR) with 95% confidence interval and P≤.05 was used to quantify strength of association between variables. Results: Out of a sample of 423 medical interns, 403 completed the questionnaire (95.3% response rate). Overall, 68.0% (274/403 of respondents had a favorable attitude toward EBM and 57.1% (230/403) had good knowledge of EBM. The majority (355/403, 88.1%) of participants had internet access. Only 19.6% (79/403) of respondents had received EBM-related training. Respondents’ knowledge of EBM was associated with previous EBM training (AOR 2.947, 95% CI 1.648-5.268, P<.001), understanding of sensitivity (AOR 2.836, 95% CI 1.824-4.408, P=.003), and internet access (AOR 2.914, 95% CI 1.494-5.685, P=.002). The use of an electronic database as a source of information (AOR 1.808, 95% CI 1.143-2.861, P=.01) and understanding of absolute risk reduction (AOR 2.750, 95% CI 1.105-6.841, P=.03) were predictors of positive attitudes. Conclusions: This study demonstrates a lack of formal EBM training and awareness of basic concepts of EBM among medical interns. Medical intern attitudes toward EBM are relatively good. To enhance EBM knowledge and skills, formal teaching of EBM should be integrated into medical education. %M 34185012 %R 10.2196/28739 %U https://mededu.jmir.org/2021/2/e28739/ %U https://doi.org/10.2196/28739 %U http://www.ncbi.nlm.nih.gov/pubmed/34185012 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 2 %P e26667 %T Using a Scenario-Based Approach to Teaching Professionalism to Medical Students: Course Description and Evaluation %A Ashcroft,James %A Warren,Patrick %A Weatherby,Thomas %A Barclay,Stephen %A Kemp,Laurence %A Davies,Richard Justin %A Hook,Catherine Elizabeth %A Fistein,Elizabeth %A Soilleux,Elizabeth %+ University of Cambridge, Department of Pathology, Tennis Court Road, Cambridge, CB2 1QP, United Kingdom, 44 1223 336916, ejs17@cam.ac.uk %K medical education %K curriculum %K training %K professionalism %D 2021 %7 24.6.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: Doctors play a key role in individuals’ lives undergoing a holistic integration into local communities. To maintain public trust, it is essential that professional values are upheld by both doctors and medical students. We aimed to ensure that students appreciated these professional obligations during the 3-year science-based, preclinical course with limited patient contact. Objective: We developed a short scenario-based approach to teaching professionalism to first-year students undertaking a medical course with a 3-year science-based, preclinical component. We aimed to evaluate, both quantitatively and qualitatively, student perceptions of the experience and impact of the course. Methods: An interactive professionalism course entitled Entry to the Profession was designed for preclinical first-year medical students. Two scenario-based sessions were created and evaluated using established professionalism guidance and expert consensus. Quantitative and qualitative feedback on course implementation and development of professionalism were gathered using Likert-type 5-point scales and debrief following course completion. Results: A total of 70 students completed the Entry to the Profession course over a 2-year period. Feedback regarding session materials and logistics ranged from 4.16 (SD 0.93; appropriateness of scenarios) to 4.66 (SD 0.61; environment of sessions). Feedback pertaining to professionalism knowledge and behaviors ranged from 3.11 (SD 0.99; need for professionalism) to 4.78 (SD 0.42; relevance of professionalism). Qualitative feedback revealed that a small group format in a relaxed, open environment facilitated discussion of the major concepts of professionalism. Conclusions: Entry to the Profession employed an innovative approach to introducing first-year medical students to complex professionalism concepts. Future longitudinal investigations should aim to explore its impact at various stages of preclinical, clinical, and postgraduate training. %M 34185007 %R 10.2196/26667 %U https://mededu.jmir.org/2021/2/e26667/ %U https://doi.org/10.2196/26667 %U http://www.ncbi.nlm.nih.gov/pubmed/34185007 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 2 %P e24358 %T Application of the Inverted Classroom Model for Teaching Pathophysiology to Chinese Undergraduate Medical Students: Usability Study %A Lin,Hui %A Zeng,Xiaoping %A Zhu,Jun %A Hu,Zhenzhen %A Ying,Ying %A Huang,Yonghong %A Wang,Hongmei %+ Department of Pathophysiology, School of Basic Medicine Sciences, Nanchang University, 461 Bayi Avenue, Nanchang, 33006, China, 86 13767004966, wanghongmay@hotmail.com %K pathophysiology %K inverted classroom %K teaching reform %K questionnaire %K medical education %K undergraduate %D 2021 %7 18.6.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: The inverted classroom model differs from the traditional teaching model as it reverses the pattern of knowledge transfer and internalization. In recent years, this new teaching model has received much attention in undergraduate medical education. Pathophysiology is a course in the undergraduate Chinese medical curriculum that is critical in bridging basic medical science and clinical medicine. Objective: The purpose of this study was to investigate the application of inverted classroom in delivering the course on pathophysiology to Chinese undergraduate medical students. Methods: In the spring semester of 2018, inverted classroom teaching was implemented for second-year clinical medicine students at the College of Medicine at Nanchang University. The topics of hypoxia and respiratory failure were selected for the inverted classroom study. The effect of the inverted classroom on teaching pathophysiology was evaluated using classroom performance metrics, a final examination, and questionnaires. Results: This study found that students in the inverted classroom group achieved higher scores in their in-course assessments (82.35 [SD 11.45] vs 81.33 [SD 9.51], respectively) and in their final exams (73.41 [SD 10.37] vs 71.13 [SD 11.22], respectively) than those in the traditional lecture-based group, but the scores were not significantly different (P=.13, unpaired two-tailed t test). There was also no significant difference in the distribution of the score segments in the class quiz (P=.09, chi-square test) and in the final exams (P=.25, chi-square test) between the 2 groups. Further, most of the students reported that the inverted classroom increased their learning motivation, made them more confident, and helped them understand the content on pathophysiology better. The students in the inverted classroom also improved in their problem-solving skills and teamwork abilities. However, some students from the inverted classroom group also reported that the self-learning and preparatory work before class increased their learning burden. Conclusions: This study shows the feasibility and promise of inverted classroom for teaching pathophysiology to undergraduate Chinese medical students. The inverted classroom improves students’ learning interests and attitudes toward learning. However, further studies are required to assess the benefits of broader acceptance and implementation of the inverted classroom among Chinese undergraduate medical students. %M 34142976 %R 10.2196/24358 %U https://mededu.jmir.org/2021/2/e24358 %U https://doi.org/10.2196/24358 %U http://www.ncbi.nlm.nih.gov/pubmed/34142976 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 2 %P e25506 %T Remote Teaching in a Preclinical Phantom Course in Operative Dentistry During the COVID-19 Pandemic: Observational Case Study %A Kanzow,Philipp %A Krantz-Schäfers,Christiane %A Hülsmann,Michael %+ Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str 40, Göttingen, 37075, Germany, 49 551 3922877, philipp.kanzow@med.uni-goettingen.de %K acceptance %K COVID-19 %K dental education %K distance learning %K effectiveness %K e-learning %K medical education %K medical student %K observational %K screencasts %K preclinical education %K remote teaching %D 2021 %7 14.5.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: During the acute COVID-19 pandemic, physical access to the University Medical Center Göttingen was restricted for students. For the first time at our dental school, theoretical knowledge was imparted to students via asynchronous online screencasts and discussed via synchronous video meetings only. Objective: We aimed to assess the acceptance and effectiveness of distance education as a new teaching format for theoretical knowledge within the preclinical course in Operative Dentistry (sixth semester of the undergraduate dental curriculum in Germany). Methods: The phantom course comprised distance education (first phase, 11 weeks) and subsequent on-site practical demonstrations and training (second phase, 10 weeks). All theoretical knowledge was taught via online screencasts during distance education (except for the first week, 3 screencasts were uploaded per week resulting in a total of 30 screencasts). Until the end of the term, all students (N=33) were able to view the screencasts for an unlimited number of times. Theoretical knowledge was assessed in a summative examination after practical on-site teaching. Acceptance and effectiveness of the new curriculum and distance education were also measured based on an evaluation survey and students’ self-perceived learning outcome, which was compared to the outcome from the two pre–COVID-19 terms. Results: Each screencast was viewed by a mean of 24 (SD 3.3) students and accessed a mean of 5.6 (SD 1.2) times per user (ie, by students who accessed the respective screencast at least once). During distance education, the number of accesses showed a linear trend over time. During the practical training phase, screencast views declined and increased again prior to the examination. Screencasts covering topics in Cariology, Restorative Dentistry, and Preventive Dentistry were viewed by more students than screencasts covering topics in Endodontology or Periodontology (both P=.047). Examination items in Periodontology showed inferior results compared to the other topics (P<.001). Within the different topics, students’ self-perceived learning outcome did not differ from that during the pre–COVID-19 terms. Although most students agreed that the presented screencasts contributed to their learning outcome, pre–COVID-19 term students more strongly felt that lectures significantly contributed to their learning outcome (P=.03). Conclusions: Screencasts showed high acceptance and effectiveness among the students but were not used as a learning tool by all students. However, students who viewed the screencasts accessed each screencast more frequently than they could have attended a conventional lecture. Screencast views were mostly due to intrinsic motivation. %M 33941512 %R 10.2196/25506 %U https://mededu.jmir.org/2021/2/e25506 %U https://doi.org/10.2196/25506 %U http://www.ncbi.nlm.nih.gov/pubmed/33941512 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 2 %P e22992 %T Using a Web-Based Quiz Game as a Tool to Summarize Essential Content in Medical School Classes: Retrospective Comparative Study %A Yuenyongviwat,Varah %A Bvonpanttarananon,Jongdee %+ Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Hatyai, 90110, Thailand, 66 74451601, varahortho@gmail.com %K medical education %K medical students %K computer games %K gaming %K web-based %K interface %K perception %K retrospective %D 2021 %7 29.4.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: Kahoot! is a web-based technology quiz game in which teachers can design their own quizzes via provided game templates. The advantages of these games are their attractive interfaces, which contain stimulating music, moving pictures, and colorful, animated shapes to maintain students’ attentiveness while they perform the quizzes. Objective: The aim of this study was to evaluate the use of Kahoot! compared with a traditional teaching approach as a tool to summarize the essential content of a medical school class in the aspects of final examination scores and the perception of students regarding aspects of their learning environment and of process management. Methods: This study used an interrupted time series design, and retrospective data were collected from 85 medical students. Of these 85 students, 43 completed a Kahoot! quiz, while 42 students completed a paper quiz. All students attended a lecture on the topic of bone and joint infection and participated in a short case discussion. Students from both groups received the same content and study material, with the exception that at the end of the lesson, students in the Kahoot! group completed a quiz summarizing the essential content from the lecture, whereas the other group received a paper quiz with the same questions and the teacher provided an explanation after the students had finished. The students’ satisfaction was evaluated after the class, and their final examination was held 2 weeks after the class. Results: The mean final examination score in the Kahoot! group was 62.84 (SD 8.79), compared to 60.81 (SD 9.25) in the control group (P=.30). The students’ satisfaction with the class environment, learning process management, and teacher were not significantly different between the 2 groups (all P>.05). Conclusions: In this study, it was found that using Kahoot! as a tool to summarize the essential content in medical school classes involving a lecture and case discussion did not affect the students’ final examination scores or their satisfaction with the class environment, learning process management, or teacher. %M 33913813 %R 10.2196/22992 %U https://mededu.jmir.org/2021/2/e22992 %U https://doi.org/10.2196/22992 %U http://www.ncbi.nlm.nih.gov/pubmed/33913813 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 2 %P e27877 %T Best Practices for Integrating Medical Students Into Telehealth Visits %A Wamsley,Maria %A Cornejo,Laeesha %A Kryzhanovskaya,Irina %A Lin,Brian W %A Sullivan,Joseph %A Yoder,Jordan %A Ziv,Tali %+ Department of Medicine, University of California San Francisco School of Medicine, San Francisco, CA, United States, 1 415 514 8660, maria.wamsley@ucsf.edu %K telehealth %K undergraduate medical education %K workplace learning %K ambulatory care %K telehealth competencies %K medical education %K student education %K digital learning %K online learning %K ambulatory %K digital health %D 2021 %7 21.4.2021 %9 Viewpoint %J JMIR Med Educ %G English %X Telehealth has become an increasingly important part of health care delivery, with a dramatic rise in telehealth visits during the COVID-19 pandemic. Telehealth visits will continue to be a part of care delivery after the pandemic subsides, and it is important that medical students receive training in telehealth skills to meet emerging telehealth competencies. This paper describes strategies for successfully integrating medical students into telehealth visits in the ambulatory setting based on existing literature and the extensive experience of the authors teaching and learning in the telehealth environment. %M 33881407 %R 10.2196/27877 %U https://mededu.jmir.org/2021/2/e27877 %U https://doi.org/10.2196/27877 %U http://www.ncbi.nlm.nih.gov/pubmed/33881407 %0 Journal Article %@ 2291-9694 %I JMIR Publications %V 9 %N 3 %P e24497 %T Medical Morphology Training Using the Xuexi Tong Platform During the COVID-19 Pandemic: Development and Validation of a Web-Based Teaching Approach %A Liu,Qinlai %A Sun,Wenping %A Du,Changqing %A Yang,Leiying %A Yuan,Na %A Cui,Haiqing %A Song,Wengang %A Ge,Li %+ Department of Histology and Embryology, Shandong First Medical University & Shandong Academy of Medical Sciences, 2 Ying Sheng East Road, Tai’an, China, 86 0538622203, juliagl@126.com %K COVID-19 %K histology and embryology %K pathology %K web-based teaching %K Xuexi Tong platform %D 2021 %7 15.3.2021 %9 Original Paper %J JMIR Med Inform %G English %X Background: Histology and Embryology and Pathology are two important basic medical morphology courses for studying human histological structures under healthy and pathological conditions, respectively. There is a natural succession between the two courses. At the beginning of 2020, the COVID-19 pandemic suddenly swept the world. During this unusual period, to ensure that medical students would understand and master basic medical knowledge and to lay a solid foundation for future medical bridge courses and professional courses, a web-based medical morphology teaching team, mainly including teachers of courses in Histology and Embryology and Pathology, was established. Objective: This study aimed to explore a new teaching mode of Histology and Embryology and Pathology courses during the COVID-19 pandemic and to illustrate its feasibility and acceptability. Methods: From March to July 2020, our team selected clinical medicine undergraduate students who started their studies in 2018 and 2019 as recipients of web-based teaching. Meanwhile, nursing undergraduate students who started their studies in 2019 and 2020 were selected for traditional offline teaching as the control group. For the web-based teaching, our team used the Xuexi Tong platform as the major platform to realize a new “seven-in-one” teaching method (ie, videos, materials, chapter tests, interactions, homework, live broadcasts, and case analysis/discussion). This new teaching mode involved diverse web-based teaching methods and contents, including flipped classroom, screen-to-screen experimental teaching, a drawing competition, and a writing activity on the theme of “What I Know About COVID-19.” When the teaching was about to end, a questionnaire was administered to obtain feedback regarding the teaching performance. In the meantime, the final written pathology examination results of the web-based teaching and traditional offline teaching groups were compared to examine the mastery of knowledge of the students. Results: Using the Xuexi Tong platform as the major platform to conduct “seven-in-one” teaching is feasible and acceptable. With regard to the teaching performance of this new web-based teaching mode, students demonstrated a high degree of satisfaction, and the questionnaire showed that 71.3% or more of the students in different groups reported a greater degree of satisfaction or being very satisfied. In fact, more students achieved high scores (90-100) in the web-based learning group than in the offline learning control group (P=.02). Especially, the number of students with objective scores >60 in the web-based learning group was greater than that in the offline learning control group (P=.045). Conclusions: This study showed that the web-based teaching mode was not inferior to the traditional offline teaching mode for medical morphology courses, proving the feasibility and acceptability of web-based teaching during the COVID-19 pandemic. Our findings lay a solid theoretical foundation for follow-up studies of medical students. %M 33566792 %R 10.2196/24497 %U https://medinform.jmir.org/2021/3/e24497 %U https://doi.org/10.2196/24497 %U http://www.ncbi.nlm.nih.gov/pubmed/33566792 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 23 %N 2 %P e25125 %T Differences in Basic Life Support Knowledge Between Junior Medical Students and Lay People: Web-Based Questionnaire Study %A Sturny,Ludovic %A Regard,Simon %A Larribau,Robert %A Niquille,Marc %A Savoldelli,Georges Louis %A Sarasin,François %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 795532579, laurent.suppan@hcuge.ch %K basic life support %K cardiopulmonary resuscitation %K medical students %K undergraduate medical education %K out-of-hospital cardiac arrest %K life support %K cardiopulmonary %K medical education %D 2021 %7 23.2.2021 %9 Original Paper %J J Med Internet Res %G English %X Background: Early cardiopulmonary resuscitation and prompt defibrillation markedly increase the survival rate in the event of out-of-hospital cardiac arrest (OHCA). As future health care professionals, medical students should be trained to efficiently manage an unexpectedly encountered OHCA. Objective: Our aim was to assess basic life support (BLS) knowledge in junior medical students at the University of Geneva Faculty of Medicine (UGFM) and to compare it with that of the general population. Methods: Junior UGFM students and lay people who had registered for BLS classes given by a Red Cross–affiliated center were sent invitation links to complete a web-based questionnaire. The primary outcome was the between-group difference in a 10-question score regarding cardiopulmonary resuscitation knowledge. Secondary outcomes were the differences in the rate of correct answers for each individual question, the level of self-assessed confidence in the ability to perform resuscitation, and a 6-question score, “essential BLS knowledge,” which only contains key elements of the chain of survival. Continuous variables were first analyzed using the Student t test, then by multivariable linear regression. Fisher exact test was used for between-groups comparison of binary variables. Results: The mean score was higher in medical students than in lay people for both the 10-question score (mean 5.8, SD 1.7 vs mean 4.2, SD 1.7; P<.001) and 6-question score (mean 3.0, SD 1.1 vs mean 2.0, SD 1.0; P<.001). Participants who were younger or already trained scored consistently better. Although the phone number of the emergency medical dispatch center was well known in both groups (medical students, 75/80, 94% vs lay people, 51/62, 82%; P=.06), most participants were unable to identify the criteria used to recognize OHCA, and almost none were able to correctly reorganize the BLS sequence. Medical students felt more confident than lay people in their ability to perform resuscitation (mean 4.7, SD 2.2 vs mean 3.1, SD 2.1; P<.001). Female gender and older age were associated with lower confidence, while participants who had already attended a BLS course prior to taking the questionnaire felt more confident. Conclusions: Although junior medical students were more knowledgeable than lay people regarding BLS procedures, the proportion of correct answers was low in both groups, and changes in BLS education policy should be considered. %M 33620322 %R 10.2196/25125 %U https://www.jmir.org/2021/2/e25125 %U https://doi.org/10.2196/25125 %U http://www.ncbi.nlm.nih.gov/pubmed/33620322 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 6 %N 2 %P e23604 %T Medical Students' Corner: Lessons From COVID-19 in Equity, Adaptability, and Community for the Future of Medical Education %A Mann,Simran %A Novintan,Shonnelly %A Hazemi-Jebelli,Yasmin %A Faehndrich,Daniel %+ School of Medicine, Imperial College London, Kensington, London, United Kingdom, 44 7964965972, sm6015@ic.ac.uk %K medical education %K COVID-19 %K student equity %K community %K adaptability %K medical student %D 2020 %7 9.10.2020 %9 Viewpoint %J JMIR Med Educ %G English %X As UK medical students, we recently completed 3 months of remote learning due to the COVID-19 pandemic, before taking online end-of-the-year exams. We are now entering our final year of medical school. Based on our experiences and our understanding of others’ experiences, we believe that three key lessons have been universal for medical students around the world. The lessons learned throughout this process address the need for a fair system for medical students, the importance of adaptability in all aspects of medical education, and the value of a strong medical school community. These lessons can be applied in the years to come to improve medical education as we know it. %M 32936774 %R 10.2196/23604 %U http://mededu.jmir.org/2020/2/e23604/ %U https://doi.org/10.2196/23604 %U http://www.ncbi.nlm.nih.gov/pubmed/32936774 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 6 %N 2 %P e21701 %T Confronting the Challenges of Anatomy Education in a Competency-Based Medical Curriculum During Normal and Unprecedented Times (COVID-19 Pandemic): Pedagogical Framework Development and Implementation %A Naidoo,Nerissa %A Akhras,Aya %A Banerjee,Yajnavalka %+ College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health Care City, Dubai, 505055, United Arab Emirates, 971 568345125, yaj.banerjee@gmail.com %K undergraduate medical education %K anatomy education %K Gagne’s 9 events of instruction %K Peyton’s 4-step approach %K Mento’s 12-step change management model %K Bourdieu’s Theory of Practice %K social media application %K interactome %K COVID-19 %K framework %D 2020 %7 7.10.2020 %9 Original Paper %J JMIR Med Educ %G English %X Background: Anatomy is considered to be one of the keystones of undergraduate medical education. However, recently, there has been drastic reduction, both in gross anatomy teaching hours and its context. Additionally, a decrease in the number of trained anatomists and an increase in the costs associated with procuring human cadavers have been noted, causing a diminution of cadaveric dissections in anatomy education. Objective: To address these challenges, there is an ardent need for a pedagogical framework such that anatomy education can be disseminated through active learning principles, within a fixed time frame, using a small team of anatomists and a small number of cadaveric specimens (for live on-site sessions) as well as collaborative learning principles. The latter is particularly important when anatomy education is delivered through distance learning, as is the case currently during the COVID-19 pandemic. Methods: Here, we have blueprinted a pedagogical framework blending the instructional design models of Gagne’s 9 events of instruction with Peyton’s 4-step approach. The framework’s applicability was validated through the delivery of anatomical concepts, using an exemplar from the structure-function course Head and Neck during the normal and COVID-19–mandated lockdown periods, employing the archetype of Frey syndrome. Preliminary evaluation of the framework was pursued using student feedback and end-of-course feedback responses. The efficiency of the framework in knowledge transfer was also appraised. Results: The blueprinted instructional plan designed to implement the pedagogical framework was successfully executed in the dissemination of anatomy education, employing a limited number of cadaveric specimens (during normal times) and a social media application (SMA)–integrated “interactome” strategy (during the COVID-19 lockdown). Students’ response to the framework was positive. However, reluctance was expressed by a majority of the faculty in adopting the framework for anatomy education. To address this aspect, a strategy has been designed using Mento’s 12-step change management model. The long-term benefits for any medical school to adopt the blended pedagogical framework have also been explicated by applying Bourdieu’s Theory of Practice. Additionally, through the design of an SMA interactome model, the framework’s applicability to the delivery of anatomy education and content during the ongoing COVID-19 pandemic was realized. Conclusions: In conclusion, the study effectively tackles some of the contemporary key challenges associated with the delivery of anatomy content in medical education during normal and unprecedented times. %M 32873536 %R 10.2196/21701 %U http://mededu.jmir.org/2020/2/e21701/ %U https://doi.org/10.2196/21701 %U http://www.ncbi.nlm.nih.gov/pubmed/32873536 %0 Journal Article %@ 1929-073X %I JMIR Publications %V 9 %N 2 %P e14666 %T The Influence of Gender on the Choice of Radiology as a Specialty Among Medical Students in Saudi Arabia: Cross-Sectional Study %A Abduljabbar,Ahmed H %A Alnajjar,Sara F %A Alshamrani,Hussein %A Bashamakh,Lujain F %A Alshehri,Hisham Z %A Alqulayti,Waleed M %A Wazzan,Mohammad A %+ College of Medicine, King Abdulaziz University, Al Sulaymaniyah, Jeddah, , Saudi Arabia, 966 530204524, Hussein.m.edu@gmail.com %K gender %K radiology %K specialty choice %D 2020 %7 28.4.2020 %9 Original Paper %J Interact J Med Res %G English %X Background: Medical undergraduates are the future doctors of the country. Therefore, determining how medical students choose their areas of specialty is essential to obtain a balanced distribution of physicians among all specialties. Although gender is a significant factor that affects specialty choice, the factors underlying gender differences in radiology are not fully elucidated. Objective: This study examined the factors that attracted medical students to and discouraged them from selecting diagnostic radiology and analyzed whether these factors differed between female and male medical students. Methods: This cross-sectional study conducted at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, used an electronic questionnaire sent to medical students from all medical years during February 2018. Subgroup analyses for gender and radiology interest were performed using the chi-square test and Cramér’s V test. Results: In total, 539 students (276 women; 263 men) responded. The most common factor preventing students from choosing radiology as a career was the lack of direct patient contact, which deterred approximately 47% who decided against considering this specialty. Negative perceptions by other physicians (P<.001), lack of acknowledgment by patients (P=.004), and lack of structured radiology rotations (P=.007) dissuaded significantly more male students than female students. Among those interested in radiology, more female students were attracted by job flexibility (P=.01), while more male students were attracted by focused patient interactions with minimal paperwork (P<.001). Conclusions: No significant difference was found between the genders in terms of considering radiology as a specialty. Misconception plays a central role in students’ judgment regarding radiology. Hence, early exposure to radiology, assuming a new teaching method, and using a curriculum that supports the active participation of students in a radiology rotation are needed to overcome this misconception. %M 32141832 %R 10.2196/14666 %U http://www.i-jmr.org/2020/2/e14666/ %U https://doi.org/10.2196/14666 %U http://www.ncbi.nlm.nih.gov/pubmed/32141832 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 21 %N 11 %P e15459 %T Medical Students’ Experiences and Outcomes Using a Virtual Human Simulation to Improve Communication Skills: Mixed Methods Study %A Guetterman,Timothy C %A Sakakibara,Rae %A Baireddy,Srikar %A Kron,Frederick W %A Scerbo,Mark W %A Cleary,James F %A Fetters,Michael D %+ Creighton University, 2500 California Plaza, Omaha, NE, 68178, United States, 1 402 280 4778, timguetterman@creighton.edu %K cancer %K virtual reality %K health communication %K interprofessional relations %K informatics %K nonverbal communication %K computer simulation %K physician-nurse relations %K empathy %D 2019 %7 27.11.2019 %9 Original Paper %J J Med Internet Res %G English %X Background: Attending to the wide range of communication behaviors that convey empathy is an important but often underemphasized concept to reduce errors in care, improve patient satisfaction, and improve cancer patient outcomes. A virtual human (VH)–based simulation, MPathic-VR, was developed to train health care providers in empathic communication with patients and in interprofessional settings and evaluated through a randomized controlled trial. Objective: This mixed methods study aimed to investigate the differential effects of a VH-based simulation developed to train health care providers in empathic patient-provider and interprofessional communication. Methods: We employed a mixed methods intervention design, involving a comparison of 2 quantitative measures—MPathic-VR–calculated scores and the objective structured clinical exam (OSCE) scores—with qualitative reflections by medical students about their experiences. This paper is a secondary, focused analysis of intervention arm data from the larger trial. Students at 3 medical schools in the United States (n=206) received simulation to improve empathic communication skills. We conducted analysis of variance, thematic text analysis, and merging mixed methods analysis. Results: OSCE scores were significantly improved for learners in the intervention group (mean 0.806, SD 0.201) compared with the control group (mean 0.752, SD 0.198; F1,414=6.09; P=.01). Qualitative analysis revealed 3 major positive themes for the MPathic-VR group learners: gaining useful communication skills, learning awareness of nonverbal skills in addition to verbal skills, and feeling motivated to learn more about communication. Finally, the results of the mixed methods analysis indicated that most of the variation between high, middle, and lower performers was noted about nonverbal behaviors. Medium and high OSCE scorers most often commented on the importance of nonverbal communication. Themes of motivation to learn about communication were only present in middle and high scorers. Conclusions: VHs are a promising strategy for improving empathic communication in health care. Higher performers seemed most engaged to learn, particularly nonverbal skills. %M 31774400 %R 10.2196/15459 %U http://www.jmir.org/2019/11/e15459/ %U https://doi.org/10.2196/15459 %U http://www.ncbi.nlm.nih.gov/pubmed/31774400 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 5 %N 2 %P e12791 %T Why Medical Students Choose to Use or Not to Use a Web-Based Electrocardiogram Learning Resource: Mixed Methods Study %A Nilsson,Mikael %A Fors,Uno %A Östergren,Jan %A Bolinder,Gunilla %A Edelbring,Samuel %+ Section of Internal Medicine and Functional Area Emergency Medicine, Department of Medicine, Karolinska University Hospital, Stockholm, 171-76, Sweden, 46 733 589910, mikael.b.nilsson@sll.se %K learning %K medical %K teaching %K electrocardiogram %D 2019 %7 11.07.2019 %9 Original Paper %J JMIR Med Educ %G English %X Background: Electrocardiogram (ECG) interpretation is a core competence and can make a significant difference to patient outcomes. However, ECG interpretation is a complex skill to learn, and research has showed that students often lack enough competence. Web-based learning has been shown to be effective. However, little is known regarding why and how students use Web-based learning when offered in a blended learning situation. Objective: The aim of this paper was to study students’ use of Web-based ECG learning resources which has not previously been studied in relation to study strategies. Methods: A qualitative explanatory design using mixed methods was adopted to explore how medical students reason around their choice to use or not to use a Web-based ECG learning resource. Overall, 15 of 33 undergraduate medical students attending a course in clinical medicine were interviewed. Data on usage of the resource were obtained via the learning management system for all students. At the final examination, all the students answered a questionnaire on study strategies and questions about internet access and estimated their own skills in ECG interpretation. Furthermore, study strategies and use patterns were correlated with results from an ECG Objective Structured Clinical Examination (OSCE) and a written course examination. Results: In total, 2 themes were central in the students’ reasoning about usage of Web-based ECG: assessment of learning needs and planning according to learning goals. Reasons for using the Web resource were to train in skills, regarding it as a valuable complement to books and lectures. The main reasons for not using the resource were believing they already had good enough skills and a lack of awareness of its availability. Usage data showed that 21 students (63%) used the Web resource. Of these, 11 were minimal users and 10 were major users based on usage activity. Large variations were found in the time spent in different functional parts of the resource. No differences were found between users and nonusers regarding the OSCE score, final examination score, self-estimate of knowledge, or favoring self-regulated learning. Conclusions: To use or not to use a Web-based ECG learning resource is largely based on self-regulated learning aspects. Decisions to use such a resource are based on multifactorial aspects such as experiences during clinical rotations, former study experiences, and perceived learning needs. The students’ own judgment of whether there was a need for a Web-based resource to achieve the learning goals and to pass the examination was crucial for their decisions to use it or not. An increased understanding of students’ regulation of learning and awareness of variations in their ECG learning needs can contribute to the improvement of course design for blended learning of ECG contexts for medical students. %M 31298220 %R 10.2196/12791 %U https://mededu.jmir.org/2019/2/e12791/ %U https://doi.org/10.2196/12791 %U http://www.ncbi.nlm.nih.gov/pubmed/31298220 %0 Journal Article %@ 2291-9279 %I JMIR Publications %V 7 %N 2 %P e10155 %T What Can Be Achieved With Motivation-Based Teaching of Medical Students? A Monocentric Retrospective Audit of Retention Among Highly Motivated Graduates Who Underwent the Learning-by-Doing Concept in Anesthesiology and Intensive Care Medicine %A Klincova,Martina %A Harazim,Hana %A Schwarz,Daniel %A Kosinova,Martina %A Smekalova,Olga %A Stourac,Petr %+ Department of Pediatric Anesthesiology and Intensive Care Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Jihlavska 20, Brno, 62500, Czech Republic, 420 602745841, petr.stourac@gmail.com %K problem-based learning %K virtual patients %K anesthesiology %K intensive care %K specialization %D 2019 %7 09.04.2019 %9 Original Paper %J JMIR Serious Games %G English %X Background: Medical education, in general, is undergoing a significant shift from traditional methods. It becomes very difficult to discover effective teaching methods within the limited possibilities in patient hands-on education, especially as seen in anesthesiology and intensive care medicine (AIM) teaching. Motivation-based teaching is very popular in all other aspects of education, but it has received scant attention in medical education literature, even though it can make a real difference for both students and physicians. Objective: The primary aim of this retrospective audit was to find out if proper motivation-based teaching of students via the development of AKUTNE.CZ’s serious games can help retain graduates of the Faculty of Medicine of Masaryk University (FMMU) for the AIM specialty. Methods: Motivation-based teaching and the learning-by-doing concept were applied to a subject called Individual Project. Our topic, The Development of the Multimedia Educational Portal, AKUTNE.CZ, has been offered since 2010. The objective has been the development of supportive material in the form of interactive algorithms, serious games, and virtual patients for problem-based learning or team-based learning lectures aimed at acute medicine. We performed a retrospective questionnaire evaluation of all participants from the 2010-2017 period, focusing on their choice of medical specialty in 2017. The data were reported descriptively. Results: We evaluated 142 students who passed Individual Project with topic The Development of the Multimedia Educational Portal, AKUTNE.CZ during 2010 to 2017. In this period, they developed up to 77 electronic serious games in the form of interactive multimedia algorithms. Out of 139 students in general medicine, 108 students (77.7%) had already graduated and 37 graduates (34.3%) worked in the AIM specialty. Furthermore, 57 graduates (52.8%) chose the same specialty after graduation, matching the topic of their algorithm, and 37 (65%) of these graduates decided to pursue AIM. Conclusions: Motivation-based teaching and the concept of learning-by-doing by the algorithm/serious game development led to the significant retention of FMMU graduates in the AIM specialty. This concept could be considered successful, and as the concept itself can also be well integrated into the teaching of other medical specialties, the potential of motivation-based teaching should be used more broadly within medical education. %M 30964443 %R 10.2196/10155 %U http://games.jmir.org/2019/2/e10155/ %U https://doi.org/10.2196/10155 %U http://www.ncbi.nlm.nih.gov/pubmed/30964443 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 5 %N 1 %P e12515 %T Telemedicine Training in Undergraduate Medical Education: Mixed-Methods Review %A Waseh,Shayan %A Dicker,Adam P %+ Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA, 19107, United States, 1 716 913 2655, shayanwa@gmail.com %K telemedicine %K education, medical, undergraduate %K schools %D 2019 %7 08.04.2019 %9 Review %J JMIR Med Educ %G English %X Background: Telemedicine has grown exponentially in the United States over the past few decades, and contemporary trends in the health care environment are serving to fuel this growth into the future. Therefore, medical schools are learning to incorporate telemedicine competencies into the undergraduate medical education of future physicians so that they can more effectively leverage telemedicine technologies for improving the quality of care, increasing patient access, and reducing health care expense. This review articulates the efforts of allopathic-degree-granting medical schools in the United States to characterize and systematize the learnings that have been generated thus far in the domain of telemedicine training in undergraduate medical education. Objective: The aim of this review was to collect and outline the current experiences and learnings that have been generated as medical schools have sought to implement telemedicine capacity-building into undergraduate medical education. Methods: We performed a mixed-methods review, starting with a literature review via Scopus, tracking with Excel, and an email outreach effort utilizing telemedicine curriculum data gathered by the Liaison Committee on Medical Education. This outreach included 70 institutions and yielded 7 interviews, 4 peer-reviewed research papers, 6 online documents, and 3 completed survey responses. Results: There is an emerging, rich international body of learning being generated in the field of telemedicine training in undergraduate medical education. The integration of telemedicine-based lessons, ethics case-studies, clinical rotations, and even teleassessments are being found to offer great value for medical schools and their students. Most medical students find such training to be a valuable component of their preclinical and clinical education for a variety of reasons, which include fostering greater familiarity with telemedicine and increased comfort with applying telemedical approaches in their future careers. Conclusions: These competencies are increasingly important in tackling the challenges facing health care in the 21st century, and further implementation of telemedicine curricula into undergraduate medical education is highly merited. %M 30958269 %R 10.2196/12515 %U http://mededu.jmir.org/2019/1/e12515/ %U https://doi.org/10.2196/12515 %U http://www.ncbi.nlm.nih.gov/pubmed/30958269 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 5 %N 1 %P e12403 %T Augmenting Flexnerism Via Twitterism: Need for Integrating Social Media Application in Blueprinting Pedagogical Strategies for Undergraduate Medical Education %A Banerjee,Yajnavalka %A Tambi,Richa %A Gholami,Mandana %A Alsheikh-Ali,Alawi %A Bayoumi,Riad %A Lansberg,Peter %+ Department of Basic Medical Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Academic Medical Center, Building - 14, Dubai Healthcare City, Dubai, 505055, United Arab Emirates, 971 0568345125, yaj.banerjee@gmail.com %K social media %K medical education %K twitter messaging %K Web 2.0 %K curriculum %D 2019 %7 25.03.2019 %9 Viewpoint %J JMIR Med Educ %G English %X Background: Flexnerism, or “competency-based medical education,” advocates that formal analytic reasoning, the kind of rational thinking fundamental to the basic sciences, especially the natural sciences, should be the foundation of physicians’ intellectual training. The complexity of 21st century health care requires rethinking of current (medical) educational paradigms. In this “Millennial Era,” promulgation of the tenets of Flexnerism in undergraduate medical education requires a design and blueprint of innovative pedagogical strategies, as the targeted learners are millennials (designated as generation-Y medical students). Objective: The aim of this proof-of-concept study was to identify the specific social media app platforms that are selectively preferred by generation-Y medical students in undergraduate medical education. In addition, we aimed to explore if these preferred social media apps can be used to design an effective pedagogical strategy in order to disseminate course learning objectives in the preclinical phase of a spiral curriculum. Methods: A cross-sectional survey was conducted by distributing a 17-item questionnaire among the first- and second-year medical students in the preclinical phase at the Mohammed Bin Rashid University of Medicine and Health Science. Results: The study identified YouTube and WhatsApp as the social media app platforms preferred by generation-Y medical students in undergraduate medical education. This study also identified the differences between female and male generation-Y medical students in terms of the use of social media apps in medical education, which we believe will assist instructors in designing pedagogical strategies to integrate social media apps. In addition, we determined the perceptions of generation-Y medical students on the implementation of social media apps in medical education. The pedagogical strategy designed using social media apps and implemented in the Biochemistry course was well accepted by generation-Y medical students and can be translated to any course in the preclinical phase of the medical curriculum. Moreover, the identified limitations of this study provide an understanding of the gaps in research in the integration of social media apps in a medical curriculum catering to generation-Y medical students. Conclusions: 21st century medical education requires effective use of social media app platforms to augment competency-based medical education: Augmentation of Flexnerism in the current scenario is possible only by the adaptation of Twitterism. %M 30907736 %R 10.2196/12403 %U http://mededu.jmir.org/2019/1/e12403/ %U https://doi.org/10.2196/12403 %U http://www.ncbi.nlm.nih.gov/pubmed/30907736 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 21 %N 3 %P e13165 %T Offline Digital Education for Medical Students: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration %A Kyaw,Bhone Myint %A Posadzki,Pawel %A Dunleavy,Gerard %A Semwal,Monika %A Divakar,Ushashree %A Hervatis,Vasilis %A Tudor Car,Lorainne %+ Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Level 18, Clinical Science Building, Singapore,, Singapore, 65 69041258, lorainne.tudor.car@ntu.edu.sg %K medical education %K systematic review %K meta-analysis %K randomized controlled trials %K students, medical %D 2019 %7 25.03.2019 %9 Original Paper %J J Med Internet Res %G English %X Background: Medical schools in low- and middle-income countries are facing a shortage of staff, limited infrastructure, and restricted access to fast and reliable internet. Offline digital education may be an alternative solution for these issues, allowing medical students to learn at their own time and pace, without the need for a network connection. Objective: The primary objective of this systematic review was to assess the effectiveness of offline digital education compared with traditional learning or a different form of offline digital education such as CD-ROM or PowerPoint presentations in improving knowledge, skills, attitudes, and satisfaction of medical students. The secondary objective was to assess the cost-effectiveness of offline digital education, changes in its accessibility or availability, and its unintended/adverse effects on students. Methods: We carried out a systematic review of the literature by following the Cochrane methodology. We searched seven major electronic databases from January 1990 to August 2017 for randomized controlled trials (RCTs) or cluster RCTs. Two authors independently screened studies, extracted data, and assessed the risk of bias. We assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations criteria. Results: We included 36 studies with 3325 medical students, of which 33 were RCTs and three were cluster RCTs. The interventions consisted of software programs, CD-ROMs, PowerPoint presentations, computer-based videos, and other computer-based interventions. The pooled estimate of 19 studies (1717 participants) showed no significant difference between offline digital education and traditional learning groups in terms of students’ postintervention knowledge scores (standardized mean difference=0.11, 95% CI –0.11 to 0.32; small effect size; low-quality evidence). Meta-analysis of four studies found that, compared with traditional learning, offline digital education improved medical students’ postintervention skills (standardized mean difference=1.05, 95% CI 0.15-1.95; large effect size; low-quality evidence). We are uncertain about the effects of offline digital education on students’ attitudes and satisfaction due to missing or incomplete outcome data. Only four studies estimated the costs of offline digital education, and none reported changes in accessibility or availability of such education or in the adverse effects. The risk of bias was predominantly high in more than half of the included studies. The overall quality of the evidence was low (for knowledge, skills, attitudes, and satisfaction) due to the study limitations and inconsistency across the studies. Conclusions: Our findings suggest that offline digital education is as effective as traditional learning in terms of medical students’ knowledge and may be more effective than traditional learning in terms of medical students’ skills. However, there is a need to further investigate students’ attitudes and satisfaction with offline digital education as well as its cost-effectiveness, changes in its accessibility or availability, and any resulting unintended/adverse effects. %M 30907731 %R 10.2196/13165 %U http://www.jmir.org/2019/3/e13165/ %U https://doi.org/10.2196/13165 %U http://www.ncbi.nlm.nih.gov/pubmed/30907731 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 5 %N 1 %P e11940 %T Computer Programming: Should Medical Students Be Learning It? %A Morton,Caroline E %A Smith,Susan F %A Lwin,Tommy %A George,Michael %A Williams,Matt %+ Medical Education Research Unit, School of Medicine, Imperial College London, Exhibition Road, London, SW7 2AZ, United Kingdom, 44 7715372467, c.morton@imperial.ac.uk %K coding %K medical education %K undergraduate curriculum %D 2019 %7 22.03.2019 %9 Original Paper %J JMIR Med Educ %G English %X Background: The ability to construct simple computer programs (coding) is being progressively recognized as a life skill. Coding is now being taught to primary-school children worldwide, but current medical students usually lack coding skills, and current measures of computer literacy for medical students focus on the use of software and internet safety. There is a need to train a cohort of doctors who can both practice medicine and engage in the development of useful, innovative technologies to increase efficiency and adapt to the modern medical world. Objective: The aim of the study was to address the following questions: (1) is it possible to teach undergraduate medical students the basics of computer coding in a 2-day course? (2) how do students perceive the value of learning computer coding at medical school? and (3) do students see computer coding as an important skill for future doctors? Methods: We developed a short coding course to teach self-selected cohorts of medical students basic coding. The course included a 2-day introduction on writing software, discussion of computational thinking, and how to discuss projects with mainstream computer scientists, and it was followed on by a 3-week period of self-study during which students completed a project. We explored in focus groups (FGs) whether students thought that coding has a place in the undergraduate medical curriculum. Results: Our results demonstrate that medical students who were complete novices at coding could be taught enough to be able to create simple, usable clinical programs with 2 days of intensive teaching. In addition, 6 major themes emerged from the FGs: (1) making sense of coding, (2) developing the students’ skill set, (3) the value of coding in medicine, research, and business, (4) role of teaching coding in medical schools, (5) the concept of an enjoyable challenge, and (6) comments on the course design. Conclusions: Medical students can acquire usable coding skills in a weekend course. They valued the teaching and identified that, as well as gaining coding skills, they had acquired an understanding of its potential both for their own projects and in health care delivery and research. They considered that coding skills teaching should be offered as an optional part of the medical curriculum. %M 30901000 %R 10.2196/11940 %U http://mededu.jmir.org/2019/1/e11940/ %U https://doi.org/10.2196/11940 %U http://www.ncbi.nlm.nih.gov/pubmed/30901000 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 20 %N 9 %P e261 %T Use of Simulator-Based Teaching to Improve Medical Students’ Knowledge and Competencies: Randomized Controlled Trial %A Fischer,Quentin %A Sbissa,Yannis %A Nhan,Pascal %A Adjedj,Julien %A Picard,Fabien %A Mignon,Alexandre %A Varenne,Olivier %+ Department of Cardiology, Cochin Hospital (Assistance Publique–Hôpitaux de Paris), Paris Descartes University, 27 Rue du Faubourg Saint Jacques, Paris, 75014, France, 33 158411662, olivier.varenne@aphp.fr %K education %K coronary angiography %K high fidelity simulation training %D 2018 %7 24.9.2018 %9 Original Paper %J J Med Internet Res %G English %X Background: Simulator-based teaching for coronary angiography (CA) is an attractive educational tool for medical students to improve their knowledge and skills. Its pedagogical impact has not been fully evaluated yet. Objective: The aim of this study was to compare traditional face-to-face teaching with a simulator-based teaching for the acquisition of coronary anatomy knowledge and CAs interpretation. Methods: A total of 118 medical school students in their fourth to sixth year were prospectively randomized in 2 groups: (1) a control teaching group (n=59, CONT group) and (2) a simulator group (using the Mentice VIST-Lab CA simulator; n=59, SIM group). The CONT group received a PowerPoint-based course, whereas the SIM group received a simulator-based course including the same information. After the course, all students were evaluated by 40 multiple choice questions (maximum of 100 points), including questions on coronary anatomy (part 1), angiographic projections (part 2), and real CAs interpretation (part 3). Satisfaction of the students was also evaluated by a simple questionnaire. Results: Student characteristics were identical in both the groups: 62/118 (52.5%) were female and age was 22.6 (SD 1.4) years. Moreover, 35.6% (42/118) were in their fourth year, 35.6% (42/118) were in the fifth year, and 28.8% (34/118) in the sixth year. During the evaluation, SIM students had higher global scores compared with CONT students, irrespective of their year of medical school (59.5 [SD 10.8] points vs 43.7 [SD 11.3] points, P<.001). The same observations were noted for each part of the test (36.9 [SD 6.6] points vs 29.6 [SD 6.9] points, P<.001; 5.9 [SD 3.0] points vs 3.1 [SD 2.8] points, P<.001; and 16.8 [SD 6.9] points vs 10.9 [SD 6.5] points, P<.001; for parts 1, 2, and 3, respectively). Student satisfaction was higher in the SIM group compared with the CONT group (98% vs 75%, P<.001). Conclusions: This study suggests that simulator-based teaching could potentially improve students’ knowledge of coronary anatomy, angiography projections, and interpretation of real clinical cases, suggesting better clinical skills. These results should encourage further evaluation of simulator-based teaching in other medical specialties and how they can translate into clinical practice. %M 30249587 %R 10.2196/jmir.9634 %U http://www.jmir.org/2018/9/e261/ %U https://doi.org/10.2196/jmir.9634 %U http://www.ncbi.nlm.nih.gov/pubmed/30249587 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 7 %N 1 %P e19 %T Integrated Decentralized Training for Health Professions Education at the University of KwaZulu-Natal, South Africa: Protocol for the I-DecT Project %A Govender,Pragashnie %A Chetty,Verusia %A Naidoo,Deshini %A Pefile,Ntsikelelo %+ College of Health Sciences, University of KwaZulu-Natal, Private Bag x54001, Durban,, South Africa, 27 312608258, naidoopg@ukzn.ac.za %K decentralized clinical training, health science, South Africa, health care %D 2018 %7 25.01.2018 %9 Protocol %J JMIR Res Protoc %G English %X Background: The Integrated Decentralized Training (i-DecT) project was created to address the current need for health care in South Africa among resource poor climates in rural and periurban settings. The University of KwaZulu-Natal (UKZN) in South Africa has embarked on a program within the School of Health Sciences (SHS) to decentralize the clinical learning platform in order to address this disparity. Framed in a pragmatic stance, this proposal is geared towards informing the roll out of decentralized clinical training (DCT) within the province of KwaZulu-Natal. There currently remains uncertainty as to how the implementation of this program will unfold, especially for the diverse SHS, which includes specialities like audiology, dentistry, occupational therapy, optometry, pharmacy, physiotherapy, speech-language pathology, and sport science. Consequently, there is a need to carefully monitor and manage this DCT in order to ensure that the participating students have a positive learning experience and achieve expected academic outcomes, and that the needs of the communities are addressed adequately. Objective: The study aims to explore the factors that will influence the roll-out of the DCT by developing an inclusive and context-specific model that will adhere to the standards set by the SHS for the DCT program at UKZN. Methods: Key role players, including but not limited to, the South African Ministry of Health policy makers, clinicians, policy makers at UKZN, clinical educators, academicians, and students of UKZN within the SHS will participate in this project. Once the infrastructural, staffing and pedagogical enablers and challenges are identified, together with a review of existing models of decentralized training, a context-specific model for DCTl will be proposed based on initial pilot data that will be tested within iterative cycles in an Action Learning Action Research (ALAR) process. Results: The study was designed to fit within the existing structures, and emerging framework and memorandum of understanding between the partners of this initiative, namely, the Ministry of Health and UKZN in order to develop health care professionals that are competent and prepared for the changing dynamics of healthcare in a developing world. Conclusions: It is envisioned that this study, the first to include a combination of health professionals in a DCT platform at UKZN, will not only contribute to effective service delivery, but may also serve to promote an interprofessional cooperation within the SHS and tertiary institutions in similar settings. %M 29371175 %R 10.2196/resprot.7551 %U http://www.researchprotocols.org/2018/1/e19/ %U https://doi.org/10.2196/resprot.7551 %U http://www.ncbi.nlm.nih.gov/pubmed/29371175 %0 Journal Article %@ 2291-5222 %I JMIR Publications %V 5 %N 9 %P e139 %T Mobile Augmented Reality as a Feature for Self-Oriented, Blended Learning in Medicine: Randomized Controlled Trial %A Noll,Christoph %A von Jan,Ute %A Raap,Ulrike %A Albrecht,Urs-Vito %+ PL Reichertz Institute for Medical Informatics, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany, 49 511 532 ext 3508, albrecht.urs-vito@mh-hannover.de %K problem-based learning %K cellular phone %K education %K medical %K mHealth %D 2017 %7 14.09.2017 %9 Original Paper %J JMIR Mhealth Uhealth %G English %X Background: Advantages of mobile Augmented Reality (mAR) application-based learning versus textbook-based learning were already shown in a previous study. However, it was unclear whether the augmented reality (AR) component was responsible for the success of the self-developed app or whether this was attributable to the novelty of using mobile technology for learning. Objective: The study’s aim was to test the hypothesis whether there is no difference in learning success between learners who employed the mobile AR component and those who learned without it to determine possible effects of mAR. Also, we were interested in potential emotional effects of using this technology. Methods: Forty-four medical students (male: 25, female: 19, mean age: 22.25 years, standard deviation [SD]: 3.33 years) participated in this study. Baseline emotional status was evaluated using the Profile of Mood States (POMS) questionnaire. Dermatological knowledge was ascertained using a single choice (SC) test (10 questions). The students were randomly assigned to learn 45 min with either a mobile learning method with mAR (group A) or without AR (group B). Afterwards, both groups were again asked to complete the previous questionnaires. AttrakDiff 2 questionnaires were used to evaluate the perceived usability as well as pragmatic and hedonic qualities. For capturing longer term effects, after 14 days, all participants were again asked to complete the SC questionnaire. All evaluations were anonymous, and descriptive statistics were calculated. For hypothesis testing, an unpaired signed-rank test was applied. Results: For the SC tests, there were only minor differences, with both groups gaining knowledge (average improvement group A: 3.59 [SD 1.48]; group B: 3.86 [SD 1.51]). Differences between both groups were statistically insignificant (exact Mann Whitney U, U=173.5; P=.10; r=.247). However, in the follow-up SC test after 14 days, group A had retained more knowledge (average decrease of the number of correct answers group A: 0.33 [SD 1.62]; group B: 1.14 [SD 1.30]). For both groups, descriptively, there were only small variations regarding emotional involvement, and learning experiences also differed little, with both groups rating the app similar for its stimulating effect. Conclusions: We were unable to show significant effects for mAR on the immediate learning success of the mobile learning setting. However, the similar level of stimulation being noted for both groups is inconsistent with the previous assumption of the success of mAR-based approach being solely attributable to the excitement of using mobile technology, independent of mAR; the mAR group showed some indications for a better long-term retention of knowledge. Further studies are needed to examine this aspect. Trial Registration: German Clinical Trials Register (DRKS): 00012980; http://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00012980 (Archived by WebCite at http://www.webcitation.org/ 6tCWoM2Jb). %M 28912113 %R 10.2196/mhealth.7943 %U http://mhealth.jmir.org/2017/9/e139/ %U https://doi.org/10.2196/mhealth.7943 %U http://www.ncbi.nlm.nih.gov/pubmed/28912113 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 3 %N 2 %P e14 %T A Web-Based Lifestyle Medicine Curriculum: Facilitating Education About Lifestyle Medicine, Behavioral Change, and Health Care Outcomes %A Frates,Elizabeth Pegg %A Xiao,Ryan C %A Sannidhi,Deepa %A McBride,Yasamina %A McCargo,Tracie %A Stern,Theodore A %+ Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 First Avenue, Charlestown, MA, 02129, United States, 1 6179668757, efrates1@partners.org %K life style %K health behavior %K healthy lifestyle %K health education %K health promotion %K wellness programs %K curriculum %K self efficacy %K young adult %K education, medical, undergraduate %K health knowledge, attitudes, practice %K universities %K mental health %K adolescent %K risk reduction behavior %K humans %D 2017 %7 11.09.2017 %9 Original Paper %J JMIR Med Educ %G English %X Background: Lifestyle medicine is the science and application of healthy lifestyles as interventions for the prevention and treatment of disease, and has gained significant momentum as a specialty in recent years. College is a critical time for maintenance and acquisition of healthy habits. Longer-term, more intensive web-based and in-person lifestyle medicine interventions can have a positive effect. Students who are exposed to components of lifestyle medicine in their education have improvements in their health behaviors. A semester-long undergraduate course focused on lifestyle medicine can be a useful intervention to help adopt and sustain healthy habits. Objective: To describe a novel, evidence based curriculum for a course teaching the concepts of Lifestyle Medicine based on a web-based course offered at the Harvard Extension School. Methods: The course was delivered in a web-based format. The Lifestyle Medicine course used evidence based principles to guide students toward a “coach approach” to behavior change, increasing their self-efficacy regarding various lifestyle-related preventive behaviors. Students are made to understand the cultural trends and national guidelines that have shaped lifestyle medicine recommendations relating to behaviors. They are encouraged to engage in behavior change. Course topics include physical activity, nutrition, addiction, sleep, stress, and lifestyle coaching and counseling. The course addressed all of the American College of Preventive Medicine/American College of Lifestyle Medicine competencies save for the competency of office systems and technologies to support lifestyle medicine counseling. Results: The course was well-received, earning a ranking of 4.9/5 at the school. Conclusions: A novel, semester-long course on Lifestyle Medicine at the Harvard Extension School is described. Student evaluations suggest the course was well-received. Further research is needed to evaluate whether such a course empowers students to adopt behavior changes. %M 28893726 %R 10.2196/mededu.7587 %U http://mededu.jmir.org/2017/2/e14/ %U https://doi.org/10.2196/mededu.7587 %U http://www.ncbi.nlm.nih.gov/pubmed/28893726 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 6 %N 8 %P e155 %T Impact of a Tutored Theoretical-Practical Training to Develop Undergraduate Students’ Skills for the Detection of Caries Lesions: Study Protocol for a Multicenter Controlled Randomized Study %A Braga,Mariana Minatel %A Lenzi,Tathiane Larissa %A Ferreira,Fernanda Rosche %A Mendes,Fausto Medeiros %A Raggio,Daniela Prócida %A Imparato,José Carlos %A Bonecker,Marcelo %A Magalhães,Ana Carolina %A Wang,Linda %A Rios,Daniela %A Pessan,Juliano Pelim %A Duque,Cristiane %A Rebelo,Maria Augusta Bessa %A Alves Filho,Ary Oliveira %A Lima,Marina De Deus Moura %A Moura,Marcoeli Silva %A De Carli,Alessandro Diogo %A Sanabe,Mariane Emi %A Cenci,Maximiliano Sergio %A Oliveira,Elenara Ferreira %A Correa,Marcos Britto %A Rocha,Rachel Oliveira %A Zenkner,Julio Eduardo %A Murisí,Pedroza Uribe %A Martignon,Stefania %A Lara,Juan Sebastian %A Aquino,Fatima Gabriela %A Carrillo,Alfredo %A Chu,Chun Hung %A Deery,Chris %A Ricketts,David %A Melo,Paulo %A Antunes,José Leopoldo Ferreira %A Ekstrand,Kim Rud %A , %+ Dental School, Pediatric Dentistry Departament, University of São Paulo, Av. Professor Lineu Prestes, 2227, Sao Paulo, 05508-000, Brazil, 55 1130917835, mmbraga@usp.br %K active learning %K cariology %K dental education %K laboratory training %D 2017 %7 16.08.2017 %9 Protocol %J JMIR Res Protoc %G English %X Background: Tutored laboratorial activities could be a manner of improving the competency development of students. However, its impact over conventional theoretical classes has not yet been tested. Additionally, different university contexts could influence this issue and should be explored. Objective: To assess the impact of a tutored theoretical-practical training for teaching undergraduate students to detect caries lesions as compared with theoretical teaching activities. The impact of these teaching/learning activities will be assessed in terms of efficacy, cost/benefit, retention of knowledge/acquired competences, and student acceptability. Methods: Sixteen centers (7 centers from Brazil and 9 centers from other countries throughout the world) are involved in the inclusion of subjects for this protocol. A randomized controlled study with parallel groups will be conducted. One group (control) will be exposed to a 60- to 90-minute conventional theoretical class and the other group (test) will be exposed to the same theoretical class and also a 90-minute laboratory class, including exercises and discussions based on the evaluation of a pool of images and extracted teeth. The mentioned outcomes will be evaluated immediately after the teaching activities and also in medium- and long-term analyses. To compare the long-term outcomes, students who enrolled in the university before the participating students will be interviewed for data collection and these data will be used as a control and compared with the trained group. This stage will be a nonrandomized phase of this study, nested in the main study. Appropriate statistical analysis will be performed according to the aims of this study. Variables related to the centers will also be analyzed and used to model adjustment as possible sources of variability among results. Results: This ongoing study is funded by a Brazilian national funding agency (CNPq- 400736/2014-4). We expect that the tutored theoretical-practical training will improve the undergraduate students’ performance in the detection of caries lesions and subsequent treatment decisions, mainly in terms of long-term retention of knowledge. Our hypothesis is that tutored theoretical-practical training is a more cost-effective option for teaching undergraduate students to detect caries lesions. Conclusions: If our hypothesis is confirmed, the use of laboratory training in conjunction with theoretical classes could be used as an educational strategy in Cariology to improve the development of undergraduate students’ skills in the detection of caries lesions and clinical decision-making. %M 28814381 %R 10.2196/resprot.7414 %U http://www.researchprotocols.org/2017/8/e155/ %U https://doi.org/10.2196/resprot.7414 %U http://www.ncbi.nlm.nih.gov/pubmed/28814381 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 3 %N 1 %P e9 %T Erosion of Digital Professionalism During Medical Students’ Core Clinical Clerkships %A Mostaghimi,Arash %A Olszewski,Aleksandra E %A Bell,Sigall K %A Roberts,David H %A Crotty,Bradley H %+ Department of Dermatology, Brigham & Women’s Hospital, 75 Francis Street, PBB-B 421, Boston, MA, 02115, United States, 1 617 525 8335, amostaghimi@partners.org %K professionalism %K health information systems %K undergraduate medical education %K social media %K medical informatics %D 2017 %7 03.05.2017 %9 Original Paper %J JMIR Med Educ %G English %X Background: The increased use of social media, cloud computing, and mobile devices has led to the emergence of guidelines and novel teaching efforts to guide students toward the appropriate use of technology. Despite this, violations of professional conduct are common. Objective: We sought to explore professional behaviors specific to appropriate use of technology by looking at changes in third-year medical students’ attitudes and behaviors at the beginning and conclusion of their clinical clerkships. Methods: After formal teaching about digital professionalism, we administered a survey to medical students that described 35 technology-related behaviors and queried students about professionalism of the behavior (on a 5-point Likert scale), observation of others engaging in the behavior (yes or no), as well as personal participation in the behavior (yes or no). Students were resurveyed at the end of the academic year. Results: Over the year, perceptions of what is considered acceptable behavior regarding privacy, data security, communications, and social media boundaries changed, despite formal teaching sessions to reinforce professional behavior. Furthermore, medical students who observed unprofessional behaviors were more likely to participate in such behaviors. Conclusions: Although technology is a useful tool to enhance teaching and learning, our results reflect an erosion of professionalism related to information security that occurred despite medical school and hospital-based teaching sessions to promote digital professionalism. True alteration of trainee behavior will require a cultural shift that includes continual education, better role models, and frequent reminders for faculty, house staff, students, and staff. %M 28468745 %R 10.2196/mededu.6879 %U http://mededu.jmir.org/2017/1/e9/ %U https://doi.org/10.2196/mededu.6879 %U http://www.ncbi.nlm.nih.gov/pubmed/28468745 %0 Journal Article %@ 2291-9279 %I JMIR Publications %V 4 %N 2 %P e22 %T Cardiopulmonary Resuscitation Training by Avatars: A Qualitative Study of Medical Students’ Experiences Using a Multiplayer Virtual World %A Creutzfeldt,Johan %A Hedman,Leif %A Felländer-Tsai,Li %+ Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, K32, Karolinska University Hospital, Stockholm, 14186, Sweden, 46 8 585 82102, johan.creutzfeldt@ki.se %K avatars %K cardiopulmonary resuscitation %K educational technology %K medical students %K experiences %K multiplayer virtual worlds %K patient simulation %K virtual learning environments %D 2016 %7 16.12.2016 %9 Original Paper %J JMIR Serious Games %G English %X Background: Emergency medical practices are often team efforts. Training for various tasks and collaborations may be carried out in virtual environments. Although promising results exist from studies of serious games, little is known about the subjective reactions of learners when using multiplayer virtual world (MVW) training in medicine. Objective: The objective of this study was to reach a better understanding of the learners’ reactions and experiences when using an MVW for team training of cardiopulmonary resuscitation (CPR). Methods: Twelve Swedish medical students participated in semistructured focus group discussions after CPR training in an MVW with partially preset options. The students’ perceptions and feelings related to use of this educational tool were investigated. Using qualitative methodology, discussions were analyzed by a phenomenological data-driven approach. Quality measures included negotiations, back-and-forth reading, triangulation, and validation with the informants. Results: Four categories characterizing the students’ experiences could be defined: (1) Focused Mental Training, (2) Interface Diverting Focus From Training, (3) Benefits of Practicing in a Group, and (4) Easy Loss of Focus When Passive. We interpreted the results, compared them to findings of others, and propose advantages and risks of using virtual worlds for learning. Conclusions: Beneficial aspects of learning CPR in a virtual world were confirmed. To achieve high participant engagement and create good conditions for training, well-established procedures should be practiced. Furthermore, students should be kept in an active mode and frequent feedback should be utilized. It cannot be completely ruled out that the use of virtual training may contribute to erroneous self-beliefs that can affect later clinical performance. %M 27986645 %R 10.2196/games.6448 %U http://games.jmir.org/2016/2/e22/ %U https://doi.org/10.2196/games.6448 %U http://www.ncbi.nlm.nih.gov/pubmed/27986645 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 2 %N 2 %P e12 %T Spaced Education and the Importance of Raising Awareness of the Personal Data Protection Act: A Medical Student Population-Based Study %A Daruwalla,Zubin J %A Loh,Jing L %A Dong,Chaoyan %+ National University Hospital, Singapore, Department of Orthopaedic Surgery, 5 Lower Kent Ridge Road, Singapore,, Singapore, 65 6772 3332, zubin@imaginehealth.sg %K medical education %K MyDoc %K Personal Data Protection Act %K secure messaging %K spaced education %K telehealth %K telemedicine %D 2016 %7 09.08.2016 %9 Original Paper %J JMIR Med Educ %G English %X Background: The Personal Data Protection Act (PDPA) of Singapore was first passed in 2012, with subsequent enforcement regulations effective in 2014. Although medical education via digital platforms is not often used in medical schools in Singapore as of yet, many current means of communication at all levels in the medical community from medical schools to clinics to hospitals are unsecure and noncompliant with the PDPA. Objective: This pilot study will assess the effectiveness of MyDoc, a secure, mobile telehealth application and messaging platform, as an educational tool, secure communications tool, and a tool to raise awareness of the PDPA. Methods: By replacing current methods of communication with MyDoc and using weekly clinical case discussions in the form of unidentifiable clinical photos and questions and answers, we raised awareness the PDPA among medical students and gained feedback and determined user satisfaction with this innovative system via questionnaires handed to 240 medical students who experienced using MyDoc over a 6-week period. Results: All 240 questionnaires were answered with very positive and promising results, including all 100 students who were not familiar with the PDPA prior to the study attributing their awareness of it to MyDoc. Conclusions: Potential uses of MyDoc in a medical school setting include PDPA-compliant student-to-student and student-to-doctor communication and clinical group case discussions with the sharing of patient-sensitive data, including clinical images and/or videos of hospital patients that students may benefit from viewing from an educational perspective. With our pilot study having excellent results in terms of acceptance and satisfaction from medical students and raising awareness of the PDPA, the integration of a secure, mobile digital health application and messaging platform is something all medical schools should consider, because our students of today are our doctors of tomorrow. %M 27731866 %R 10.2196/mededu.5586 %U http://mededu.jmir.org/2016/2/e12/ %U https://doi.org/10.2196/mededu.5586 %U http://www.ncbi.nlm.nih.gov/pubmed/27731866 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 2 %N 1 %P e9 %T Health Sciences Students’ Self-Assessment of Information and Communication Technology Skills and Attitude Toward e-Learning %A Buabbas,Ali Jassem %A Al-Shawaf,Hamza Mohammad Hassan %A Almajran,Abdullah Abdulaziz %+ Faculty of Medicine, Department of Community Medicine and Behavioral Sciences, Kuwait University, Jabriya, Kuwait, 965 25319504, ali.buabbas@hsc.edu.kw %K ICT literacy %K health sciences student attitudes %K health informatics %K e-learning %K medical education %D 2016 %7 20.06.2016 %9 Original Paper %J JMIR Med Educ %G English %X Background: In medical education, information and communication technology (ICT) knowledge and skills have become a necessity and an integral part of preparing tomorrow’s doctors to be sufficiently competent to use informatics resources effectively and efficiently for the best practice of medicine. Objective: This research aimed to study the literacy of the preprofessional students in ICT before and after taking the basic informatics course at the Health Sciences Center at Kuwait University, to understand their potential and their attitudes toward using ICT, including e-learning. Methods: A validated questionnaire was used to collect data from 200 students in 2 stages: before and after the informatics course on the preprofessional program. In addition, the tutors’ observational assessments of the students’ achievements during the informatics course were obtained. Results: The response rate of students before the course was 85.5% (171/200) and after was 77% (154/200). Of 200 students, 85% were female, and 15% were male. This disproportional representation of genders was due to the fact that 85% of registered students were female. Approximately 59% (101/171) of the students assessed themselves before the course as computer literate; afterward, this increased to 70.1% (108/154). Students who were still computer illiterate (29.2%; 45/154) mostly used the excuse of a lack of time (60%; 27/45). In generic ICT skills, the highest levels were for word processing, email, and Web browsing, whereas the lowest levels were for spreadsheets and database. In specific ICT skills, most respondents were reported low levels for statistical package use and Web page design. The results found that there was a significant improvement between students’ general ICT skills before and after the course. The results showed that there were significant improvement between how frequently students were using Medline (P<.001), Google Scholar (P<.001), and Cochrane Library (P<.001) before and after the informatics course. Furthermore, most of the students who completed the course (72.8%; 110/151) chose the learning management system as the most useful e-learning tool. The results of the tutors’ assessments confirmed the obvious improvement in most of the students’ skills in using ICT. Conclusions: The ICT knowledge and skills of the students before the course seemed insufficient, and the magnitude of the improvements that were acquired throughout the informatics course was obvious in most of the students’ performance. However, the findings reveal that more practice was required. The attitudes of most of the students toward the potential of e-learning were considered positive, although the potential of Web-based learning in medical training was not well known among the students. %M 27731863 %R 10.2196/mededu.5606 %U http://mededu.jmir.org/2016/1/e9/ %U https://doi.org/10.2196/mededu.5606 %U http://www.ncbi.nlm.nih.gov/pubmed/27731863 %0 Journal Article %@ 2369-3762 %I JMIR Publications Inc. %V 1 %N 2 %P e17 %T Developing a Curriculum to Promote Professionalism for Medical Students Using Social Media: Pilot of a Workshop and Blog-Based Intervention %A Flickinger,Tabor E %A O'Hagan,Thomas %A Chisolm,Margaret S %+ Division of General, Geriatric, Palliative and Hospital Medicine, Department of Medicine, University of Virginia School of Medicine, PO Box 800744, Charlottesville, VA, 22908, United States, 1 434 924 5608, tflick72@gmail.com %K medical education %K medical students %K professionalism %K social media %K social networking %D 2015 %7 01.12.2015 %9 Original Paper %J JMIR Medical Education %G English %X Background: As the use of social media (SM) tools becomes increasingly widespread, medical trainees need guidance on applying principles of professionalism to their online behavior. Objective: To develop a curriculum to improve knowledge and skills regarding professionalism of SM use by medical students. Methods: This project was conducted in 3 phases: (1) a needs assessment was performed via a survey of medical students regarding SM use, rationale for and frequency of use, and concerns; (2) a workshop-format curriculum was designed and piloted for preclinical students to gain foundational knowledge of online professionalism; and (3) a complementary longitudinal SM-based curriculum was designed and piloted for clinical students to promote both medical humanism and professionalism. Results: A total of 72 medical students completed the survey (response rate 30%). Among the survey respondents, 71/72 (99%) reported visiting social networking sites, with 55/72 (76%) reporting daily visits. Privacy of personal information (62/72, 86%) and mixing of personal/professional identities (49/72, 68%) were the students’ most commonly endorsed concerns regarding SM use. The workshop-format curriculum was evaluated qualitatively via participant feedback. Of the 120 students who participated in the workshop, 91 completed the post workshop evaluation (response rate 76%), with 56 positive comments and 54 suggestions for improvement. The workshop was experienced by students as enjoyable, thought provoking, informative, and relevant. Suggestions for improvement included adjustments to timing, format, and content of the workshop. The SM-based curriculum was evaluated by a small-scale pilot of 11 students, randomized to the intervention group (participation in faculty-moderated blog) or the control group. Outcomes were assessed quantitatively and qualitatively via personal growth scales, participant feedback, and analysis of blog themes. There was a trend toward improvement in total personal growth scores among those students in the blog group from 3.65 (0.47) to 4.11 (0.31) (mean [SD]) with no change observed for the students in the control group (3.89 [0.11] before and after evaluation). Themes relevant to humanism and professionalism were observed in the blog discussion. Conclusions: Most medical students surveyed reported using SM and identified privacy and personal-professional boundaries as areas of concern. The workshop format and SM-based curricula were well-received by students whose formative feedback will inform the refinement and further development of efforts to promote professionalism among medical students. %M 27731846 %R 10.2196/mededu.4886 %U http://mededu.jmir.org/2015/2/e17/ %U https://doi.org/10.2196/mededu.4886 %U http://www.ncbi.nlm.nih.gov/pubmed/27731846 %0 Journal Article %@ 2369-3762 %I JMIR Publications Inc. %V 1 %N 2 %P e12 %T Undergraduate Medical Students Using Facebook as a Peer-Mentoring Platform: A Mixed-Methods Study %A Pinilla,Severin %A Nicolai,Leo %A Gradel,Maximilian %A Pander,Tanja %A Fischer,Martin R %A von der Borch,Philip %A Dimitriadis,Konstantinos %+ Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, Pettenkoferstrasse 8a, Munich, 80336, Germany, 49 89440052133, severin.pinilla@med.uni-muenchen.de %K medical education %K peer mentoring %K social media %K Facebook %D 2015 %7 27.10.2015 %9 Original Paper %J JMIR Medical Education %G English %X Background: Peer mentoring is a powerful pedagogical approach for supporting undergraduate medical students in their learning environment. However, it remains unclear what exactly peer mentoring is and whether and how undergraduate medical students use social media for peer-mentoring activities. Objective: We aimed at describing and exploring the Facebook use of undergraduate medical students during their first 2 years at a German medical school. The data should help medical educators to effectively integrate social media in formal mentoring programs for medical students. Methods: We developed a coding scheme for peer mentoring and conducted a mixed-methods study in order to explore Facebook groups of undergraduate medical students from a peer-mentoring perspective. Results: All major peer-mentoring categories were identified in Facebook groups of medical students. The relevance of these Facebook groups was confirmed through triangulation with focus groups and descriptive statistics. Medical students made extensive use of Facebook and wrote a total of 11,853 posts and comments in the respective Facebook groups (n=2362 total group members). Posting peaks were identified at the beginning of semesters and before exam periods, reflecting the formal curriculum milestones. Conclusions: Peer mentoring is present in Facebook groups formed by undergraduate medical students who extensively use these groups to seek advice from peers on study-related issues and, in particular, exam preparation. These groups also seem to be effective in supporting responsive and large-scale peer-mentoring structures; formal mentoring programs might benefit from integrating social media into their activity portfolio. %M 27731859 %R 10.2196/mededu.5063 %U http://mededu.jmir.org/2015/2/e12/ %U https://doi.org/10.2196/mededu.5063 %U http://www.ncbi.nlm.nih.gov/pubmed/27731859 %0 Journal Article %@ 2369-3762 %I JMIR Publications Inc. %V 1 %N 2 %P e6 %T Digital Literacy in the Medical Curriculum: A Course With Social Media Tools and Gamification %A Mesko,Bertalan %A Győrffy,Zsuzsanna %A Kollár,János %+ Institute of Behavioural Sciences, Semmelweis University, H-1089, Budapest, Nagyvárad tér 4, Hungary, 36 (1) 459 1500, berci@medicalfuturist.com %K medical education %K social media %K digital literacy %D 2015 %7 01.10.2015 %9 Original Paper %J JMIR Medical Education %G English %X Background: The profession of practicing medicine is based on communication, and as social media and other digital technologies play a major role in today’s communication, digital literacy must be included in the medical curriculum. The value of social media has been demonstrated several times in medicine and health care, therefore it is time to prepare medical students for the conditions they will have to face when they graduate. Objective: The aim of our study was to design a new e-learning-based curriculum and test it with medical students. Method: An elective course was designed to teach students how to use the Internet, with a special emphasis on social media. An e-learning platform was also made available and students could access material about using digital technologies on the online platforms they utilized the most. All students filled in online surveys before and after the course in order to provide feedback about the curriculum. Results: Over a 3-year period, 932 students completed the course. The course did not increase the number of hours spent online but aimed at making that time more efficient and useful. Based on the responses of students, they found the information provided by the curriculum useful for their studies and future practices. Conclusions: A well-designed course, improved by constant evaluation-based feedback, can be suitable for preparing students for the massive use of the Internet, social media platforms, and digital technologies. New approaches must be applied in modern medical education in order to teach students new skills. Such curriculums that put emphasis on reaching students on the online channels they use in their studies and everyday lives introduce them to the world of empowered patients and prepare them to deal with the digital world. %M 27731856 %R 10.2196/mededu.4411 %U http://mededu.jmir.org/2015/2/e6/ %U https://doi.org/10.2196/mededu.4411 %U http://www.ncbi.nlm.nih.gov/pubmed/27731856 %0 Journal Article %@ 1438-8871 %I JMIR Publications Inc. %V 17 %N 9 %P e223 %T Moving Knowledge Acquisition From the Lecture Hall to the Student Home: A Prospective Intervention Study %A Raupach,Tobias %A Grefe,Clemens %A Brown,Jamie %A Meyer,Katharina %A Schuelper,Nikolai %A Anders,Sven %+ University Medical Centre Göttingen, Clinic for Cardiology and Pneumology, Georg-August University Göttingen, Robert-Koch-Strasse 40, Göttingen, D-37075, Germany, 49 55139 ext 8922, raupach@med.uni-goettingen.de %K knowledge %K lecture %K medical education %K podcast %K retention %D 2015 %7 28.09.2015 %9 Original Paper %J J Med Internet Res %G English %X Background: Podcasts are popular with medical students, but the impact of podcast use on learning outcomes in undergraduate medical education has not been studied in detail. Objective: Our aim was to assess the impact of podcasts accompanied by quiz questions and lecture attendance on short- and medium-term knowledge retention. Methods: Students enrolled for a cardio-respiratory teaching module were asked to prepare for 10 specific lectures by watching podcasts and submitting answers to related quiz questions before attending live lectures. Performance on the same questions was assessed in a surprise test and a retention test. Results: Watching podcasts and submitting answers to quiz questions (versus no podcast/quiz use) was associated with significantly better test performance in all items in the surprise test and 7 items in the retention test. Lecture attendance (versus no attendance) was associated with higher test performance in 3 items and 1 item, respectively. In a linear regression analysis adjusted for age, gender, and overall performance levels, both podcast/quiz use and lecture attendance were significant predictors of student performance. However, the variance explained by podcast/quiz use was greater than the variance explained by lecture attendance in the surprise test (38.7% vs 2.2%) and retention test (19.1% vs 4.0%). Conclusions: When used in conjunction with quiz questions, podcasts have the potential to foster knowledge acquisition and retention over and above the effect of live lectures. %M 26416467 %R 10.2196/jmir.3814 %U http://www.jmir.org/2015/9/e223/ %U https://doi.org/10.2196/jmir.3814 %U http://www.ncbi.nlm.nih.gov/pubmed/26416467 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 1 %N 1 %P e3 %T Global Outreach of a Locally-Developed Mobile Phone App for Undergraduate Psychiatry Education %A Zhang,Melvyn WB %A Cheok,Christopher CS %A Ho,Roger CM %+ National Healthcare Group, Level 9, Department of Psychological Medicine, National University Healthcare Systems (NUHS) Tower Block 5 Lower Kent Ridge Road, Singapore, 119054, Singapore, 65 7725555, melvynzhangweibin@gmail.com %K psychiatry %K education %K eLearning %K mobile phone apps %K mobile phones %K feasibility %K proof of concept %D 2015 %7 08.06.2015 %9 Original Paper %J JMIR Medical Education %G English %X Background: Over the past decade, there have been massive developments in both Web-based and mobile phone technologies. Mobile phones are well accepted by students, trainees, and doctors. A review of the current literature has identified the following specialties that have used mobile phones in education: pediatrics, ophthalmology, nephrology, plastic surgery, orthopedics, pharmacology, and urology. However, to date, there are no published papers examining the application of the latest mobile phone technologies for psychiatry education internationally. Objectives: The main objectives of this study are (1) to determine the feasibility and receptiveness of a locally-developed psychiatry mobile phone app and user perspectives (both quantitative and qualitative) towards it, and (2) to determine the receptiveness of a locally-developed app for psychiatry education internationally. Methods: A Web-based app that contained textbook contents, videos, and quizzes was developed using HTML5 technologies in 2012. Native apps were subsequently developed in 2013. Information about the apps was disseminated locally to Singaporean medical students, but the respective native apps were made available on the app stores. A user perspective survey was conducted locally to determine student’s perception of the app. Results: From the inception of the app until the time of preparation of this manuscript, there have been a cumulative total of 28,500 unique visits of the responsive HTML5 Web-based mobile phone app. There have been a cumulative total of 2200 downloads of the Mastering Psychiatry app from the Apple app store and 7000 downloads of the same app from the Android app store. The initial user perspective survey conducted locally highlighted that approximately a total of 95.2% (177/186) of students felt that having a psychiatry mobile phone app was deemed to be useful. Further chi-squared analysis demonstrated that there was a significant difference between males and females in their perception of having textbook contents in the mobile phone app (χ24=12.9, P=.0012). Conclusions: To the best of our knowledge, this is the first study to demonstrate the feasibility and global acceptance of a local, self-designed educational app for psychiatry education. Whilst the current research has managed to demonstrate the feasibility and acceptance of such an app, future studies would be warranted to look, in-depth, into whether there are cultural differences in terms of perceptions towards having such an app in psychiatry and what contents different cultures and cohorts of students might want within an app. %M 27731838 %R 10.2196/mededu.4179 %U https://medinform.jmir.org/2015/1/e3/ %U https://doi.org/10.2196/mededu.4179 %U http://www.ncbi.nlm.nih.gov/pubmed/27731838