%0 Journal Article %@ 2369-3762 %I JMIR Publications %V 11 %N %P e58100 %T Comparison of an Emergency Medicine Asynchronous Learning Platform Usage Before and During the COVID-19 Pandemic: Retrospective Analysis Study %A Briggs,Blake %A Mulekar,Madhuri %A Morales,Hannah %A Husain,Iltifat %K asynchronous learning %K medical education %K podcast %K COVID-19 %K emergency medicine %K online learning %K engagement %K web-based %K online study %K online class %K videoconferencing %K assessment %K effectiveness %K challenges %K knowledge retention %K performance %K virtual learning %K pre-pandemic %K post-pandemic %D 2025 %7 21.2.2025 %9 %J JMIR Med Educ %G English %X Background: The COVID-19 pandemic challenged medical educators due to social distancing. Podcasts and asynchronous learning platforms help distill medical education in a socially distanced environment. Medical educators interested in providing asynchronous teaching should know how these methods performed during the pandemic. Objective: The purpose of this study was to assess the level of engagement for an emergency medicine (EM) board review podcast and website platform, before and during the COVID-19 pandemic. We measured engagement via website traffic, including such metrics as visits, bounce rate, unique visitors, and page views. We also evaluated podcast analytics, which included total listeners, engaged listeners, and number of plays. Methods: Content was designed after the American Board of EM Model, covering only 1 review question per episode. Website traffic and podcast analytics were studied monthly from 2 time periods of 20 months each, before the pandemic (July 11, 2018, to February 31, 2020) and during the pandemic (May 1, 2020, to December 31, 2021). March and April 2020 data were omitted from the analysis due to variations in closure at various domestic and international locations. Results underwent statistical analysis in March 2022. Results: A total of 132 podcast episodes and 93 handouts were released from July 11, 2018, to December 31, 2021. The mean number of listeners per podcast increased significantly from 2.11 (SD 1.19) to 3.77 (SD 0.76; t test, P<.001), the mean number engaged per podcast increased from 1.72 (SD 1.00) to 3.09 (SD 0.62; t test, P<.001), and the mean number of plays per podcast increased from 42.54 (SD 40.66) to 69.23 (SD 17.54; t test, P=.012). Similarly, the mean number of visits per posting increased from 5.85 (SD 3.28) to 15.39 (SD 3.06; t test, P<.001), the mean number of unique visitors per posting increased from 3.74 (SD 1.83) to 10.41 (SD 2.33; t test, P<.001), and the mean number of page views per posting increased from 17.13 (SD 10.63) to 33.32 (SD 7.01; t test, P<.001). Note that, all measures showed a decrease from November 2021 to December 2021. Conclusions: During the COVID-19 pandemic, there was an increased engagement for our EM board review podcast and website platform over a long-term period, specifically through website visitors and the number of podcast plays. Medical educators should be aware of the increasing usage of web-based education tools, and that asynchronous learning is favorably viewed by learners. Limitations include the inability to view Spotify (Spotify Technology S.A.) analytics during the study period, and confounding factors like increased popularity of social media inadvertently promoting the podcast. %R 10.2196/58100 %U https://mededu.jmir.org/2025/1/e58100 %U https://doi.org/10.2196/58100 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 27 %N %P e66157 %T Identifying Research Priorities in Digital Education for Health Care: Umbrella Review and Modified Delphi Method Study %A Potter,Alison %A Munsch,Chris %A Watson,Elaine %A Hopkins,Emily %A Kitromili,Sofia %A O'Neill,Iain Cameron %A Larbie,Judy %A Niittymaki,Essi %A Ramsay,Catriona %A Burke,Joshua %A Ralph,Neil %+ Technology Enhanced Learning, NHS England, Explorer House, Adanac Drive, Southampton, SO16 0AS, United Kingdom, 44 01962 690405, alison.potter13@nhs.net %K digital education %K health professions education %K research priorities %K umbrella review %K Delphi %K artificial intelligence %K AI %D 2025 %7 19.2.2025 %9 Review %J J Med Internet Res %G English %X Background: In recent years, the use of digital technology in the education of health care professionals has surged, partly driven by the COVID-19 pandemic. However, there is still a need for focused research to establish evidence of its effectiveness. Objective: This study aimed to define the gaps in the evidence for the efficacy of digital education and to identify priority areas where future research has the potential to contribute to our understanding and use of digital education. Methods: We used a 2-stage approach to identify research priorities. First, an umbrella review of the recent literature (published between 2020 and 2023) was performed to identify and build on existing work. Second, expert consensus on the priority research questions was obtained using a modified Delphi method. Results: A total of 8857 potentially relevant papers were identified. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, we included 217 papers for full review. All papers were either systematic reviews or meta-analyses. A total of 151 research recommendations were extracted from the 217 papers. These were analyzed, recategorized, and consolidated to create a final list of 63 questions. From these, a modified Delphi process with 42 experts was used to produce the top-five rated research priorities: (1) How do we measure the learning transfer from digital education into the clinical setting? (2) How can we optimize the use of artificial intelligence, machine learning, and deep learning to facilitate education and training? (3) What are the methodological requirements for high-quality rigorous studies assessing the outcomes of digital health education? (4) How does the design of digital education interventions (eg, format and modality) in health professionals’ education and training curriculum affect learning outcomes? and (5) How should learning outcomes in the field of health professions’ digital education be defined and standardized? Conclusions: This review provides a prioritized list of research gaps in digital education in health care, which will be of use to researchers, educators, education providers, and funding agencies. Additional proposals are discussed regarding the next steps needed to advance this agenda, aiming to promote meaningful and practical research on the use of digital technologies and drive excellence in health care education. %M 39969988 %R 10.2196/66157 %U https://www.jmir.org/2025/1/e66157 %U https://doi.org/10.2196/66157 %U http://www.ncbi.nlm.nih.gov/pubmed/39969988 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 11 %N %P e64550 %T Reviewing Mobile Apps for Teaching Human Anatomy: Search and Quality Evaluation Study %A Rivera García,Guadalupe Esmeralda %A Cervantes López,Miriam Janet %A Ramírez Vázquez,Juan Carlos %A Llanes Castillo,Arturo %A Cruz Casados,Jaime %+ Tecnológico Nacional de México, Instituto Tecnológico Superior de Pánuco, Av. Artículo Tercero Constitucional, Colonia Solidaridad, Pánuco, Veracruz, 93990, Mexico, 52 846 1064254, esmeralda.rivera@itspanuco.edu.mx %K anatomy %K Google Play %K mobile health %K mHealth %K Mobile App Rating Scale %K MARS %D 2025 %7 14.2.2025 %9 Original Paper %J JMIR Med Educ %G English %X Background: Mobile apps designed for teaching human anatomy offer a flexible, interactive, and personalized learning platform, enriching the educational experience for both students and health care professionals. Objective: This study aimed to conduct a systematic review of the human anatomy mobile apps available on Google Play, evaluate their quality, highlight the highest scoring apps, and determine the relationship between objective quality ratings and subjective star ratings. Methods: The Mobile App Rating Scale (MARS) was used to evaluate the apps. The intraclass correlation coefficient was calculated using a consistency-type 2-factor random model to measure the reliability of the evaluations made by the experts. In addition, Pearson correlations were used to analyze the relationship between MARS quality scores and subjective evaluations of MARS quality item 23. Results: The mobile apps with the highest overall quality scores according to the MARS (ie, sections A, B, C, and D) were Organos internos 3D (anatomía) (version 4.34), Sistema óseo en 3D (Anatomía) (version 4.32), and VOKA Anatomy Pro (version 4.29). To measure the reliability of the MARS quality evaluations (sections A, B, C, and D), the intraclass correlation coefficient was used, and the result was “excellent.” Finally, Pearson correlation results revealed a significant relationship (r=0.989; P<.001) between the quality assessments conducted by health care professionals and the subjective evaluations of item 23. Conclusions: The average evaluation results of the selected apps indicated a “good” level of quality, and those with the highest ratings could be recommended. However, the lack of scientific backing for these technological tools is evident. It is crucial that research centers and higher education institutions commit to the active development of new mobile health apps, ensuring their accessibility and validation for the general public. %M 39951706 %R 10.2196/64550 %U https://mededu.jmir.org/2025/1/e64550 %U https://doi.org/10.2196/64550 %U http://www.ncbi.nlm.nih.gov/pubmed/39951706 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 11 %N %P e58183 %T Medical Students’ Acceptance of Tailored e–Mental Health Apps to Foster Their Mental Health: Cross-Sectional Study %A Grüneberg,Catharina %A Bäuerle,Alexander %A Karunakaran,Sophia %A Darici,Dogus %A Dörrie,Nora %A Teufel,Martin %A Benson,Sven %A Robitzsch,Anita %K eHealth %K medical education %K medical students %K tailored interventions %K UTAUT %K intention to use %K e–mental health apps %K app %K foster %K cross-sectional study %K mental health problems %K physician %K well-being %K mobile apps %K acceptance %K assessment %K mental health apps %D 2025 %7 24.1.2025 %9 %J JMIR Med Educ %G English %X Background: Despite the high prevalence of mental health problems among medical students and physicians, help-seeking remains low. Digital mental health approaches offer beneficial opportunities to increase well-being, for example, via mobile apps. Objective: This study aimed to assess the acceptance, and its underlying predictors, of tailored e–mental health apps among medical students by focusing on stress management and the promotion of personal skills. Methods: From November 2022 to July 2023, a cross-sectional study was conducted with 245 medical students at the University of Duisburg-Essen, Germany. Sociodemographic, mental health, and eHealth-related data were assessed. The Unified Theory of Acceptance and Use of Technology (UTAUT) was applied. Differences in acceptance were examined and a multiple hierarchical regression analysis was conducted. Results: The general acceptance of tailored e–mental health apps among medical students was high (mean 3.72, SD 0.92). Students with a job besides medical school reported higher acceptance (t107.3=–2.16; P=.03; Padj=.027; Cohen d=4.13) as well as students with higher loads of anxiety symptoms (t92.4=2.36; P=.02; Padj=.03; Cohen d=0.35). The t values were estimated using a 2-tailed t test. Regression analysis revealed that acceptance was significantly predicted by anxiety symptoms (β=.11; P=.045), depressive symptoms (β=–.11; P=.05), internet anxiety (β=–.12; P=.01), digital overload (β=.1; P=.03), and the 3 UTAUT core predictors—performance expectancy (β=.24; P<.001), effort expectancy (β=.26; P<.001), and social influence (β=.43; P<.001). Conclusions: The high acceptance of e–mental health apps among medical students and its predictors lay a valuable basis for the development and implementation of tailored e–mental health apps within medical education to foster their mental health. More research using validated measures is needed to replicate our findings and to further investigate medical students’ specific needs and demands regarding the framework of tailored e–mental health apps. %R 10.2196/58183 %U https://mededu.jmir.org/2025/1/e58183 %U https://doi.org/10.2196/58183 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 27 %N %P e52591 %T Global Use, Adaptation, and Sharing of Massive Open Online Courses for Emergency Health on the OpenWHO Platform: Survey Study %A Johnston,Jamie Sewan %A Skinner,Nadine Ann %A Tokar,Anna %A Arabi,Elham %A Ndiaye,Ngouille Yabsa %A Strehlow,Matthew Charles %A Utunen,Heini %+ Stanford Center for Health Education, Stanford University, 408 Panama Mall, Stanford, CA, 94305, United States, 1 650 647 0501, jamiejs@stanford.edu %K MOOCs %K online learning %K global health education %K digital health %K health worker training %K health emergencies %K outbreak %K COVID-19 %D 2025 %7 10.1.2025 %9 Original Paper %J J Med Internet Res %G English %X Background: The COVID-19 pandemic demonstrated the global need for accessible content to rapidly train health care workers during health emergencies. The massive open access online course (MOOC) format is a broadly embraced strategy for widespread dissemination of trainings. Yet, barriers associated with technology access, language, and cultural context limit the use of MOOCs, particularly in lower-resource communities. There is tremendous potential for MOOC developers to increase the global scale and contextualization of learning; however, at present, few studies examine the adaptation and sharing of health MOOCs to address these challenges. Objective: The World Health Organization’s Health Emergencies Programme Learning and Capacity Development Unit and the Stanford Center for Health Education collaborated to survey learners from 4 emergency health MOOCs on the OpenWHO platform to examine differences in course use by World Bank country income classification across three dimensions: (1) how health education MOOCs are used and shared, (2) how health workers adapt MOOC content to meet local training and information needs, and (3) how content adaptations help frontline health workers overcome barriers to using MOOCs. Methods: This study draws upon two sources of data: (1) course enrollment data collected from the 4 emergency health MOOCs (N=96,395) and (2) survey data collected from learners who participated in at least 1 of the 4 MOOCs (N=926). Descriptive statistics are used to summarize learner characteristics. Differences in enrollment, sharing, and adaptation by country income classification are examined using Pearson chi-square test. Results: Of the enrollees who indicated their country of residence, half were from lower-middle-income countries (LMICs; 43,168/85,882, 50%) and another 9% (7146/85,882) from low-income countries. The majority of all respondents shared content (819/926, 88%) and used content in official trainings (563/926, 61%). Respondents were more likely to share and use content for trainings in LMICs than in high-income countries (91% vs 81%; P=.001). Learners in LMICs also shared content with more people on average compared with high-income country learners although the difference is not statistically significant (9.48 vs 6.73 people; P=.084). Compared with learners in high-income countries, learners in LMICs were more likely to adapt materials to distribute via offline formats or technologies, such as WhatsApp or text message (31% vs 8%; P<.001); to address cultural, linguistic, or other contextual needs (20% vs 12%; P=.076); and to meet local guidelines (20% vs 9%; P=.010). Learners in LMICs indicated greater accessibility challenges due to technological and linguistic barriers. Conclusions: Learners commonly share content from MOOCs about public health emergencies; this is especially true in low-income countries and LMICs. However, content is often adapted and shared via alternative formats. Our findings identify a critical opportunity to improve MOOC design and dramatically scale the impact of MOOCs to better meet diverse global needs. %M 39792445 %R 10.2196/52591 %U https://www.jmir.org/2025/1/e52591 %U https://doi.org/10.2196/52591 %U http://www.ncbi.nlm.nih.gov/pubmed/39792445 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e60312 %T Looking Back on Digital Medical Education Over the Last 25 Years and Looking to the Future: Narrative Review %A Ogundiya,Oluwadamilola %A Rahman,Thahmina Jasmine %A Valnarov-Boulter,Ioan %A Young,Tim Michael %+ Queen Square Institute of Neurology, University College London, No/7 Queen Square, London, WC1N 3BG, United Kingdom, 44 203 1082781, t.young@ucl.ac.uk %K digital health %K digital medical education %K health education %K medical education %K mobile phone %K artificial intelligence %K AI %D 2024 %7 19.12.2024 %9 Review %J J Med Internet Res %G English %X Background: The last 25 years have seen enormous progression in digital technologies across the whole of the health service, including health education. The rapid evolution and use of web-based and digital techniques have been significantly transforming this field since the beginning of the new millennium. These advancements continue to progress swiftly, even more so after the COVID-19 pandemic. Objective: This narrative review aims to outline and discuss the developments that have taken place in digital medical education across the defined time frame. In addition, evidence for potential opportunities and challenges facing digital medical education in the near future was collated for analysis. Methods: Literature reviews were conducted using PubMed, Web of Science Core Collection, Scopus, Google Scholar, and Embase. The participants and learners in this study included medical students, physicians in training or continuing professional development, nurses, paramedics, and patients. Results: Evidence of the significant steps in the development of digital medical education in the past 25 years was presented and analyzed in terms of application, impact, and implications for the future. The results were grouped into the following themes for discussion: learning management systems; telemedicine (in digital medical education); mobile health; big data analytics; the metaverse, augmented reality, and virtual reality; the COVID-19 pandemic; artificial intelligence; and ethics and cybersecurity. Conclusions: Major changes and developments in digital medical education have occurred from around the start of the new millennium. Key steps in this journey include technical developments in teleconferencing and learning management systems, along with a marked increase in mobile device use for accessing learning over this time. While the pace of evolution in digital medical education accelerated during the COVID-19 pandemic, further rapid progress has continued since the resolution of the pandemic. Many of these changes are currently being widely used in health education and other fields, such as augmented reality, virtual reality, and artificial intelligence, providing significant future potential. The opportunities these technologies offer must be balanced against the associated challenges in areas such as cybersecurity, the integrity of web-based assessments, ethics, and issues of digital privacy to ensure that digital medical education continues to thrive in the future. %M 39700490 %R 10.2196/60312 %U https://www.jmir.org/2024/1/e60312 %U https://doi.org/10.2196/60312 %U http://www.ncbi.nlm.nih.gov/pubmed/39700490 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e60670 %T Optimizing Compassion Training in Medical Trainees Using an Adjunct mHealth App: A Preliminary Single-Arm Feasibility and Acceptability Study %A Wooldridge,Jennalee S %A Soriano,Emily C %A Chu,Gage %A Shirazi,Anaheed %A Shapiro,Desiree %A Patterson,Marta %A Kim,Hyun-Chung %A Herbert,Matthew S %+ Mental Health Service, VA San Diego Healthcare System, 3350 La Jolla Village Dr, San Diego, CA, 92161, United States, 1 6194978326, m1herbert@health.ucsd.edu %K mobile phone %K compassion %K empathy %K mHealth %K mobile health %K medical student %K medical resident %K mHealth app %K app %K medical trainee %K training %K feasibility %K acceptability %K pilot %K mindfulness %K self-compassion %K smartphone app %K compassion %K applicability %D 2024 %7 26.11.2024 %9 Original Paper %J JMIR Form Res %G English %X Background: While structured compassion training programs have shown promise for increasing compassion among medical trainees, a major challenge is applying the concepts and practices taught during the program into the complex, dynamic, time-pressured, and often hectic hospital workplace. Objective: The purpose of this pilot study was to examine the feasibility, acceptability, and preliminary effects of Compassion Coach, a mobile health (mHealth) smartphone app designed to bolster a 6-week mindfulness and self-compassion training program for medical trainees. Methods: In Compassion Coach, notifications to remind, encourage, and measure the perceived impact of informal mindfulness and compassion practices taught during the program were delivered at 7 AM, 12 PM, and 7 PM, respectively, 3 times per week over the course of the training program. The app also contained a library of guided audio formal mindfulness and compassion practices to allow quick and easy access. In this pilot study, we collected data from 29 medical students and residents who downloaded Compassion Coach and completed surveys assessing perceived effectiveness and acceptability. Engagement with the Compassion Coach app was passively tracked through notification response rate and library resource access over time. Results: The average response rate to notifications was 58% (SD 29%; range 12%-98%), with a significant decline over time (P=.009; odds ratio 0.98, 95% CI 0.96-0.99). Across all participants and occasions, the majority agreed the informal practices prompted by Compassion Coach helped them feel grounded and centered (110/150, 73%), improved compassion (29/41, 71%), reduced burnout (106/191, 56%), and improved their mood (133/191, 70%). In total, 16 (55%) of the 29 participants accessed guided audio recordings on average 3 (SD 3.4) times throughout the program. At the posttreatment time point, most participants (13/18, 72%) indicated that Compassion Coach helped them engage in compassion practices in daily life, and half (9/18, 50%) indicated that Compassion Coach helped improve interactions with patients. Conclusions: Overall, preliminary results of Compassion Coach are encouraging and suggest the integration of a smartphone app with an ongoing mindfulness and self-compassion training program may bolster the effects of the program on medical trainees. However, there was variability in engagement with Compassion Coach and perceived helpfulness. Additional research is indicated to optimize this novel mHealth approach and conduct a study powered to formally evaluate effects. %M 39589766 %R 10.2196/60670 %U https://formative.jmir.org/2024/1/e60670 %U https://doi.org/10.2196/60670 %U http://www.ncbi.nlm.nih.gov/pubmed/39589766 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e53299 %T Development and Usability of the OHiFamily Mobile App to Enhance Accessibility to Maternal and Infant Information for Expectant Families in Ohio: Qualitative Study %A Perme,Natalie %A Reid,Endia %A Eluagu,Macdonald Chinwenwa %A Thompson,John %A Hebert,Courtney %A Gabbe,Steven %A Swoboda,Christine Marie %+ The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), The Ohio State University Wexner Medical Center, Suite 4101, 700 Ackerman Rd., Columbus, OH, 43210, United States, 1 13157612701, swoboda.2@osu.edu %K health resources %K pregnancy %K patient engagement %K mHealth %K maternal %K mobile health %K app %K focus group %K landscape analysis %K birth %K preterm %K premature %K mortality %K death %K pediatric %K infant %K neonatal %K design %K development %K obstetric %K mobile phone %D 2024 %7 8.11.2024 %9 Original Paper %J JMIR Form Res %G English %X Background: The Infant Mortality Research Partnership in Ohio is working to help pregnant individuals and families on Medicaid who are at risk for infant mortality and preterm birth. As part of this initiative, researchers at The Ohio State University worked to develop a patient-facing mobile app, OHiFamily, targeted toward, and created for, this population. To address the social determinants of health that can affect maternal and infant health, the app provides curated information on community resources, health care services, and educational materials in a format that is easily accessible and intended to facilitate contact between families and resources. The OHiFamily app includes 3 distinct features, that is, infant care logging (eg, feeding and diaper changes), curated educational resources, and a link to the curated Ohio resource database (CORD). This paper describes the development and assessment of the OHiFamily app as well as CORD. Objective: This study aimed to describe the development of the OHiFamily mobile app and CORD and the qualitative feedback received by the app’s intended audience. Methods: The researchers performed a landscape analysis and held focus groups to determine the resources and app features of interest to Ohio families on Medicaid. Results: Participants from several focus groups were interested in an app that could offer community resources with contact information, information about medical providers and information and ways to contact them, health tips, and information about pregnancy and infant development. Feedback was provided by 9 participants through 3 focus group sessions. Using this feedback, the team created a curated resource database and mobile app to help users locate and access resources, as well as access education materials and infant tracking features. Conclusions: OHiFamily offers a unique combination of features and access to local resources for families on Medicaid in Ohio not seen in other smartphone apps. %M 39514852 %R 10.2196/53299 %U https://formative.jmir.org/2024/1/e53299 %U https://doi.org/10.2196/53299 %U http://www.ncbi.nlm.nih.gov/pubmed/39514852 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e52729 %T Understanding Users’ Engagement in a Provider-Created Mobile App for Training to Advance Hepatitis C Care: Knowledge Assessment Survey Study %A Wegener,Maximilian %A Sims,Katarzyna %A Brooks,Ralph %A Nichols,Lisa %A Sideleau,Robert %A McKay,Sharen %A Villanueva,Merceditas %+ Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, Yale University, 135 College Street, Suite 323, New Haven, CT, 06510, United States, 1 2037857026, maximilian.wegener@yale.edu %K HIV %K HCV %K hepatitis C virus %K interactive digital interventions (IDI) %K education %K mobile application %K user engagement %K training %K awareness %K treatment %K testing %D 2024 %7 1.11.2024 %9 Original Paper %J JMIR Form Res %G English %X Background: The World Health Organization and the Centers for Disease Control and Prevention have set ambitious hepatitis C virus (HCV) elimination targets for 2030. Current estimates show that the United States is not on pace to meet elimination targets due to multiple patient, clinic, institutional, and societal level barriers that contribute to HCV testing and treatment gaps. Among these barriers are unawareness of testing and treatment needs, misinformation concerning adverse treatment reactions, need for substance use sobriety, and treatment efficacy. Strategies to improve viral hepatitis education are needed. Objective: We aim to provide a high-quality HCV educational app for patients and health care workers, particularly nonprescriber staff. The app was vetted by health care providers and designed to guide users through the HCV testing and treatment stages in a self-exploratory way to promote engagement and knowledge retention. The app is comprised of five learning modules: (1) Testing for Hep C (hepatitis C), (2) Tests for Hep C Positive Patients, (3) Treatments Available to You, (4) What to Expect During Treatment, and (5) What to Expect After Treatment. Methods: An HCV knowledge assessment survey was administered to providers and patients at the Yale School of Medicine and 11 Connecticut HIV clinics as part of a grant-funded activity. The survey findings and pilot testing feedback guided the app’s design and content development. Data on app usage from November 2019 to November 2022 were analyzed, focusing on user demographics, engagement metrics, and module usage patterns. Results: There were 561 app users; 216 (38.5%) accessed the training modules of which 151 (69.9%) used the app for up to 60 minutes. Of them, 65 (30.1%) users used it for >60 minutes with a median time spent of 5 (IQR 2-8) minutes; the median time between initial accession and last use was 39 (IQR 18-60) days. Users accessed one or more modules and followed a nonsequential pattern of use: module 1: 163 (75.4%) users; module 4: 82 (38%); module 5: 67 (31%); module 3: 49 (22.7%); module 2: 41 (19%). Conclusions: This app, created in an academic setting, is one of a few available in English and Spanish that provides content-vetted HCV education for patients and health care supportive staff. It offers the convenience of on-demand education, allowing users to access crucial information about HCV management and treatment in a self-directed fashion that acknowledges and promotes variable preferences in learning approaches. While app uptake was relatively limited, we propose that future efforts should focus on combined promotion efforts with marketing strategies experts aligned with academic experts. Incorporating ongoing user feedback and integrating personalized reminders and quizzes, will further enhance engagement, supporting the broader public health HCV elimination goals. %M 39486023 %R 10.2196/52729 %U https://formative.jmir.org/2024/1/e52729 %U https://doi.org/10.2196/52729 %U http://www.ncbi.nlm.nih.gov/pubmed/39486023 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e55149 %T Social Media Usage for Medical Education and Smartphone Addiction Among Medical Students: National Web-Based Survey %A Clavier,Thomas %A Chevalier,Emma %A Demailly,Zoé %A Veber,Benoit %A Messaadi,Imad-Abdelkader %A Popoff,Benjamin %K medical student %K social network %K social media %K smartphone addiction %K medical education %K mobile addiction %K social networks %D 2024 %7 22.10.2024 %9 %J JMIR Med Educ %G English %X Background: Social media (SoMe) have taken a major place in the medical field, and younger generations are increasingly using them as their primary source to find information. Objective: This study aimed to describe the use of SoMe for medical education among French medical students and assess the prevalence of smartphone addiction in this population. Methods: A cross-sectional web-based survey was conducted among French medical students (second to sixth year of study). The questionnaire collected information on SoMe use for medical education and professional behavior. Smartphone addiction was assessed using the Smartphone Addiction Scale Short-Version (SAS-SV) score. Results: A total of 762 medical students responded to the survey. Of these, 762 (100%) were SoMe users, spending a median of 120 (IQR 60‐150) minutes per day on SoMe; 656 (86.1%) used SoMe for medical education, with YouTube, Instagram, and Facebook being the most popular platforms. The misuse of SoMe in a professional context was also identified; 27.2% (207/762) of students posted hospital internship content, and 10.8% (82/762) searched for a patient’s name on SoMe. Smartphone addiction was prevalent among 29.1% (222/762) of respondents, with a significant correlation between increased SoMe use and SAS-SV score (r=0.39, 95% CI 0.33‐0.45; P<.001). Smartphone-addicted students reported a higher impact on study time (211/222, 95% vs 344/540, 63.6%; P<.001) and a greater tendency to share hospital internship content on social networks (78/222, 35.1% vs 129/540, 23.8%; P=.002). Conclusions: Our findings reveal the extensive use of SoMe for medical education among French medical students, alongside a notable prevalence of smartphone addiction. These results highlight the need for medical schools and educators to address the responsible use of SoMe and develop strategies to mitigate the risks associated with excessive use and addiction. %R 10.2196/55149 %U https://mededu.jmir.org/2024/1/e55149 %U https://doi.org/10.2196/55149 %0 Journal Article %@ 2369-3762 %I %V 10 %N %P e53193 %T The Utility of Wearable Cameras in Developing Examination Questions and Answers on Physical Examinations: Preliminary Study %A Fukui,Sho %A Shimizu,Taro %A Nishizaki,Yuji %A Shikino,Kiyoshi %A Yamamoto,Yu %A Kobayashi,Hiroyuki %A Tokuda,Yasuharu %K medical education %K medical technology %K wearable device %K wearable camera %K medical examination %K exam %K examination %K exams %K examinations %K physical %K resident physicians %K wearable %K wearables %K camera %K cameras %K video %K videos %K innovation %K innovations %K innovative %K recording %K recordings %K survey %K surveys %D 2024 %7 19.7.2024 %9 %J JMIR Med Educ %G English %X To assess the utility of wearable cameras in medical examinations, we created a physician-view video-based examination question and explanation, and the survey results indicated that these cameras can enhance the evaluation and educational capabilities of medical examinations. %R 10.2196/53193 %U https://mededu.jmir.org/2024/1/e53193 %U https://doi.org/10.2196/53193 %0 Journal Article %@ 2369-3762 %I %V 10 %N %P e52461 %T Global Trends in mHealth and Medical Education Research: Bibliometrics and Knowledge Graph Analysis %A He,Yuanhang %A Xie,Zhihong %A Li,Jiachen %A Meng,Ziang %A Xue,Dongbo %A Hao,Chenjun %K mHealth %K mobile health %K medical education %K bibliometric %K knowledge map %K VOSviewer %D 2024 %7 4.6.2024 %9 %J JMIR Med Educ %G English %X Background: Mobile health (mHealth) is an emerging mobile communication and networking technology for health care systems. The integration of mHealth in medical education is growing extremely rapidly, bringing new changes to the field. However, no study has analyzed the publication and research trends occurring in both mHealth and medical education. Objective: The aim of this study was to summarize the current application and development trends of mHealth in medical education by searching and analyzing published articles related to both mHealth and medical education. Methods: The literature related to mHealth and medical education published from 2003 to 2023 was searched in the Web of Science core database, and 790 articles were screened according to the search strategy. The HistCite Pro 2.0 tool was used to analyze bibliometric indicators. VOSviewer, Pajek64, and SCImago Graphica software were used to visualize research trends and identify hot spots in the field. Results: In the past two decades, the number of published papers on mHealth in medical education has gradually increased, from only 3 papers in 2003 to 130 in 2022; this increase became particularly evident in 2007. The global citation score was determined to be 10,600, with an average of 13.42 citations per article. The local citation score was 96. The United States is the country with the most widespread application of mHealth in medical education, and most of the institutions conducting in-depth research in this field are also located in the United States, closely followed by China and the United Kingdom. Based on current trends, global coauthorship and research exchange will likely continue to expand. Among the research journals publishing in this joint field, journals published by JMIR Publications have an absolute advantage. A total of 105 keywords were identified, which were divided into five categories pointing to different research directions. Conclusions: Under the influence of COVID-19, along with the popularization of smartphones and modern communication technology, the field of combining mHealth and medical education has become a more popular research direction. The concept and application of digital health will be promoted in future developments of medical education. %R 10.2196/52461 %U https://mededu.jmir.org/2024/1/e52461 %U https://doi.org/10.2196/52461 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 13 %N %P e53167 %T Exploring the Distribution of 3D-Printed Simulator Designs Using Open-Source Databases to Facilitate Simulation-Based Learning Through a University and Nonprofit Collaboration: Protocol for a Scoping Review %A Sritharan,Mithusha %A Siraj,Samyah %A Brunton,Ginny %A Dubrowski,Adam %+ Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe St N, Oshawa, ON, L1G 0C5, Canada, 1 905 721 8668, samyah.siraj@ontariotechu.net %K simulation %K three-dimensional printing %K health professions education %K database %K simulator %K simulator design %K health care provider training %K simulation-based education %K simulation technology %K open-source %K databases %K simulation-based learning %K e-Learning %K scoping review %K technology %K 3D printed simulators %K design %K 3D printing %K 3D %K health care training %K university-based %K research centers %K gaps %D 2024 %7 27.5.2024 %9 Protocol %J JMIR Res Protoc %G English %X Background: Advancements in technology have enhanced education, training, and application in health care. However, limitations are present surrounding the accessibility and use of simulation technology (eg, simulators) for health profession education. Improving the accessibility of technology developed in university-based research centers by nonprofit organizations (NPOs; eg, hospitals) has the potential to benefit the health of populations worldwide. One example of such technology is 3D-printed simulators. Objective: This scoping review aims to identify how the use of open-source databases for the distribution of simulator designs used for 3D printing can promote credible solutions for health care training while minimizing the risks of commercialization of designs for profit. Methods: This scoping review will follow the Arksey and O’Malley methodological framework and the Joanna Briggs Institute guidance for scoping reviews. Ovid MEDLINE, CINAHL, Web of Science, and PsycINFO will be searched with an applied time frame of 2012 to 2022. Additionally, gray literature will be searched along with reference list searching. Papers that explore the use of open-source databases in academic settings and the health care sector for the distribution of simulator designs will be included. A 2-step screening process will be administered to titles and abstracts, then full texts, to establish paper eligibility. Screening and data extraction of the papers will be completed by 2 reviewers (MS and SS) for quality assurance. The scoping review will report information on the facilitation of distributing 3D-printed simulator designs through open-source databases. Results: The results of this review will identify gaps in forming partnerships with NPOs and university-based research centers to share simulator designs. The scoping review will be initiated in December 2024. Conclusions: The information collected will be relevant and useful for stakeholders such as health care providers, researchers, and NPOs for the purpose of overcoming the gaps in research regarding the use and distribution of simulation technology. The scoping review has not been conducted yet. Therefore, there are currently no findings to report on. International Registered Report Identifier (IRRID): PRR1-10.2196/53167 %M 38801764 %R 10.2196/53167 %U https://www.researchprotocols.org/2024/1/e53167 %U https://doi.org/10.2196/53167 %U http://www.ncbi.nlm.nih.gov/pubmed/38801764 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e44973 %T Effect of Adding Personalized Instant Messaging Apps to a Brief Smoking Cessation Model in Community Smokers in Hong Kong: Pragmatic Randomized Clinical Trial %A Wu,Yongda Socrates %A Cheung,Yee Tak Derek %A Lee,Jay Jung Jae %A Wong,Carlos King Ho %A Ho,Sai Yin %A Li,William Ho Cheung %A Yao,Ying %A Lam,Tai Hing %A Wang,Man Ping %+ School of Nursing, The University of Hong Kong, 5/F, Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong, China (Hong Kong), 852 39176636, mpwang@hku.hk %K instant messaging %K text messaging %K chatting %K smoking cessation %K COVID-19 %K community smoker %D 2024 %7 13.5.2024 %9 Original Paper %J J Med Internet Res %G English %X Background: While text messaging has proven effective for smoking cessation (SC), engagement in the intervention remains suboptimal. Objective: This study aims to evaluate whether using more interactive and adaptive instant messaging (IM) apps on smartphones, which enable personalization and chatting with SC advisors, can enhance SC outcomes beyond the provision of brief SC advice and active referral (AR) to SC services. Methods: From December 2018 to November 2019, we proactively recruited 700 adult Chinese daily cigarette users in Hong Kong. Participants were randomized in a 1:1 ratio. At baseline, all participants received face-to-face brief advice on SC. Additionally, they were introduced to local SC services and assisted in selecting one. The intervention group received an additional 26 personalized regular messages and access to interactive chatting through IM apps for 3 months. The regular messages aimed to enhance self-efficacy, social support, and behavioral capacity for quitting, as well as to clarify outcome expectations related to cessation. We developed 3 sets of messages tailored to the planned quit date (within 30 days, 60 days, and undecided). Participants in the intervention group could initiate chatting with SC advisors on IM themselves or through prompts from regular messages or proactive inquiries from SC advisors. The control group received 26 SMS text messages focusing on general health. The primary outcomes were smoking abstinence validated by carbon monoxide levels of <4 parts per million at 6 and 12 months after the start of the intervention. Results: Of the participants, 505/700 (72.1%) were male, and 450/648 (69.4%) were aged 40 or above. Planning to quit within 30 days was reported by 500/648 (77.2%) participants, with fewer intervention group members (124/332, 37.3%) reporting previous quit attempts compared with the control group (152/335, 45.4%; P=.04). At the 6- and 12-month follow-ups (with retention rates of 456/700, 65.1%, and 446/700, 63.7%, respectively), validated abstinence rates were comparable between the intervention (14/350, 4.0%, and 19/350, 5.4%) and control (11/350, 3.1% and 21/350, 6.0%) groups. Compared with the control group, the intervention group reported greater utilization of SC services at 12 months (RR 1.26, 95% CI 1.01-1.56). Within the intervention group, engaging in chat sessions with SC advisors predicted better validated abstinence at 6 months (RR 3.29, 95% CI 1.13-9.63) and any use of SC services (RR 1.66, 95% CI 1.14-2.43 at 6 months; RR 1.67, 95% CI 1.26-2.23 at 12 months). Conclusions: An IM-based intervention, providing support and assistance alongside brief SC advice and AR, did not yield further increases in quitting rates but did encourage the utilization of SC services. Future research could explore whether enhanced SC service utilization leads to improved long-term SC outcomes. Trial Registration: ClinicalTrials.gov NCT03800719; https://clinicaltrials.gov/ct2/show/NCT03800719 %M 38739429 %R 10.2196/44973 %U https://www.jmir.org/2024/1/e44973 %U https://doi.org/10.2196/44973 %U http://www.ncbi.nlm.nih.gov/pubmed/38739429 %0 Journal Article %@ 2818-3045 %I JMIR Publications %V 1 %N %P e55678 %T Immediate Impact of an 8-Week Virtual Reality Educational Program on Burnout and Work Engagement Among Health Care Professionals: Pre-Post Pilot Study %A Ferrer Costa,Jose %A Moran,Nuria %A Garcia Marti,Carlos %A Colmenares Hernandez,Leomar Javier %A Radu Ciorba Ciorba,Florin %A Ciudad,Maria Jose %+ Innovation and Projects Department, Badalona Serveis Assistencials, Pl Pau Casals 1, Badalona, 08911, Spain, 34 937407482, jferrer10@gmail.com %K virtual reality %K burnout %K mindfulness %K health care professionals %K mental health %K health promotion %K educational intervention %D 2024 %7 25.4.2024 %9 Original Paper %J JMIR XR Spatial Comput %G English %X Background: Health care professionals globally face increasing levels of burnout characterized by emotional exhaustion, depersonalization, and a reduced sense of accomplishment, and it has been notably exacerbated during the COVID-19 pandemic. This condition not only impacts the well-being of health care workers but also affects patient care and contributes to significant economic burden. Traditional approaches to mitigating burnout have included various psychosocial interventions, with mindfulness being recognized for its effectiveness in enhancing mental health and stress management. The emergence of virtual reality (VR) technology offers a novel immersive platform for delivering mindfulness and emotional management training. Objective: This study aimed to evaluate the immediate impact of an 8-week VR educational program on burnout and work engagement among health care professionals. Methods: This nonrandomized pre-post intervention study enrolled 90 health care professionals, including nurses, physicians, and allied health staff, from 3 different centers. Of these 90 professionals, 83 (92%) completed the program. The intervention consisted of 8 weekly VR sessions of 10-13 minutes each, using Meta Quest 2 headsets. The sessions focused on mindfulness and emotional management. The Maslach Burnout Inventory (MBI) and Utrecht Work Engagement Scale (UWES) were used for assessments. Data analysis involved inferential statistical techniques for evaluating the impact on the scales, including paired t tests for normally distributed variables and Wilcoxon signed rank tests for nonnormally distributed variables. The significance of changes was indicated by P values <.05, with effect sizes measured using Cohen d for t tests and Cohen r for Wilcoxon tests for quantifying the magnitude of the intervention’s effect. Results: The statistical analysis revealed significant improvements in the MBI and UWES indices after the intervention (P<.05). Specifically, the MBI showed reductions in emotional exhaustion (t82=5.58; P<.001; Cohen d=0.61) and depersonalization (t82=4.67; P<.001; Cohen d=0.51), and an increase in personal accomplishment (t82=−3.62; P<.001; Cohen d=0.4). The UWES revealed enhancements in vigor (t82=−3.77; P<.001; Cohen d=0.41), dedication (Z=−3.63; P<.001; Cohen r=0.41), and absorption (Z=−3.52; P<.001; Cohen r=0.4). Conclusions: The study provides initial data supporting the effectiveness of VR-based educational programs for reducing burnout and enhancing work engagement among health care professionals. While limitations, such as the absence of a control group, are acknowledged, the significant improvements in burnout and engagement indices coupled with high participant adherence and minimal VR discomfort underline the potential of VR interventions in health care settings. These encouraging findings pave the way for more comprehensive studies, including randomized controlled trials, to further validate and expand upon these results. %R 10.2196/55678 %U https://xr.jmir.org/2024/1/e55678 %U https://doi.org/10.2196/55678 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e50118 %T Development of Web-Based Education Modules to Improve Carer Engagement in Cancer Care: Design and User Experience Evaluation of the e-Triadic Oncology (eTRIO) Modules for Clinicians, Patients, and Carers %A Laidsaar-Powell,Rebekah %A Giunta,Sarah %A Butow,Phyllis %A Keast,Rachael %A Koczwara,Bogda %A Kay,Judy %A Jefford,Michael %A Turner,Sandra %A Saunders,Christobel %A Schofield,Penelope %A Boyle,Frances %A Yates,Patsy %A White,Kate %A Miller,Annie %A Butt,Zoe %A Bonnaudet,Melanie %A Juraskova,Ilona %+ Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, The University of Sydney, Room 310, Level 3, Griffith Taylor Building (A19), Manning Road, Sydney, 2006, Australia, 61 2 9351 6811, rebekah.laidsaar-powell@sydney.edu.au %K family carers %K patient education %K health professional education %K web-based intervention %K mobile phone %D 2024 %7 17.4.2024 %9 Original Paper %J JMIR Med Educ %G English %X Background: Carers often assume key roles in cancer care. However, many carers report feeling disempowered and ill‐equipped to support patients. Our group published evidence-based guidelines (the Triadic Oncology [TRIO] Guidelines) to improve oncology clinician engagement with carers and the management of challenging situations involving carers. Objective: To facilitate implementation of the TRIO Guidelines in clinical practice, we aimed to develop, iteratively refine, and conduct user testing of a suite of evidence-based and interactive web-based education modules for oncology clinicians (e-Triadic Oncology [eTRIO]), patients with cancer, and carers (eTRIO for Patients and Carers [eTRIO‐pc]). These were designed to improve carer involvement, communication, and shared decision-making in the cancer management setting. Methods: The eTRIO education modules were based on extensive research, including systematic reviews, qualitative interviews, and consultation analyses. Guided by the person-based approach, module content and design were reviewed by an expert advisory group comprising academic and clinical experts (n=13) and consumers (n=5); content and design were continuously and iteratively refined. User experience testing (including “think-aloud” interviews and administration of the System Usability Scale [SUS]) of the modules was completed by additional clinicians (n=5), patients (n=3), and carers (n=3). Results: The final clinician module comprises 14 sections, requires approximately 1.5 to 2 hours to complete, and covers topics such as carer-inclusive communication and practices; supporting carer needs; and managing carer dominance, anger, and conflicting patient-carer wishes. The usability of the module was rated by 5 clinicians, with a mean SUS score of 75 (SD 5.3), which is interpreted as good. Clinicians often desired information in a concise format, divided into small “snackable” sections that could be easily recommenced if they were interrupted. The carer module features 11 sections; requires approximately 1.5 hours to complete; and includes topics such as the importance of carers, carer roles during consultations, and advocating for the patient. The patient module is an adaptation of the relevant carer module sections, comprising 7 sections and requiring 1 hour to complete. The average SUS score as rated by 6 patients and carers was 78 (SD 16.2), which is interpreted as good. Interactive activities, clinical vignette videos, and reflective learning exercises are incorporated into all modules. Patient and carer consumer advisers advocated for empathetic content and tone throughout their modules, with an easy-to-read and navigable module interface. Conclusions: The eTRIO suite of modules were rigorously developed using a person-based design methodology to meet the unique information needs and learning requirements of clinicians, patients, and carers, with the goal of improving effective and supportive carer involvement in cancer consultations and cancer care. %M 38630531 %R 10.2196/50118 %U https://mededu.jmir.org/2024/1/e50118 %U https://doi.org/10.2196/50118 %U http://www.ncbi.nlm.nih.gov/pubmed/38630531 %0 Journal Article %@ 2291-9279 %I JMIR Publications %V 12 %N %P e56037 %T Effects of a Serious Smartphone Game on Nursing Students' Theoretical Knowledge and Practical Skills in Adult Basic Life Support: Randomized Wait List–Controlled Trial %A Fijačko,Nino %A Masterson Creber,Ruth %A Metličar,Špela %A Strnad,Matej %A Greif,Robert %A Štiglic,Gregor %A Skok,Pavel %+ Faculty of Health Sciences, University of Maribor, Žitna 15, Maribor, 2000, Slovenia, 386 23004764, nino.fijacko@um.si %K serious smartphone game %K adult basic life support %K teaching %K game %K games %K gaming %K education %K nurse %K nursing %K nurses %K educational %K mHealth %K mobile health %K app %K apps %K application %K applications %K smartphone %K smartphones %K RCT %K randomized controlled trial %K controlled trial %K technology-enhanced learning %K TEL %K life support %K knowledge retention %K theoretical knowledge %K practice %K practical %K resuscitation %D 2024 %7 5.4.2024 %9 Original Paper %J JMIR Serious Games %G English %X Background: Retention of adult basic life support (BLS) knowledge and skills after professional training declines over time. To combat this, the European Resuscitation Council and the American Heart Association recommend shorter, more frequent BLS sessions. Emphasizing technology-enhanced learning, such as mobile learning, aims to increase out-of-hospital cardiac arrest (OHCA) survival and is becoming more integral in nursing education. Objective: The aim of this study was to investigate whether playing a serious smartphone game called MOBICPR at home can improve and retain nursing students’ theoretical knowledge of and practical skills in adult BLS. Methods: This study used a randomized wait list–controlled design. Nursing students were randomly assigned in a 1:1 ratio to either a MOBICPR intervention group (MOBICPR-IG) or a wait-list control group (WL-CG), where the latter received the MOBICPR game 2 weeks after the MOBICPR-IG. The aim of the MOBICPR game is to engage participants in using smartphone gestures (eg, tapping) and actions (eg, talking) to perform evidence-based adult BLS on a virtual patient with OHCA. The participants’ theoretical knowledge of adult BLS was assessed using a questionnaire, while their practical skills were evaluated on cardiopulmonary resuscitation quality parameters using a manikin and a checklist. Results: In total, 43 nursing students participated in the study, 22 (51%) in MOBICPR-IG and 21 (49%) in WL-CG. There were differences between the MOBICPR-IG and the WL-CG in theoretical knowledge (P=.04) but not in practical skills (P=.45) after MOBICPR game playing at home. No difference was noted in the retention of participants’ theoretical knowledge and practical skills of adult BLS after a 2-week break from playing the MOBICPR game (P=.13). Key observations included challenges in response checks with a face-down manikin and a general neglect of safety protocols when using an automated external defibrillator. Conclusions: Playing the MOBICPR game at home has the greatest impact on improving the theoretical knowledge of adult BLS in nursing students but not their practical skills. Our findings underscore the importance of integrating diverse scenarios into adult BLS training. Trial Registration: ClinicalTrials.gov (NCT05784675); https://clinicaltrials.gov/study/NCT05784675 %M 38578690 %R 10.2196/56037 %U https://games.jmir.org/2024/1/e56037 %U https://doi.org/10.2196/56037 %U http://www.ncbi.nlm.nih.gov/pubmed/38578690 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e55742 %T User Friendliness and Perioperative Guidance Benefits of a Cataract Surgery Education App: Randomized Controlled Trial %A Gerbutavicius,Rokas %A Merle,David A %A Wolf,Armin %A Dimopoulos,Spyridon %A Kortuem,Karsten Ulrich %A Kortuem,Friederike Charlotte %+ Department for Ophthalmology, University of Tuebingen, Elfriede-Aulhorn-Str.7, Tuebingen, 72076, Germany, 49 70712988088, rokas.gerbutavicius@med.uni-tuebingen.de %K mHealth %K mobile health %K workflow optimization %K patient satisfaction %K health education %K educational background %K phacoemulsification %D 2024 %7 29.3.2024 %9 Original Paper %J JMIR Form Res %G English %X Background: Cataract surgeries are among the most performed surgeries worldwide. A thorough patient education is essential to inform patients about the perioperative process and postoperative target results concerning the intraocular lens and objectives for visual outcomes. However, addressing all relevant aspects and questions is time-consuming. Mobile apps can facilitate this process for both patients and physicians and thus be beneficial. However, the success of such an app depends on its user friendliness and acceptance by patients. Objective: This study aimed to evaluate the user friendliness and acceptance of a cataract surgery education app on mobile devices among patients undergoing cataract surgery, the characteristics of patients who benefit the most from app use, and the influence of the app on patient satisfaction with treatment. Methods: All patients who underwent cataract surgery at an ophthalmological practice from August 2020 to July 2021 were invited to participate in this randomized controlled trial. Out of 493 invited patients, 297 (60.2%) were enrolled in this study. Patients were randomized into 3 different groups. Half of the patients were offered to participate in Group 1 with use of the “Patient Journey” app. However, if they decided not to use the app, they were included in Group 2 (app denial). The other half of the patients were included in Group 3 (control) with no use of the app and with information provided conventionally. The app provided general information on the ophthalmological center, surgeons, cataract, and treatment options. Different questionnaires were used in all 3 groups to evaluate satisfaction with the perioperative process. Group 1 evaluated the app. Demographic characteristics, such as age, gender, and educational degree, were assessed. Results: Group 1 included 77 patients (median age 69 years). Group 2 included 61 patients, and their median age was higher (median age 79 years). Group 3 included 159 patients (median age 74 years). There was no difference in satisfaction with the perioperative process and clinic between the 3 groups. Almost all app users appreciated the digital details provided for the organization and the information on the surgery. Age did not play a major role in appreciation of the app. Female patients tended to appreciate the information provided more than male patients. Patients who did not have a higher university degree experienced more benefits from the informational content of the app and were the most satisfied with the information. However, male patients and academics were in general more aware of technology and handled the app more easily. Conclusions: The app showed high user friendliness and acceptance, and could particularly benefit specific patient groups. App users demonstrated a noninferior high satisfaction with the treatment in the ophthalmological center in comparison with patients who were informed about the surgery only conventionally. %M 38551619 %R 10.2196/55742 %U https://formative.jmir.org/2024/1/e55742 %U https://doi.org/10.2196/55742 %U http://www.ncbi.nlm.nih.gov/pubmed/38551619 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 8 %N %P e50528 %T A Mobile Applet for Assessing Medication Adherence and Managing Adverse Drug Reactions Among Patients With Cancer: Usability and Utility Study %A Ni,Chenxu %A Wang,Yi-fu %A Zhang,Yun-ting %A Yuan,Min %A Xu,Qing %A Shen,Fu-ming %A Li,Dong-Jie %A Huang,Fang %+ Shanghai Tenth People’s Hospital, 301 Middle Yanchang Road, Shanghai, 200072, China, 86 66302570, hazel_huang@126.com %K WeChat applet %K usability testing %K utility testing %K cancer patients %K patients %K cancer %K qualitative study %D 2024 %7 29.2.2024 %9 Original Paper %J JMIR Form Res %G English %X Background: Medication adherence and the management of adverse drug reactions (ADRs) are crucial to the efficacy of antitumor drugs. A WeChat applet, also known as a “Mini Program,” is similar to the app but has marked advantages. The development and use of a WeChat applet makes follow-up convenient for patients with cancer. Objective: This study aimed to assess the usability and utility of a newly developed WeChat applet, “DolphinCare,” among patients with cancer in Shanghai. Methods: A qualitative methodology was used to obtain an in-depth understanding of the experiences of patients with cancer when using DolphinCare from the usability and utility aspects. The development phase consisted of 2 parts: alpha and beta testing. Alpha testing combined the theory of the Fogg Behavior Model and the usability model. Alpha testing also involved testing the design of DolphinCare using a conceptual framework, which included factors that could affect medication adherence and ADRs. Beta testing was conducted using in-depth interviews. In-depth interviews allowed us to assist the patients in using DolphinCare and understand whether they liked or disliked DolphinCare and found it useful. Results: We included participants who had an eHealth Literacy Scale (eHEALS) score of ≥50%, and a total of 20 participants were interviewed consecutively. The key positive motivators described by interviewers were to be reminded to take their medications and to alleviate their ADRs. The majority of the patients were able to activate and use DolphinCare by themselves. Most patients indicated that their trigger to follow-up DolphinCare was the recommendation of their known and trusted health care professionals. All participants found that labels containing the generic names of their medication and the medication reminders were useful, including timed pop-up push notifications and text alerts. The applet presented the corresponding information collection forms of ADRs to the patient to fill out. The web-based consultation system enables patients to consult pharmacists or physicians in time when they have doubts about medications or have ADRs. The applet had usabilities and utilities that could improve medication adherence and the management of ADRs among patients with cancer. Conclusions: This study provides preliminary evidence regarding the usability and utility of this type of WeChat applet among patients with cancer, which is expected to be promoted for managing follow-up among other patients with other chronic disease. %M 38421700 %R 10.2196/50528 %U https://formative.jmir.org/2024/1/e50528 %U https://doi.org/10.2196/50528 %U http://www.ncbi.nlm.nih.gov/pubmed/38421700 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 10 %N %P e48507 %T Occupational Therapy Students’ Evidence-Based Practice Skills as Reported in a Mobile App: Cross-Sectional Study %A Johnson,Susanne G %A Espehaug,Birgitte %A Larun,Lillebeth %A Ciliska,Donna %A Olsen,Nina Rydland %+ Department of Health and Functioning, Western Norway University of Applied Sciences, Inndalseveien 28, Bergen, 5063, Norway, 47 92213202, susanne.grodem.johnson@hvl.no %K active learning strategies %K application %K cross-sectional study %K development %K education %K higher education %K interactive %K mobile application %K mobile app %K occupational therapy students %K occupational therapy %K students %K usability %K use %D 2024 %7 21.2.2024 %9 Original Paper %J JMIR Med Educ %G English %X Background: Evidence-based practice (EBP) is an important aspect of the health care education curriculum. EBP involves following the 5 EBP steps: ask, assess, appraise, apply, and audit. These 5 steps reflect the suggested core competencies covered in teaching and learning programs to support future health care professionals applying EBP. When implementing EBP teaching, assessing outcomes by documenting the student’s performance and skills is relevant. This can be done using mobile devices. Objective: The aim of this study was to assess occupational therapy students’ EBP skills as reported in a mobile app. Methods: We applied a cross-sectional design. Descriptive statistics were used to present frequencies, percentages, means, and ranges of data regarding EBP skills found in the EBPsteps app. Associations between students’ ability to formulate the Population, Intervention, Comparison, and Outcome/Population, Interest, and Context (PICO/PICo) elements and identifying relevant research evidence were analyzed with the chi-square test. Results: Of 4 cohorts with 150 students, 119 (79.3%) students used the app and produced 240 critically appraised topics (CATs) in the app. The EBP steps “ask,” “assess,” and “appraise” were often correctly performed. The clinical question was formulated correctly in 53.3% (128/240) of the CATs, and students identified research evidence in 81.2% (195/240) of the CATs. Critical appraisal checklists were used in 81.2% (195/240) of the CATs, and most of these checklists were assessed as relevant for the type of research evidence identified (165/195, 84.6%). The least frequently correctly reported steps were “apply” and “audit.” In 39.6% (95/240) of the CATs, it was reported that research evidence was applied. Only 61% (58/95) of these CATs described how the research was applied to clinical practice. Evaluation of practice changes was reported in 38.8% (93/240) of the CATs. However, details about practice changes were lacking in all these CATs. A positive association was found between correctly reporting the "population" and "interventions/interest" elements of the PICO/PICo and identifying research evidence (P<.001). Conclusions: We assessed the students’ EBP skills based on how they documented following the EBP steps in the EBPsteps app, and our results showed variations in how well the students mastered the steps. “Apply” and “audit” were the most difficult EBP steps for the students to perform, and this finding has implications and gives directions for further development of the app and educational instruction in EBP. The EBPsteps app is a new and relevant app for students to learn and practice EBP, and it can be used to assess students’ EBP skills objectively. %M 38381475 %R 10.2196/48507 %U https://mededu.jmir.org/2024/1/e48507 %U https://doi.org/10.2196/48507 %U http://www.ncbi.nlm.nih.gov/pubmed/38381475 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 25 %N %P e46336 %T The Effectiveness of Publicly Available Web-Based Interventions in Promoting Health App Use, Digital Health Literacy, and Media Literacy: Pre-Post Evaluation Study %A König,Lars %A Suhr,Ralf %+ Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité – Universitätsmedizin Berlin, Charitéplatz 1, Berlin, 10117, Germany, 49 30419549262, lars.koenig@charite.de %K digital health literacy %K e-learning %K health apps %K health education %K health literacy %K media literacy %K mHealth %K mobile health %K serious games %K user experience %K web-based intervention %D 2023 %7 4.12.2023 %9 Original Paper %J J Med Internet Res %G English %X Background: According to the World Health Organization, implementing mobile health (mHealth) technologies can increase access to quality health services worldwide. mHealth apps for smartphones, also known as health apps, are a central component of mHealth, and they are already used in diverse medical contexts. To benefit from health apps, potential users need specific skills that enable them to use such apps in a responsible and constructive manner. Objective: This study aimed to evaluate the effectiveness of the free and widely used web-based intervention, The APPocalypse?. Besides providing knowledge about health apps, the web-based intervention was designed to promote digital health and media literacy by teaching skills that enable users to distinguish between trustworthy and less trustworthy health apps. It was hypothesized that after completing the web-based intervention, participants’ knowledge in the domain of health apps, their digital health literacy, and their media literacy would be higher than it was before completing the web-based intervention. Methods: The study was divided into 3 parts. During part 1, participants (n=365; 181 female, 181 male, and 3 diverse; mean age 17.74, SD 1.391 years) provided demographic information and answered the pre- and postmeasurements. The measurements included questionnaires about participants’ knowledge in the domain of health apps, digital health literacy, and media literacy. During part 2, participants had 1 week to complete the web-based intervention. During part 3, participants answered the pre- and postmeasurements again. Furthermore, they answered educational quality and user experience questionnaires. Bayesian paired samples 2-tailed t tests were conducted to test the hypotheses. Results: Overall, the results support the hypotheses. After completing the web-based intervention, participants demonstrated more elaborate knowledge in the domain of health apps. Specifically, they displayed higher competencies in the domains of subjective (Bayes factor10 [BF10]=1.475×1079; effect size δ=–1.327) and objective health app knowledge (BF10=8.162×1080; effect size δ=–1.350). Furthermore, participants demonstrated higher digital health literacy. Specifically, they displayed higher competencies in the domains of information appraisal (BF10=3.413×1043; effect size δ=–0.870), information searching (BF10=3.324×1023; effect size δ=–0.604), evaluating reliability (BF10=3.081×1035; effect size δ=–0.766), and determining relevance (BF10=3.451×1024; effect size δ=–0.618). Regarding media literacy, the results were mixed. Participants displayed higher competencies in the domain of technology literacy beliefs (BF10=1.533×1021; effect size δ=–0.570). In the domain of technology control beliefs, their competencies did not seem to improve (BF10=0.109; effect size δ=–0.058). In comparison to relevant benchmarks, the web-based intervention offers exceptional educational quality and a superior user experience. Conclusions: The free web-based intervention The APPocalypse? might promote the constructive use of health apps, digital health literacy, and media literacy. Therefore, it may contribute to achieving the health-related United Nations Sustainable Development Goals. %M 38048146 %R 10.2196/46336 %U https://www.jmir.org/2023/1/e46336 %U https://doi.org/10.2196/46336 %U http://www.ncbi.nlm.nih.gov/pubmed/38048146 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e47977 %T Use of Peer-Led Web-Based Platforms for Peer-Assisted Learning Among Canadian Anesthesia Residents and Fellows: Cross-Sectional Study %A Li,Casey %A Salman,Maria %A Esmail,Tariq %A Matava,Clyde %+ Department of Anesthesia and Pain Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada, 1 4168137445, clyde.matava@sickkids.ca %K medical education %K anesthesia %K residents %K fellowship %K social media %K peer led %K peer assisted learning %K anesthesiology %K mobile device usage %K health care %K medical trainee %K perception %K mobile app %K digital health %D 2023 %7 13.11.2023 %9 Original Paper %J JMIR Form Res %G English %X Background: Peer-assisted learning (PAL) using peer-led web-based platforms (PWPs), including social media, can be a highly effective method of supporting medical trainees. PWPs, such as mobile apps for sharing anesthesia resources and social media groups or discussion forums pertaining to anesthesia training, may play a role in facilitating anesthesia trainee-led web-based education. However, there have been many challenges facing anesthesia trainees when it comes to incorporating PWPs, especially social media and mobile apps for PAL. Objective: The primary objective of this survey was to assess the proportion of trainees that use social media and mobile apps. The secondary objective was to identify the trainees’ perceptions on the use of social media and mobile apps for educational purposes, including PAL. Methods: This cross-sectional study was conducted through a survey administered via email at a single large academic center. The survey tool collected data between 2016 and 2017 on the following: demographic data (year of study, field of specialty), use of technology and web-based resources for medicine, use of social media platforms for anesthesia or training, benefits and barriers to future uses of social media for training, and ideas for trainee-led websites. Descriptive statistics were reported. Results: In total, 80 anesthesia trainees (51 residents and 29 fellows) responded to the survey (response rate of 33% of out 240 trainees contacted). All trainees reported having a mobile device that most (n=61, 76%) reported using multiple times a day to access medical resources. The highest perceived benefits of PWPs according to residents were that the most valuable information was available on-demand (n=27, 53%), they saved time (n=27, 53%), and they improved their overall learning experience within anesthesia (n=24, 47%). In comparison, fellows thought that PWPs were beneficial because they provided multiple perspectives of a single topic (n=13, 45%) and served as an additional platform to discuss ideas with peers (n=13, 45%). The most popular platforms used by both residents and fellows were Facebook (residents: n=44, 86%; fellows: n=26, 90%) followed by LinkedIn (residents: n=21, 42%; fellows: n=9, 29%). Even though most anesthesia trainees used social media for personal reasons, only 26% (n=21) reported having used resident- or fellow-driven PWP resources. Examples of PWPs that trainees used included anesthesia groups and a resident Dropbox resource folder. Conclusions: There was generally an acceptance for using PWPs for PAL as they provided various benefits for trainees at all levels of learning. PWPs have the potential to garner an increased sense of community and sharing within learning experiences throughout all levels of training. The information gained from this survey will help inform the basis for developing an anesthesia trainee-led e-learning platform. %M 37955954 %R 10.2196/47977 %U https://formative.jmir.org/2023/1/e47977 %U https://doi.org/10.2196/47977 %U http://www.ncbi.nlm.nih.gov/pubmed/37955954 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e47228 %T Usability of Augmented Reality Technology in Situational Telementorship for Managing Clinical Scenarios: Quasi-Experimental Study %A Bui,Dung T %A Barnett,Tony %A Hoang,Ha %A Chinthammit,Winyu %+ Centre for Rural Health, School of Health Sciences, College of Health and Medicine, University of Tasmania, E Block, Newnham Campus, Launceston, 7248, Australia, 61 363243318, dungtrung.bui@utas.edu.au %K augmented reality %K mentorship %K patient simulation %K patient care management %K quasi-experimental study %K telehealth %D 2023 %7 2.10.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: Telementorship provides a way to maintain the professional skills of isolated rural health care workers. The incorporation of augmented reality (AR) technology into telementoring systems could be used to mentor health care professionals remotely under different clinical situations. Objective: This study aims to evaluate the usability of AR technology in telementorship for managing clinical scenarios in a simulation laboratory. Methods: This study used a quasi-experimental design. Experienced health professionals and novice health practitioners were recruited for the roles of mentors and mentees, respectively, and then trained in the use of the AR setup. In the experiment, each mentee wearing an AR headset was asked to respond to 4 different clinical scenarios: acute coronary syndrome (ACS), acute myocardial infarction (AMI), pneumonia severe reaction to antibiotics (PSRA), and hypoglycemic emergency (HE). Their mentor used a laptop to provide remote guidance, following the treatment protocols developed for each scenario. Rating scales were used to measure the AR’s usability, mentorship effectiveness, and mentees’ self-confidence and skill performance. Results: A total of 4 mentors and 15 mentees participated in this study. Mentors and mentees were positive about using the AR technology, despite some technical issues and the time required to become familiar with the technology. The positive experience of telementorship was highlighted (mean 4.8, SD 0.414 for mentees and mean of 4.25, SD 0.5 for mentors on the 5-point Likert scale). Mentees’ confidence in managing each of the 4 scenarios improved after telementoring (P=.001 for the ACS, AMI, and PSRA scenarios and P=.002 for the HE scenario). Mentees’ individual skill performance rates ranged from 98% in the ACS scenario to 97% in the AMI, PSRA, and HE scenarios. Conclusions: This study provides evidence about the usability of AR technology in telementorship for managing clinical scenarios. The findings suggest the potential for this technology to be used to support health workers in real-world clinical environments and point to new directions of research. %M 37782533 %R 10.2196/47228 %U https://mededu.jmir.org/2023/1/e47228 %U https://doi.org/10.2196/47228 %U http://www.ncbi.nlm.nih.gov/pubmed/37782533 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e43313 %T Evaluating Change in Student Pharmacists’ Familiarity, Attitudes, Comfort, and Knowledge as a Result of Integrating Digital Health Topics Into a Case Conference Series: Cohort Study %A Darnell,Julia C %A Lou,Mimi %A Goldstone,Lisa W %+ College of Pharmacy, Western University of Health Sciences, 309 E. Second St, Pomona, CA, 91766, United States, 1 909 469 7048, darnellj@westernu.edu %K digital health %K telehealth %K digital therapeutics %K mobile health applications %K wearable health technologies %K pharmacy education %K medical education %K patient cases %K technology %K education %K digital %K digital health %K survey %K intervention %D 2023 %7 10.7.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: The use of technology in health care, often referred to as digital health, has expanded rapidly because of the need to provide remote care during the COVID-19 pandemic. In light of this rapid boom, it is clear that health care professionals need to be trained in these technologies in order to provide high-level care. Despite the growing number of technologies used across health care, digital health is not a commonly taught topic in health care curricula. Several pharmacy organizations have called attention to the need to teach digital health to student pharmacists; however, there is currently no consensus on best methods to do so. Objective: The objective of this study was to determine if there was a significant change in student pharmacist scores on the Digital Health Familiarity, Attitudes, Comfort, and Knowledge Scale (DH-FACKS) after exposure to digital health topics in a yearlong discussion–based case conference series. Methods: Student pharmacists’ initial comfort, attitudes, and knowledge were gathered by a baseline DH-FACKS score at the beginning of the fall semester. Digital health concepts were integrated into a number of cases in the case conference course series throughout the academic year. The DH-FACKS was administered again to students after completion of the spring semester. Results were matched, scored, and analyzed to assess any difference in DH-FACKS scores. Results: A total of 91 of 373 students completed both the pre- and postsurvey (response rate of 24%). Using a scale from 1 to 10, the mean student-reported knowledge of digital health increased from 4.5 (SD 2.5) before intervention to 6.6 (SD 1.6) after intervention (P<.001) and the mean self-reported comfort increased from 4.7 (SD 2.5) before intervention to 6.7 (SD 1.8) after intervention (P<.001). There was a significant increase in scores for all 4 elements of the DH-FACKS. The mean familiarity scores increased from 11.6 (SD 3.7) to 15.8 (SD 2.2), out of a maximum of 20 (P<.001). The mean attitudes scores increased from 15.6 (SD 2.1) to 16.5 (SD 1.9), out of a maximum of 20 (P=.001). The mean comfort scores increased from 10.1 (SD 3.9) to 14.8 (SD 3.1), out of a maximum of 20 (P<.001). The mean knowledge scores increased from 9.9 (SD 3.4) to 12.8 (SD 3.9), out of a maximum of 20 (P<.001). Conclusions: Including digital health topics in a case conference series is an effective and approachable way of providing education on important digital health concepts to students. Students experienced an increase in familiarity, attitudes, comfort, and knowledge after the yearlong intervention. As case-based discussions are an important component of most pharmacy and other medical curricula, this method can be easily applied by other programs that wish to give their students practice applying their knowledge of digital health to complex case-based scenarios. %M 37428523 %R 10.2196/43313 %U https://mededu.jmir.org/2023/1/e43313 %U https://doi.org/10.2196/43313 %U http://www.ncbi.nlm.nih.gov/pubmed/37428523 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 9 %N %P e42512 %T Virtual Reflection Group Meetings as a Structured Active Learning Method to Enhance Perceived Competence in Critical Care: Focus Group Interviews With Advanced Practice Nursing Students %A Solberg,Marianne Trygg %A Sørensen,Anne Lene %A Clarke,Sara %A Nes,Andrea Aparecida Goncalves %+ Lovisenberg Diaconal University College, Lovisenberggata 15 b, Oslo, 0456, Norway, 47 47097070, marianne.trygg.solberg@ldh.no %K advanced practice nurse %K nursing education %K virtual reflection group %K teaching design %K critical care %K active learning approach %D 2023 %7 23.3.2023 %9 Original Paper %J JMIR Med Educ %G English %X Background: Advanced practice nurses (APNs) are in high demand in critical care units. In Norway, APNs are educated at the master’s degree level and acquire the competence to ensure the independent, safe, and effective treatment of patients in constantly and rapidly changing health situations. APNs’ competence embraces expert knowledge and skills to perform complex decision-making in the clinical context; therefore, it is essential that educational institutions in nursing facilitate learning activities that ensure and improve students’ achievement of the required competence. In clinical practice studies of APN education, face-to-face reflection group (FFRG) meetings, held on campus with the participation of a nurse educator and advanced practice nursing students (APNSs), are a common learning activity to improve the competence of APNSs. Although FFRG meetings stimulate APNSs’ development of required competencies, they may also result in unproductive academic discussions, reduce the time that APNSs spend in clinical practice, and make it impossible for nurse preceptors (NPs) to attend the meetings, which are all challenges that need to be addressed. Objective: This study aimed to address the challenges experienced in FFRG meetings by implementing virtual reflection group (VRG) meetings and to explore the experiences of APNSs, NPs, and nurse educators in VRG meetings as an active learning method supported by technology to stimulate students’ development of the required competence to become APNs in critical care. Methods: This study adopted a qualitative explorative design with 2 focus group interviews and used inductive content analysis to explore the collected data. Results: The main finding is that reflection group meetings supported by technology resulted in a better-structured active learning method. The VRG meeting design allowed APNSs to spend more time in clinical practice placements. The APNSs and NPs experienced that they participated actively and effectively in the meetings, which led to a perceived increase in competence. The APNSs also perceived an improved learning experience compared with their prior expectations. Conclusions: Users perceived that the implemented novel teaching design supported by technology, the VRG meeting, was a more effective method than FFRG meetings on campus to develop APNSs’ required competence in critical care. The VRG was also perceived as an improved method to solve the challenges encountered in FFRG meetings. Specifically, the APNSs felt that they were prepared to undertake complex decision-making with a higher level of analytic cognition in a clinical context and to lead professional discussions in the ward. This developed teaching design can easily be adapted to diverse educational programs at various levels of professional education. %M 36951919 %R 10.2196/42512 %U https://mededu.jmir.org/2023/1/e42512 %U https://doi.org/10.2196/42512 %U http://www.ncbi.nlm.nih.gov/pubmed/36951919 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 3 %P e35983 %T The Use of Telegram in Surgical Education: Exploratory Study %A Soon,Marcus Khai Siang %A Martinengo,Laura %A Lu,Junde %A Car,Lorainne Tudor %A Chia,Clement Luck Khng %+ Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Rd 69047142 Clinical Sciences Building Level 18, Singapore, 308232, Singapore, 65 69047142, lorainne.tudor.car@ntu.edu.sg %K COVID-19 %K undergraduate medical education %K distance education %K social media %K Telegram %K general surgery %K messaging apps %D 2022 %7 27.9.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: The COVID-19 pandemic has disrupted medical education, shifting learning online. Social media platforms, including messaging apps, are well integrated into medical education. However, Telegram’s role in medical education remains relatively unexplored. Objective: This study aims to explore the perceptions of medical students regarding the role of messaging apps in medical education and their experience of using Telegram for surgical education. Methods: A Telegram channel “Telegram Education for Surgery Learning and Application (TESLA)” was created to supplement medical students’ learning. We invited 13 medical students who joined the TESLA channel for at least a month to participate in individual semistructured interviews. Interviews were conducted via videoconferencing using an interview guide and were then transcribed and analyzed by 2 researchers using inductive thematic content analysis. Results: Two themes were identified: (1) learning as a medical student and (2) the role of mobile learning (mLearning) in medical education. Students shared that pandemic-related safety measures, such as reduced clinic allocations and the inability to cross between wards, led to a decrease in clinical exposure. Mobile apps, which included proprietary study apps and messaging apps, were increasingly used by students to aid their learning. Students favored Telegram over other messaging apps and reported the development of TESLA as beneficial, particularly for revision and increasing knowledge. Conclusions: The use of apps for medical education increased during the COVID-19 pandemic. Medical students commonly used apps to consolidate their learning and revise examination topics. They found TESLA useful, relevant, and trustworthy. %M 36099020 %R 10.2196/35983 %U https://mededu.jmir.org/2022/3/e35983 %U https://doi.org/10.2196/35983 %U http://www.ncbi.nlm.nih.gov/pubmed/36099020 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 2 %P e34042 %T Digital Health and Learning in Speech-Language Pathology, Phoniatrics, and Otolaryngology: Survey Study for Designing a Digital Learning Toolbox App %A Lin,Yuchen %A Lemos,Martin %A Neuschaefer-Rube,Christiane %+ Clinic for Phoniatrics, Pedaudiology & Communication Disorders, University Hospital and Medical Faculty, Rheinisch-Westfaelische Technische Hochschule Aachen, Pauwelsstrasse 30, Aachen, 52074, Germany, 49 241 80 88954, yuchen.lin@rwth-aachen.de %K digital learning %K mLearning %K mHealth %K speech-language pathology %K phoniatrics %K otolaryngology %K communication disorders %K mobile phone %D 2022 %7 27.4.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: The digital age has introduced opportunities and challenges for clinical education and practice caused by infinite incoming information and novel technologies for health. In the interdisciplinary field of communication sciences and disorders (CSD), engagement with digital topics has emerged slower than in other health fields, and effective strategies for accessing, managing, and focusing on digital resources are greatly needed. Objective: We aimed to conceptualize and investigate preferences of stakeholders regarding a digital learning toolbox, an app containing a library of current resources for CSD. This cross-sectional survey study conducted in German-speaking countries investigated professional and student perceptions and preferences regarding such an app’s features, functions, content, and associated concerns. Methods: An open web-based survey was disseminated to professionals and students in the field of CSD, including speech-language pathologists (SLPs; German: Logopäd*innen), speech-language pathology students, phoniatricians, otolaryngologists, and medical students. Insights into preferences and perceptions across professions, generations, and years of experience regarding a proposed app were investigated. Results: Of the 164 participants, an overwhelming majority (n=162, 98.8%) indicated readiness to use such an app, and most participants (n=159, 96.9%) perceived the proposed app to be helpful. Participants positively rated app functions that would increase utility (eg, tutorial, quality rating function, filters based on content or topic, and digital format); however, they had varied opinions regarding an app community feature. Regarding app settings, most participants rated the option to share digital resources through social media links (144/164, 87.8%), receive and manage push notifications (130/164, 79.3%), and report technical issues (160/164, 97.6%) positively. However, significant variance was noted across professions (H3=8.006; P=.046) and generations (H3=9.309; P=.03) regarding a username-password function, with SLPs indicating greater perceived usefulness in comparison to speech-language pathology students (P=.045), as was demonstrated by Generation X versus Generation Z (P=.04). Participants perceived a range of clinical topics to be important; however, significant variance was observed across professions, between physicians and SLPs regarding the topic of diagnostics (H3=9.098; P=.03) and therapy (H3=21.236; P<.001). Concerns included technical challenges, data protection, quality of the included resources, and sustainability of the proposed app. Conclusions: This investigation demonstrated that professionals and students show initial readiness to engage in the co-design and use of an interdisciplinary digital learning toolbox app. Specifically, this app could support effective access, sharing, evaluation, and knowledge management in a digital age of rapid change. Formalized digital skills education in the field of CSD is just a part of the solution. It will be crucial to explore flexible, adaptive strategies collaboratively for managing digital resources and tools to optimize targeted selection and use of relevant, high-quality evidence in a world of bewildering data. %M 35475980 %R 10.2196/34042 %U https://mededu.jmir.org/2022/2/e34042 %U https://doi.org/10.2196/34042 %U http://www.ncbi.nlm.nih.gov/pubmed/35475980 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 8 %N 1 %P e31080 %T Perception of Web-Based Didactic Activities During the COVID-19 Pandemic Among Anesthesia Residents: Pilot Questionnaire Study %A Nozari,Ala %A Mukerji,Shivali %A Lok,Ling-Ling %A Gu,Qingrou %A Buhl,Lauren %A Jain,Sanjay %A Ortega,Rafael %+ Boston University School of Medicine, 72 E Concord St, Boston, MA, United States, 1 6176386956, smukerji@bu.edu %K resident education %K COVID-19 %K barriers to education %K didactic %K medical education %K online education %K web-based education %K virtual training %K anesthesiology residents %K medical residents %K pandemic %K virtual didactics %D 2022 %7 31.3.2022 %9 Original Paper %J JMIR Med Educ %G English %X Background: Physical and social distancing recommendations aimed at limiting exposure during the COVID-19 pandemic have forced residency programs to increasingly rely on videoconferencing and web-based resources. Objective: In this pilot study, we aimed to explore the effects of the COVID-19 pandemic on residency training experience, and to delineate the perceived barriers to the successful implementation of web-based medical education. Methods: A 19-item survey was compiled and distributed electronically using Qualtrics. This anonymous survey included information on the training level of each resident, their participation in formal didactics before and during the pandemic, and their perception of the ease and limitations of virtual didactics. The resident’s opinions on specific educational resources were assessed, and the effectiveness of new delivery methods on resident engagement and learning was examined. Results: Thirty anesthesiology residents were surveyed, 19 of whom agreed to participate in the pilot study. One participant with incomplete responses was excluded, yielding a final cohort of 18 respondents. Most residents (56%, 10/18) reported that the COVID-19 pandemic negatively affected their residency training. The time spent on didactic training and independent studies was, nevertheless, not affected by the pandemic for 90% (16/18) of respondents. Nonetheless, 72% (13/18) of residents were less engaged during virtual lectures in comparison to in-person didactics. Important limitations included distraction from the physical environment (67%, 12/18), internet instability (67%, 12/18), less obligation to participate (44%, 8/18), technical difficulty and unmuted microphones (33%, 6/18, each), and people speaking over each other (28%, 5/18). Despite these limitations, most residents stated that they would like to keep a combination of virtual didactics including live Zoom lectures (56%, 10/18), prerecorded web didactics (56%, 10/18), and virtual ground rounds via Zoom (50%, 9/18) as the “new normal.” Conclusions: Despite important limitations listed in this report, anesthesia residents would like to keep a combination of virtual lectures and presentations as the new normal after the COVID-19 pandemic. %M 35275840 %R 10.2196/31080 %U https://mededu.jmir.org/2022/1/e31080 %U https://doi.org/10.2196/31080 %U http://www.ncbi.nlm.nih.gov/pubmed/35275840 %0 Journal Article %@ 2292-9495 %I JMIR Publications %V 9 %N 1 %P e35199 %T The Effects of Introducing a Mobile App–Based Procedural Logbook on Trainee Compliance to a Central Venous Catheter Insertion Accreditation Program: Before-and-After Study %A Tamblyn,Robert %A Brieva,Jorge %A Cain,Madeleine %A Martinez,F Eduardo %+ Division of Critical Care, John Hunter Hospital, Hunter New England Local Health District, Lookout Rd, New Lambton Heights, Newcastle, 2305, Australia, 61 432032151, robert.d.tamblyn@gmail.com %K logbook %K education %K training %K central venous catheter %K CVC %K intensive care %K smartphone %K mobile phone %K mobile apps %K mHealth %K mobile health %K accreditation program %K digital health %K digital record %D 2022 %7 7.3.2022 %9 Original Paper %J JMIR Hum Factors %G English %X Background: To reduce complications associated with central venous catheter (CVC) insertions, local accreditation programs using a supervised procedural logbook are essential. To increase compliance with such a logbook, a mobile app could provide the ideal platform for training doctors in an adult intensive care unit (ICU). Objective: The aim of this paper was to compare trainee compliance with the completion of a logbook as part of a CVC insertion accreditation program, before and after the introduction of an app-based logbook. Methods: This is a retrospective observational study of logbook data, before and after the introduction of a purpose-built, app-based, electronic logbook to complement an existing paper-based logbook. Carried out over a 2-year period in the adult ICU of the John Hunter Hospital, Newcastle, NSW, Australia, the participants were ICU trainee medical officers completing a CVC insertion accreditation program. The primary outcome was the proportion of all CVC insertions documented in the patients’ electronic medical records appearing as logbook entries. To assess logbook entry quality, we measured and compared the proportion of logbook entries that were approved by a supervisor and contained a supervisor’s signature for the before and after periods. We also analyzed trainee participation before and after the intervention by comparing the total number of active logbook users, and the proportion of first-time users who logged 3 or more CVC insertions. Results: Of the 2987 CVC insertions documented in the electronic medical records between April 7, 2019, and April 6, 2021, 2161 (72%) were included and separated into cohorts before and after the app’s introduction. Following the introduction of the app-based logbook, the percentage of CVC insertions appearing as logbook entries increased from 3.6% (38/1059) to 20.5% (226/1102; P<.001). There was no difference in the proportion of supervisor-approved entries containing a supervisor’s signature before and after the introduction of the app, with 76.3% (29/38) and 83.2% (188/226), respectively (P=.31). After the introduction of the app, there was an increase in the percentage of active logbook users from 15.3% (13/85) to 62.8% (54/86; P<.001). Adherence to one’s logbook was similar in both groups with 60% (6/10) of first-time users in the before group and 79.5% (31/39) in the after group going on to log at least 3 or more CVCs during their time working in ICU. Conclusions: The addition of an electronic app-based logbook to a preexisting paper-based logbook was associated with a higher rate of logbook compliance in trainee doctors undertaking an accreditation program for CVC insertion in an adult ICU. There was a large increase in logbook use observed without a reduction in the quality of logbook entries. The overall trainee participation also improved with an observed increase in active logbook users and no reduction in the average number of entries per user following the introduction of the app. Further studies on app-based logbooks for ICU procedural accreditation programs are warranted. %M 35051900 %R 10.2196/35199 %U https://humanfactors.jmir.org/2022/1/e35199 %U https://doi.org/10.2196/35199 %U http://www.ncbi.nlm.nih.gov/pubmed/35051900 %0 Journal Article %@ 2369-2960 %I JMIR Publications %V 8 %N 3 %P e35252 %T Adaptation of an In-Person Internship to a Virtual Format for Public Health Undergraduates %A Kernan,William D %A Basch,Corey H %+ Department of Public Health, William Paterson University of New Jersey, 300 Pompton Road, Wayne, NJ, 07470, United States, 1 973 720 3479, kernanw@wpunj.edu %K internship %K remote learning %K high-impact practice %K COVID-19 %K public health education %K learning outcomes %K virtual learning %K virtual internship %K public health %K health education %K undergraduate education %K virtual education %D 2022 %7 4.3.2022 %9 Viewpoint %J JMIR Public Health Surveill %G English %X The disruption of traditional, in-person learning due to the COVID-19 pandemic necessitated the rapid development and use of revised and novel learning opportunities using a variety of remote instructional methodologies. This viewpoint describes the process used by an undergraduate Public Health program to transition a traditional, in-person, semester-long, 480-hour internship to a virtual-only learning experience guided by the existing student learning outcomes. Working closely with public health professionals at existing internship agencies, alumni from the program, student interns, and program faculty developed a modified virtual internship composed of 6 components. The development of this modified virtual internship model was guided by previous research on the components of successful internships and the elements of high-impact learning practices. %M 35089869 %R 10.2196/35252 %U https://publichealth.jmir.org/2022/3/e35252 %U https://doi.org/10.2196/35252 %U http://www.ncbi.nlm.nih.gov/pubmed/35089869 %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 %@ 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 %@ 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 %@ 2561-326X %I JMIR Publications %V 5 %N 11 %P e24448 %T Twitter Use by Academic Nuclear Medicine Programs: Pilot Content Analysis Study %A Panda,Ananya %A Sharma,Akash %A Dundar,Ayca %A Packard,Ann %A Aase,Lee %A Kotsenas,Amy %A Kendi,Ayse Tuba %+ Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, United States, 1 612 408 9737, kendi.ayse@mayo.edu %K social media %K Twitter %K radiology %K nuclear medicine %K nuclear radiology %K social network %K medical education %K networking %D 2021 %7 8.11.2021 %9 Original Paper %J JMIR Form Res %G English %X Background: There is scant insight into the presence of nuclear medicine (NM) and nuclear radiology (NR) programs on social media. Objective: Our purpose was to assess Twitter engagement by academic NM/NR programs in the United States. Methods: We measured Twitter engagement by the academic NM/NR community, accounting for various NM/NR certification pathways. The Twitter presence of NM/NR programs at both the department and program director level was identified. Tweets by programs were cross-referenced against potential high-yield NM- or NR-related hashtags, and tabulated at a binary level. A brief survey was done to identify obstacles and benefits to Twitter use by academic NM/NR faculty. Results: For 2019-2020, 88 unique programs in the United States offered NM/NR certification pathways. Of these, 52% (46/88) had Twitter accounts and 24% (21/88) had at least one post related to NM/NR. Only three radiology departments had unique Twitter accounts for the NM/molecular imaging division. Of the other 103 diagnostic radiology residency programs, only 16% (16/103) had a presence on Twitter and 5% (5/103) had tweets about NM/NR. Only 9% (8/88) of NM/NR program directors were on Twitter, and three program directors tweeted about NM/NR. The survey revealed a lack of clarity and resources around using Twitter, although respondents acknowledged the perceived value of Twitter engagement for attracting younger trainees. Conclusions: Currently, there is minimal Twitter engagement by the academic NM/NR community. The perceived value of Twitter engagement is counterbalanced by identifiable obstacles. Given radiologists’ overall positive views of social media’s usefulness, scant social media engagement by the NM community may represent a missed opportunity. More Twitter engagement and further research by trainees and colleagues should be encouraged, as well as the streamlined use of unique hashtags. %M 34747708 %R 10.2196/24448 %U https://formative.jmir.org/2021/11/e24448 %U https://doi.org/10.2196/24448 %U http://www.ncbi.nlm.nih.gov/pubmed/34747708 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 4 %P e29486 %T Evaluating Applicant Perceptions of the Impact of Social Media on the 2020-2021 Residency Application Cycle Occurring During the COVID-19 Pandemic: Survey Study %A Naaseh,Ariana %A Thompson,Sean %A Tohmasi,Steven %A Wiechmann,Warren %A Toohey,Shannon %A Wray,Alisa %A Boysen-Osborn,Megan %+ University of California, Irvine School of Medicine, 1001 Health Sciences Road, Irvine, CA, 92617, United States, 1 (949) 824 4285, mbo@hs.uci.edu %K residency application %K social media %K medical education %K resident %K medical student %K perspective %K residency recruitment %K virtual application %K virtual residency %D 2021 %7 5.10.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: Due to challenges related to the COVID-19 pandemic, residency programs in the United States conducted virtual interviews during the 2020-2021 application season. As a result, programs and applicants may have relied more heavily on social media–based communication and dissemination of information. Objective: We sought to determine social media’s impact on residency applicants during an entirely virtual application cycle. Methods: An anonymous electronic survey was distributed to 465 eligible 2021 Match applicants at 4 University of California Schools of Medicine in the United States. Results: A total of 72 participants (15.5% of eligible respondents), applying to 16 specialties, responded. Of those who responded, 53% (n=38) reported following prospective residency accounts on social media, and 89% (n=34) of those respondents were positively or negatively influenced by these accounts. The top three digital methods by which applicants sought information about residency programs included the program website, digital conversations with residents and fellows of that program, and Instagram. Among respondents, 53% (n=38) attended virtual information sessions for prospective programs. A minority of applicants (n=19, 26%) adjusted the number of programs they applied to based on information found on social media, with most (n=14, 74%) increasing the number of programs to which they applied. Survey respondents ranked social media’s effectiveness in allowing applicants to learn about programs at 6.7 (SD 2.1) on a visual analogue scale from 1-10. Most applicants (n=61, 86%) felt that programs should use social media in future application cycles even if they are nonvirtual. Conclusions: Social media appears to be an important tool for resident recruitment. Future studies should seek more information on its effect on later parts of the application cycle and the Match. %M 34591779 %R 10.2196/29486 %U https://mededu.jmir.org/2021/4/e29486 %U https://doi.org/10.2196/29486 %U http://www.ncbi.nlm.nih.gov/pubmed/34591779 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 3 %P e31149 %T Awareness, Views, Perceptions, and Beliefs of Pharmacy Interns Regarding Digital Health in Saudi Arabia: Cross-sectional Study %A Alsahali,Saud %+ Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, Unaizah, Qassim, 56215, Saudi Arabia, 966 505161171, s.alsahali@qu.edu.sa %K digital health %K eHealth %K mHealth %K telehealth %K telemedicine %K attitude %K awareness %K pharmacy interns %D 2021 %7 3.9.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: Digital health technologies and apps are rapidly advancing in recent years. It is expected to have more roles in transforming the health care system in this era of digital services. However, limited research is available regarding delivering digital health education in pharmacy and the pharmacy students’ perspectives on digital health. Objective: This study aims to assess pharmacy interns’ awareness of digital health apps in Saudi Arabia and their views regarding the coverage of digital health in the education of pharmacists. In addition, we assessed the interns’ perceptions and beliefs about the concepts, benefits, and implementation of digital health in practice settings. Methods: A cross-sectional study using a web-based survey was conducted among pharmacy interns at Unaizah College of Pharmacy, Qassim University, Saudi Arabia. An invitation with a link to the web-based survey was sent to all interns registered at the college between January and March 2021. Results: A total of 68 out of 77 interns registered in the internship year participated in this study, giving a response rate of 88%. The mean total score for pharmacy interns’ awareness of digital health apps in Saudi Arabia was 5.66 (SD 1.74; maximum attainable score=7). The awareness with different apps ranged from 97% (66/68) for the Tawakkalna app to 65% (44/68) for the Ministry of Health 937 call center. The mean total score for attitude and beliefs toward concepts and benefits of telehealth and telemedicine apps was 58.25 (SD 10.44; maximum attainable score=75). In this regard, 84% (57/68) of the interns believed that telehealth could enhance the quality of care, 71% (48/68) believed that it could help effectively provide patient counseling, and 69% (47/68) believed it could improve patients’ adherence to therapy. In this study, 41% (28/68) believed that the current coverage of digital health in the curriculum was average, whereas only 18% (12/68) believed it was high or very high coverage. Moreover, only 38% (26/68) attended additional educational activities related to digital health. Consequently, the majority (43/68, 63%) were of the opinion that there is a high or very high need to educate and train pharmacists in the field of digital health. Conclusions: Overall, the interns showed good awareness of common digital health apps in Saudi Arabia. Moreover, the majority of the interns had positive perceptions and beliefs about the concepts, benefits, and implementation of digital health. However, the findings showed that there is still scope for improvement in some areas. Moreover, most interns indicated that there is a need for more education and training in the field of digital health. Consequently, early exposure to content related to digital health and pharmacy informatics is an important step to help in the wide use of these technologies in the graduates’ future careers. %M 34338649 %R 10.2196/31149 %U https://mededu.jmir.org/2021/3/e31149 %U https://doi.org/10.2196/31149 %U http://www.ncbi.nlm.nih.gov/pubmed/34338649 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 23 %N 5 %P e16463 %T WeChat as a Platform for Problem-Based Learning Among Hematological Postgraduates: Feasibility and Acceptability Study %A Luo,Ping %A Pang,Wenwen %A Wang,Yingying %A Liu,Minghui %A Zhou,Shu %A Liu,Shuai %A Zhang,Xian %A Liu,Li %A Liu,Yanan %A Zhou,Fuling %+ Department of Hematology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, , China, 86 02767814127, zhoufuling@whu.edu.cn %K problem-based learning %K PBL %K WeChat %K hematology %K postgraduate %K education %D 2021 %7 25.5.2021 %9 Original Paper %J J Med Internet Res %G English %X Background: Hematological medicine is a practical discipline that is difficult to study. Problem-based learning (PBL) is an innovative student-centered teaching method wherein students define their own learning objectives from clinically based problems. Considering that WeChat is the most popular communication app in China, we selected it as a new platform for online PBL to reduce the limitations of traditional PBL in hematology teaching. Objective: This study aims to explore a new pedagogical method called WeChat-PBL, which is based on real micro clinical cases for postgraduates majoring in hematology and to demonstrate its feasibility and acceptability. Methods: A total of 48 hematological postgraduates and 7 tutors participated in this study. We divided the participants into 7 groups where students can learn theoretical knowledge. After each course, the members of each group were required to complete in-class quizzes. Moreover, the students and tutors were required to fill out periodic (after each class) and overall (after each semester) evaluations. Results: A total of 8 micro clinical cases were presented in WeChat-PBL. The average quiz score for acute myelogenous leukemia, chronic myeloid leukemia, multiple myeloma, acute promyelocytic leukemia, and lymphoma were 89.0%, 86.0%, 83.4%, 88.8%, and 77.5%, respectively. Periodic evaluations showed that both students and tutors were satisfied with the process of WeChat-PBL. The overall evaluation results showed that WeChat-PBL was able to positively impact the learning experiences of hematological postgraduates. Conclusions: Our results indicate the feasibility and acceptability of the WeChat-PBL teaching method for postgraduates majoring in hematology. %M 34032573 %R 10.2196/16463 %U https://www.jmir.org/2021/5/e16463 %U https://doi.org/10.2196/16463 %U http://www.ncbi.nlm.nih.gov/pubmed/34032573 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 2 %P e28733 %T Audiovisual Content for a Radiology Fellowship Selection Process During the COVID-19 Pandemic: Pilot Web-Based Questionnaire Study %A Godoy,Ivan Rodrigues Barros %A Neto,Luís Pecci %A Skaf,Abdalla %A Leão-Filho,Hilton Muniz %A Freddi,Tomás De Andrade Lourenço %A Jasinowodolinski,Dany %A Yamada,André Fukunishi %+ Department of Radiology, Hospital do Coração and Teleimagem, Rua Desembargador Eliseu Guilherme 147, São Paulo, 04004-030, Brazil, 55 11996171704, ivanrbgodoy@gmail.com %K audiovisual reports %K COVID-19 %K fellowship %K radiology %K smartphones %K video recording %K web technology %D 2021 %7 20.5.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: Traditional radiology fellowships are usually 1- or 2-year clinical training programs in a specific area after completion of a 4-year residency program. Objective: This study aimed to investigate the experience of fellowship applicants in answering radiology questions in an audiovisual format using their own smartphones after answering radiology questions in a traditional printed text format as part of the application process during the COVID-19 pandemic. We hypothesized that fellowship applicants would find that recorded audiovisual radiology content adds value to the conventional selection process, may increase engagement by using their own smartphone device, and facilitate the understanding of imaging findings of radiology-based questions, while maintaining social distancing. Methods: One senior staff radiologist of each subspecialty prepared 4 audiovisual radiology questions for each subspecialty. We conducted a survey using web-based questionnaires for 123 fellowship applications for musculoskeletal (n=39), internal medicine (n=61), and neuroradiology (n=23) programs to evaluate the experience of using audiovisual radiology content as a substitute for the conventional text evaluation. Results: Most of the applicants (n=122, 99%) answered positively (with responses of “agree” or “strongly agree”) that images in digital forms are of superior quality to those printed on paper. In total, 101 (82%) applicants agreed with the statement that the presentation of cases in audiovisual format facilitates the understanding of the findings. Furthermore, 81 (65%) candidates agreed or strongly agreed that answering digital forms is more practical than conventional paper forms. Conclusions: The use of audiovisual content as part of the selection process for radiology fellowships is a new approach to evaluate the potential to enhance the applicant’s experience during this process. This technology also allows for the evaluation of candidates without the need for in-person interaction. Further studies could streamline these methods to minimize work redundancy with traditional text assessments or even evaluate the acceptance of using only audiovisual content on smartphones. %M 33956639 %R 10.2196/28733 %U https://mededu.jmir.org/2021/2/e28733 %U https://doi.org/10.2196/28733 %U http://www.ncbi.nlm.nih.gov/pubmed/33956639 %0 Journal Article %@ 2291-5222 %I JMIR Publications %V 9 %N 4 %P e25377 %T Measuring the Quality of Clinical Skills Mobile Apps for Student Learning: Systematic Search, Analysis, and Comparison of Two Measurement Scales %A Gladman,Tehmina %A Tylee,Grace %A Gallagher,Steve %A Mair,Jonathan %A Grainger,Rebecca %+ Education Unit, University of Otago Wellington, PO Box 7343, Newtown, Wellington, 6242, New Zealand, 64 04 918 6749, tehmina.gladman@otago.ac.nz %K mobile apps %K MARS %K MARuL %K medical education %K app review %K mobile phone %D 2021 %7 23.4.2021 %9 Original Paper %J JMIR Mhealth Uhealth %G English %X Background: Mobile apps are widely used in health professions, which increases the need for simple methods to determine the quality of apps. In particular, teachers need the ability to curate high-quality mobile apps for student learning. Objective: This study aims to systematically search for and evaluate the quality of clinical skills mobile apps as learning tools. The quality of apps meeting the specified criteria was evaluated using two measures—the widely used Mobile App Rating Scale (MARS), which measures general app quality, and the Mobile App Rubric for Learning (MARuL), a recently developed instrument that measures the value of apps for student learning—to assess whether MARuL is more effective than MARS in identifying high-quality apps for learning. Methods: Two mobile app stores were systematically searched using clinical skills terms commonly found in medical education and apps meeting the criteria identified using an approach based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 9 apps were identified during the screening process. The apps were rated independently by 2 reviewers using MARS and MARuL. Results: The intraclass correlation coefficients (ICCs) for the 2 raters using MARS and MARuL were the same (MARS ICC [two-way]=0.68; P<.001 and MARuL ICC [two-way]=0.68; P<.001). Of the 9 apps, Geeky Medics-OSCE revision (MARS Android=3.74; MARS iOS=3.68; MARuL Android=75; and MARuL iOS=73) and OSCE PASS: Medical Revision (MARS Android=3.79; MARS iOS=3.71; MARuL Android=69; and MARuL iOS=73) scored highly on both measures of app quality and for both Android and iOS. Both measures also showed agreement for the lowest rated app, Patient Education Institute (MARS Android=2.21; MARS iOS=2.11; MARuL Android=18; and MARuL iOS=21.5), which had the lowest scores in all categories except information (MARS) and professional (MARuL) in both operating systems. MARS and MARuL were both able to differentiate between the highest and lowest quality apps; however, MARuL was better able to differentiate apps based on teaching and learning quality. Conclusions: This systematic search and rating of clinical skills apps for learning found that the quality of apps was highly variable. However, 2 apps—Geeky Medics-OSCE revision and OSCE PASS: Medical Revision—rated highly for both versions and with both quality measures. MARS and MARuL showed similar abilities to differentiate the quality of the 9 apps. However, MARuL’s incorporation of teaching and learning elements as part of a multidimensional measure of quality may make it more appropriate for use with apps focused on teaching and learning, whereas MARS’s more general rating of quality may be more appropriate for health apps targeting a general health audience. Ratings of the 9 apps by both measures also highlighted the variable quality of clinical skills mobile apps for learning. %M 33890859 %R 10.2196/25377 %U https://mhealth.jmir.org/2021/4/e25377 %U https://doi.org/10.2196/25377 %U http://www.ncbi.nlm.nih.gov/pubmed/33890859 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 7 %N 1 %P e24032 %T Using Machine Learning Algorithms to Predict People’s Intention to Use Mobile Learning Platforms During the COVID-19 Pandemic: Machine Learning Approach %A Akour,Iman %A Alshurideh,Muhammad %A Al Kurdi,Barween %A Al Ali,Amel %A Salloum,Said %+ Research Institute of Sciences & Engineering, University of Sharjah, Academic City, Sharjah, United Arab Emirates, 971 507679647, salloum78@live.com %K COVID-19 %K pandemic %K mobile learning %K fear %K technology acceptance model %K theory of planned behavior %K prediction %K intent %K online learning %K machine learning %K behavior %D 2021 %7 4.2.2021 %9 Original Paper %J JMIR Med Educ %G English %X Background: Mobile learning has become an essential instruction platform in many schools, colleges, universities, and various other educational institutions across the globe, as a result of the COVID-19 pandemic crisis. The resulting severe, pandemic-related circumstances have disrupted physical and face-to-face contact teaching practices, thereby requiring many students to actively use mobile technologies for learning. Mobile learning technologies offer viable web-based teaching and learning platforms that are accessible to teachers and learners worldwide. Objective: This study investigated the use of mobile learning platforms for instruction purposes in United Arab Emirates higher education institutions. Methods: An extended technology acceptance model and theory of planned behavior model were proposed to analyze university students’ adoption of mobile learning platforms for accessing course materials, searching the web for information related to their disciplines, sharing knowledge, and submitting assignments during the COVID-19 pandemic. We collected a total of 1880 questionnaires from different universities in the United Arab Emirates. Partial least squares-structural equation modeling and machine learning algorithms were used to assess the research model, which was based on the data gathered from a student survey. Results: Based on our results, each hypothesized relationship within the research model was supported by our data analysis results. It should also be noted that the J48 classifier (89.37% accuracy) typically performed better than the other classifiers when it came to the prediction of the dependent variable. Conclusions: Our study revealed that teaching and learning could considerably benefit from adopting remote learning systems as educational tools during the COVID-19 pandemic. However, the value of such systems could be lessened because of the emotions that students experience, including a fear of poor grades, stress resulting from family circumstances, and sadness resulting from a loss of friends. Accordingly, these issues can only be resolved by evaluating the emotions of students during the pandemic. %M 33444154 %R 10.2196/24032 %U http://mededu.jmir.org/2021/1/e24032/ %U https://doi.org/10.2196/24032 %U http://www.ncbi.nlm.nih.gov/pubmed/33444154 %0 Journal Article %@ 2291-5222 %I JMIR Publications %V 9 %N 1 %P e22633 %T Configuration of Mobile Learning Tools to Support Basic Physical Assessment in Nursing Education: Longitudinal Participatory Design Approach %A Egilsdottir,H Ösp %A Heyn,Lena Günterberg %A Brembo,Espen Andreas %A Byermoen,Kirsten Røland %A Moen,Anne %A Eide,Hilde %+ Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Grønland 58, Drammen, 3045, Norway, 47 94886406, osp.egilsdottir@usn.no %K learning %K mobile phone %K mobile application %K education, nursing %K students, nursing %K education, clinical %K nursing skills %K physical examination %K computer simulation %K clinical competence %D 2021 %7 7.1.2021 %9 Original Paper %J JMIR Mhealth Uhealth %G English %X Background: As many students in higher education are skilled users of mobile technology, mobile learning (mLearning) can be a promising educational strategy to enhance their learning experience. mLearning might also be well suited for nursing students as they navigate between multiple learning contexts in their educational curriculum. As an educational strategy, mLearning may also reduce challenges caused by the theory-practice gap in nursing by supporting skills and knowledge transfer between the university and clinical settings. As the introduction of basic physical assessment skills (B-PASs) into Norwegian bachelor’s degree education in nursing occurred quite recently, there is a lack of competence in supervision and teaching in both university and clinical settings. As such, mLearning appears to be a good strategy to support student B-PAS learning and knowledge transfer across learning contexts. Objective: This study aims to explore and elicit the perspectives of students regarding the way in which a selection of digital learning resources supports B-PAS learning and application in clinical rotation, which of the selected digital learning resources are beneficial to include in a suite of mLearning tools, and how the selected digital learning resources could support the transfer of skills and knowledge from the academic to clinical context. Methods: We used a longitudinal participatory design approach to co-design a suite of mLearning tools. The co-design processes took place in several workshops (WSs) over a period of 3 months: 2 WSs with first-year students (n=6), 3 WSs with second-year students (n=6), and 3 WSs with third-year students (n=8). The students evaluated several digital learning resources in both academic and clinical contexts. The digital learning resources included digital simulation with virtual patients, massive open online courses, and multimedia learning material. In the co-design WS, the potential and benefits of these digital learning resources for the learning and application of B-PASs were explored. Results: The students reported that the digital learning resources stimulated learning in 7 different ways. They also emphasized the importance of including all selected and tested digital learning resources. Moreover, students supported the inclusion of additional learning material, such as multiple-choice tests and written assignments, aimed at providing feedback and contributing to knowledge development. Conclusions: The co-design processes and collaboration with the nursing students provided insight into how a suite of mLearning tools may support the learning and application of B-PASs and human bioscience knowledge in clinical rotation. From the students’ perspective, one of the strengths of the suite of mLearning tools was the range of content, as this met a broader range of student learning preferences regarding learning B-PASs. The suite of mLearning tools contributes to and supports skills training and knowledge transfer between multiple learning contexts. %M 33410756 %R 10.2196/22633 %U https://mhealth.jmir.org/2021/1/e22633 %U https://doi.org/10.2196/22633 %U http://www.ncbi.nlm.nih.gov/pubmed/33410756 %0 Journal Article %@ 2291-9279 %I JMIR Publications %V 8 %N 3 %P e17823 %T Biosensor Real-Time Affective Analytics in Virtual and Mixed Reality Medical Education Serious Games: Cohort Study %A Antoniou,Panagiotis E %A Arfaras,George %A Pandria,Niki %A Athanasiou,Alkinoos %A Ntakakis,George %A Babatsikos,Emmanouil %A Nigdelis,Vasilis %A Bamidis,Panagiotis %+ Lab of Medical Physics, The Medical School, Aristotle University of Thessaloniki, PO Box 376, Thessaloniki, 54124, Greece, 30 2310 999310, bamidis@auth.gr %K virtual patients %K affective learning %K electroencephalography %K medical education %K virtual reality %K wearable sensors %K serious medical games %D 2020 %7 2.9.2020 %9 Original Paper %J JMIR Serious Games %G English %X Background: The role of emotion is crucial to the learning process, as it is linked to motivation, interest, and attention. Affective states are expressed in the brain and in overall biological activity. Biosignals, like heart rate (HR), electrodermal activity (EDA), and electroencephalography (EEG) are physiological expressions affected by emotional state. Analyzing these biosignal recordings can point to a person’s emotional state. Contemporary medical education has progressed extensively towards diverse learning resources using virtual reality (VR) and mixed reality (MR) applications. Objective: This paper aims to study the efficacy of wearable biosensors for affect detection in a learning process involving a serious game in the Microsoft HoloLens VR/MR platform. Methods: A wearable array of sensors recording HR, EDA, and EEG signals was deployed during 2 educational activities conducted by 11 participants of diverse educational level (undergraduate, postgraduate, and specialist neurosurgeon doctors). The first scenario was a conventional virtual patient case used for establishing the personal biosignal baselines for the participant. The second was a case in a VR/MR environment regarding neuroanatomy. The affective measures that we recorded were EEG (theta/beta ratio and alpha rhythm), HR, and EDA. Results: Results were recorded and aggregated across all 3 groups. Average EEG ratios of the virtual patient (VP) versus the MR serious game cases were recorded at 3.49 (SD 0.82) versus 3.23 (SD 0.94) for students, 2.59 (SD 0.96) versus 2.90 (SD 1.78) for neurosurgeons, and 2.33 (SD 0.26) versus 2.56 (SD 0.62) for postgraduate medical students. Average alpha rhythm of the VP versus the MR serious game cases were recorded at 7.77 (SD 1.62) μV versus 8.42 (SD 2.56) μV for students, 7.03 (SD 2.19) μV versus 7.15 (SD 1.86) μV for neurosurgeons, and 11.84 (SD 6.15) μV versus 9.55 (SD 3.12) μV for postgraduate medical students. Average HR of the VP versus the MR serious game cases were recorded at 87 (SD 13) versus 86 (SD 12) bpm for students, 81 (SD 7) versus 83 (SD 7) bpm for neurosurgeons, and 81 (SD 7) versus 77 (SD 6) bpm for postgraduate medical students. Average EDA of the VP versus the MR serious game cases were recorded at 1.198 (SD 1.467) μS versus 4.097 (SD 2.79) μS for students, 1.890 (SD 2.269) μS versus 5.407 (SD 5.391) μS for neurosurgeons, and 0.739 (SD 0.509) μS versus 2.498 (SD 1.72) μS for postgraduate medical students. The variations of these metrics have been correlated with existing theoretical interpretations regarding educationally relevant affective analytics, such as engagement and educational focus. Conclusions: These results demonstrate that this novel sensor configuration can lead to credible affective state detection and can be used in platforms like intelligent tutoring systems for providing real-time, evidence-based, affective learning analytics using VR/MR-deployed medical education resources. %M 32876575 %R 10.2196/17823 %U http://games.jmir.org/2020/3/e17823/ %U https://doi.org/10.2196/17823 %U http://www.ncbi.nlm.nih.gov/pubmed/32876575 %0 Journal Article %@ 2291-5222 %I JMIR Publications %V 8 %N 7 %P e18015 %T A Tool for Rating the Value of Health Education Mobile Apps to Enhance Student Learning (MARuL): Development and Usability Study %A Gladman,Tehmina %A Tylee,Grace %A Gallagher,Steve %A Mair,Jonathan %A Rennie,Sarah C %A Grainger,Rebecca %+ Education Unit, University of Otago Wellington, PO Box 7343, Newtown, Wellington, 6242, New Zealand, 64 04 918 6749, tehmina.gladman@otago.ac.nz %K questionnaire design %K medical education %K health occupations students %K just-in-time learning %K self-directed learning %K mobile phone %K rubric %K mobile learning %K mobile apps %K mhealth %K digital learning %D 2020 %7 31.7.2020 %9 Original Paper %J JMIR Mhealth Uhealth %G English %X Background: To realize the potential for mobile learning in clinical skills acquisition, medical students and their teachers should be able to evaluate the value of an app to support student learning of clinical skills. To our knowledge, there is currently no rubric for evaluation of quality or value that is specific for apps to support medical student learning. Such a rubric might assist students to be more confident in using apps to support their learning. Objective: The objective of this study was to develop an instrument that can be used by health professional educators to rate the value of a mobile app to support health professional student learning. Methods: Using the literature, we developed a list of potential criteria for the evaluation of educational app value, which were then refined with a student group using a modified nominal group technique. The refined list was organized into themes, and the initial rubric, Mobile App Rubric for Learning (MARuL, version 1), was developed. iOS and Android app stores were searched for clinical skills apps that met our inclusion criteria. After the 2 reviewers were trained and the item descriptions were refined (version 2), a random sample of 10 included apps, 5 for each mobile operating system, was reviewed. Interitem and interrater analyses and discussions with the reviewers resulted in refinement of MARuL to version 3. The reviewers completed a review of 41 clinical skills mobile apps, and a second round of interitem and interrater reliability testing was performed, leading to version 4 of the MARuL. Results: Students identified 28 items (from an initial set of 144 possible items) during the nominal group phase, and these were then grouped into 4 themes: teaching and learning, user centered, professional, and usability. Testing and refinement with reviewers reduced the list to 26 items. Internal consistency for MARuL was excellent (α=.96), and the interrater reliability as measured by the intraclass correlation coefficient (ICC) was good (ICC=0.66). Conclusions: MARuL offers a fast and user-friendly method for teachers to select valuable apps to enhance student learning. %M 32735228 %R 10.2196/18015 %U https://mhealth.jmir.org/2020/7/e18015 %U https://doi.org/10.2196/18015 %U http://www.ncbi.nlm.nih.gov/pubmed/32735228 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 6 %N 1 %P e17729 %T A Mobile Medical Knowledge Dissemination Platform (HeadToToe): Mixed Methods Study %A Zamberg,Ido %A Windisch,Olivier %A Agoritsas,Thomas %A Nendaz,Mathieu %A Savoldelli,Georges %A Schiffer,Eduardo %+ Division of General Internal Medicine, Department of Medicine, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva, 1205, Switzerland, 41 768035683, idozamberg@gmail.com %K clinical skills %K clinical competence %K clinical practice guidelines %K medical education %K smartphone %K innovation %K medical guidance %K mobile phone %D 2020 %7 27.5.2020 %9 Original Paper %J JMIR Med Educ %G English %X Background: Finding readily accessible, high-quality medical references can be a challenging task. HeadToToe is a mobile platform designed to allow easy and quick access to sound, up-to-date, and validated medical knowledge and guidance. It provides easy access to essential clinical medical content in the form of documents, videos, clinical scores, and other formats for the day-to-day access and use by medical students and physicians during their pre- and postgraduate education. Objective: The aim of this paper is to describe the architecture, user interface, and potential strengths and limitations of an innovative knowledge dissemination platform developed at the University of Geneva, Switzerland. We also report preliminary results from a user-experience survey and usage statistics over a selected period. Methods: The dissemination platform consists of a smartphone app. Through an administration interface, content is managed by senior university and hospital staff. The app includes the following sections: (1) main section of medical guidance, organized by clinical field; (2) checklists for history-taking and clinical examination, organized by body systems; (3) laboratory section with frequently used lab values; and (4) favorites section. Each content item is programmed to be available for a given duration as defined by the content’s author. Automatic notifications signal the author when the content is about to expire, hence, promoting its timely updating and reducing the risk of using obsolete content. In the background, a third-party statistical collecting tool records anonymous utilization statistics. Results: We launched the final version of the platform in March 2019, both at the Faculty of Medicine at the University of Geneva and at the University Hospital of Geneva in Switzerland. A total of 622 students at the university and 613 health professionals at the hospital downloaded the app. Two-thirds of users at both institutions had an iOS device. During the practical examination period (ie, May 2019) there was a significant increase in the number of active users (P=.003), user activity (P<.001), and daily usage time (P<.001) among medical students. In addition, there were 1086 clinical skills video views during this period compared to a total of 484 in the preceding months (ie, a 108% increase). On a 10-point Likert scale, students and physicians rated the app with mean scores of 8.2 (SD 1.9) for user experience, 8.1 (SD 2.0) for usefulness, and 8.5 (SD 1.8) for relevance of content. In parallel, postgraduate trainees viewed more than 6000 documents during the first 3 months after the implementation in the Division of Neurology at our institution. Conclusions: HeadToToe is an educator-driven, mobile dissemination platform, which provides rapid and user-friendly access to up-to-date medical content and guidance. The platform was given high ratings for user experience, usefulness, and content quality and was used more often during the exam period. This suggests that the platform could be used as tool for exam preparation. %M 32249758 %R 10.2196/17729 %U http://mededu.jmir.org/2020/1/e17729/ %U https://doi.org/10.2196/17729 %U http://www.ncbi.nlm.nih.gov/pubmed/32249758 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 5 %N 2 %P e12809 %T Media Use Among Students From Different Health Curricula: Survey Study %A Zupanic,Michaela %A Rebacz,Patrick %A Ehlers,Jan P %+ Personality Psychology and Diagnostics, Department of Psychology, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str 50, Witten, 58448, Germany, 49 2302926 ext 756, michaela.zupanic@uni-wh.de %K social media %K medical education %K computers %K interprofessional relations %K distance education %K health occupations %D 2019 %7 19.08.2019 %9 Original Paper %J JMIR Med Educ %G English %X Background: Mobile devices such as smartphones, tablets, and laptop computers enable users to search for information and communicate with others at any place and any time. Such devices are increasingly being used at universities for teaching and learning. The use of mobile devices by students depends, among others, on the individual media literacy level and the curricular framework. Objective: The objective of this study was to explore whether there were differences in media use in students from various curricula at the Faculty of Health, Witten/Herdecke University. Methods: During the 2015-16 winter term, a survey was conducted at the Faculty of Health, Witten/Herdecke University, in which a total of 705 students (out of 1091 students; response rate: 705/1091, 64.61%) from 4 schools participated voluntarily: medicine (346/598), dentistry (171/204), psychology (142/243), and nursing science (46/46). The questionnaire developed for the study included 132 questions on 4 topics: (1) electronic and mobile devices (19 questions), (2) communication and organization of learning (45 questions), (3) apps/programs/websites/media (34 questions), and (4) media literacy (34 questions). The questionnaire was distributed and anonymously completed during in-class courses. Results: Students from all 4 schools had at least two electronic devices, with smartphones (97.4%, 687/705) and laptops (94.8%, 669/705) being the most common ones. Students agreed that electronic devices enabled them to effectively structure the learning process (mean 3.16, SD 0.62) and shared the opinion that university teaching should include imparting media literacy (mean 2.84, SD 0.84). Electronic device ownership was the highest among medical students (mean 2.68, SD 0.86) and medical students were the only ones to use a tutorial (36.1%, 125/346). Dental students most widely used text messages (mean 3.41, SD 0.49) and social media (mean 2.57, SD 1.10) to organize learning. Psychology students considered mobile devices to be most ineffective (mean 2.81, SD 0.83). Nursing science students used emails (mean 3.47, SD 0.73) and desktop computers (39%, 18/46) most widely. Conclusions: The results show that almost all students use electronic learning (e-learning) tools. At the same time, different profiles for different degree programs become apparent, which are to be attributed to not only the varying curricula and courses but also to the life circumstances of different age groups. Universities should, therefore, pay attention to the diverse user patterns and media literacy levels of students when planning courses to enable successful use of e-learning methods. %M 31429412 %R 10.2196/12809 %U http://mededu.jmir.org/2019/2/e12809/ %U https://doi.org/10.2196/12809 %U http://www.ncbi.nlm.nih.gov/pubmed/31429412 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 5 %N 1 %P e10955 %T Impact of an Electronic App on Resident Responses to Simulated In-Flight Medical Emergencies: Randomized Controlled Trial %A Nadir,Nur-Ain %A Cook,Courtney J %A Bertino,Raymond E %A Squillante,Marc D %A Taylor,Cameron %A Dragoo,David %A Podolej,Gregory S %A Svendsen,Jessica D %A Fish,Jessica L %A McGarvey,Jeremy S %A Bond,William F %+ Jump Simulation, OSF Healthcare, 1306 N Berkeley Avenue, Peoria, IL, United States, 1 2246279524, nurainnadir@yahoo.com %K in-flight medical emergencies %K ground medical control %K commercial aviation %K simulation %D 2019 %7 7.6.2019 %9 Original Paper %J JMIR Med Educ %G English %X Background: Health care providers are often called to respond to in-flight medical emergencies, but lack familiarity with expected supplies, interventions, and ground medical control support. Objective: The objective of this study was to determine whether a mobile phone app (airRx) improves responses to simulated in-flight medical emergencies. Methods: This was a randomized study of volunteer, nonemergency resident physician participants who managed simulated in-flight medical emergencies with or without the app. Simulations took place in a mock-up cabin in the simulation center. Standardized participants played the patient, family member, and flight attendant roles. Live, nonblinded rating was used with occasional video review for data clarification. Participants participated in two simulated in-flight medical emergencies (shortness of breath and syncope) and were evaluated with checklists and global rating scales (GRS). Checklist item success rates, key critical action times, GRS, and pre-post simulation confidence in managing in-flight medical emergencies were compared. Results: There were 29 participants in each arm (app vs control; N=58) of the study. Mean percentages of completed checklist items for the app versus control groups were mean 56.1 (SD 10.3) versus mean 49.4 (SD 7.4) for shortness of breath (P=.001) and mean 58 (SD 8.1) versus mean 49.8 (SD 7.0) for syncope (P<.001). The GRS improved with the app for the syncope case (mean 3.14, SD 0.89 versus control mean 2.6, SD 0.97; P=.003), but not the shortness of breath case (mean 2.90, SD 0.97 versus control mean 2.81, SD 0.80; P=.43). For timed checklist items, the app group contacted ground support faster for both cases, but the control group was faster to complete vitals and basic exam. Both groups indicated higher confidence in their postsimulation surveys, but the app group demonstrated a greater increase in this measure. Conclusions: Use of the airRx app prompted some actions, but delayed others. Simulated performance and feedback suggest the app is a useful adjunct for managing in-flight medical emergencies. %M 31199299 %R 10.2196/10955 %U http://mededu.jmir.org/2019/1/e10955/ %U https://doi.org/10.2196/10955 %U http://www.ncbi.nlm.nih.gov/pubmed/31199299 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 21 %N 2 %P e12895 %T Influences on the Implementation of Mobile Learning for Medical and Nursing Education: Qualitative Systematic Review by the Digital Health Education Collaboration %A Lall,Priya %A Rees,Rebecca %A Law,Gloria Chun Yi %A Dunleavy,Gerard %A Cotič,Živa %A Car,Josip %+ Evidence for Policy and Practice Information and Co-ordinating Centre, Social Science Research Unit, Department of Social Science, University College London Institute of Education, University College London, 18 Woburn Square, London, WCIH 0NR, United Kingdom, 44 07932 243030, rebecca.rees@ucl.ac.uk %K medical education %K nursing education %K distance education %K qualitative research %K systematic review %D 2019 %7 28.02.2019 %9 Original Paper %J J Med Internet Res %G English %X Background: In the past 5 decades, digital education has increasingly been used in health professional education. Mobile learning (mLearning), an emerging form of educational technology using mobile devices, has been used to supplement learning outcomes through enabling conversations, sharing information and knowledge with other learners, and aiding support from peers and instructors regardless of geographic distance. Objective: This review aimed to synthesize findings from qualitative or mixed-methods studies to provide insight into factors facilitating or hindering implementation of mLearning strategies for medical and nursing education. Methods: A systematic search was conducted across a range of databases. Studies with the following criteria were selected: examined mLearning in medical and nursing education, employed a mixed-methods or qualitative approach, and published in English after 1994. Findings were synthesized using a framework approach. Results: A total of 1946 citations were screened, resulting in 47 studies being selected for inclusion. Most studies evaluated pilot mLearning interventions. The synthesis identified views on valued aspects of mobile devices in terms of efficiency and personalization but concerns over vigilance and poor device functionality; emphasis on the social aspects of technology, especially in a clinical setting; the value of interaction learning for clinical practice; mLearning as a process, including learning how to use a device; and the importance of institutional infrastructure and policies. Conclusions: The portability of mobile devices can enable interactions between learners and educational material, fellow learners, and educators in the health professions. However, devices need to be incorporated institutionally, and learners and educators need additional support to fully comprehend device or app functions. The strategic support of mLearning is likely to require procedural guidance for practice settings and device training and maintenance services on campus. %M 30816847 %R 10.2196/12895 %U https://www.jmir.org/2019/2/e12895/ %U https://doi.org/10.2196/12895 %U http://www.ncbi.nlm.nih.gov/pubmed/30816847 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 5 %N 1 %P e10400 %T Video-Based Communication Assessment: Development of an Innovative System for Assessing Clinician-Patient Communication %A Mazor,Kathleen M %A King,Ann M %A Hoppe,Ruth B %A Kochersberger,Annie O %A Yan,Jie %A Reim,Jesse D %+ Meyers Primary Care Institute, University of Massachusetts Medical School, Reliant Medical Group and Fallon Health Plan, 385 Grove St, Meyers Primary Care Institute, Worcester, MA, 01605, United States, 1 508 791 7392, Kathleen.mazor@umassmed.edu %K communication %K crowdsourcing %K health care %K mobile phone %K patient-centered care %K video-based communication assessment %D 2019 %7 14.02.2019 %9 Viewpoint %J JMIR Med Educ %G English %X Good clinician-patient communication is essential to provide quality health care and is key to patient-centered care. However, individuals and organizations seeking to improve in this area face significant challenges. A major barrier is the absence of an efficient system for assessing clinicians’ communication skills and providing meaningful, individual-level feedback. The purpose of this paper is to describe the design and creation of the Video-Based Communication Assessment (VCA), an innovative, flexible system for assessing and ultimately enhancing clinicians’ communication skills. We began by developing the VCA concept. Specifically, we determined that it should be convenient and efficient, accessible via computer, tablet, or smartphone; be case based, using video patient vignettes to which users respond as if speaking to the patient in the vignette; be flexible, allowing content to be tailored to the purpose of the assessment; allow incorporation of the patient’s voice by crowdsourcing ratings from analog patients; provide robust feedback including ratings, links to highly rated responses as examples, and learning points; and ultimately, have strong psychometric properties. We collected feedback on the concept and then proceeded to create the system. We identified several important research questions, which will be answered in subsequent studies. The VCA is a flexible, innovative system for assessing clinician-patient communication. It enables efficient sampling of clinicians’ communication skills, supports crowdsourced ratings of these spoken samples using analog patients, and offers multifaceted feedback reports. %M 30710460 %R 10.2196/10400 %U http://mededu.jmir.org/2019/1/e10400/ %U https://doi.org/10.2196/10400 %U http://www.ncbi.nlm.nih.gov/pubmed/30710460 %0 Journal Article %@ 2291-5222 %I JMIR Publications %V 7 %N 1 %P e12637 %T Perspectives of Nonphysician Clinical Students and Medical Lecturers on Tablet-Based Health Care Practice Support for Medical Education in Zambia, Africa: Qualitative Study %A Barteit,Sandra %A Neuhann,Florian %A Bärnighausen,Till %A Bowa,Annel %A Lüders,Sigrid %A Malunga,Gregory %A Chileshe,Geoffrey %A Marimo,Clemence %A Jahn,Albrecht %+ Heidelberg Institute of Global Health, Im Neuenheimer Feld 130.3, Heidelberg, 69120, Germany, 49 06221 ext 5634030, barteit@uni-heidelberg.de %K educational technology %K computers, handheld %K computer-assisted decision making %K mobile apps %K information dissemination %K education %K allied health occupations %K Africa, Southern %K Zambia %D 2019 %7 15.1.2019 %9 Original Paper %J JMIR Mhealth Uhealth %G English %X Background: Zambia is faced with a severe shortage of health workers and challenges in national health financing. This burdens the medical licentiate practitioner (MLP) program for training nonphysician clinical students in Zambia because of the shortage of qualified medical lecturers and learning resources at training sites. To address this shortage and strengthen the MLP program, a self-directed electronic health (eHealth) platform was introduced, comprising technology-supported learning (e-learning) for medical education and support for health care practice. MLP students were provided with tablets that were preloaded with content for offline access. Objective: This study aimed to explore MLP students’ and medical lecturers’ perceptions of the self-directed eHealth platform with an offline-based tablet as a training and health care practice support tool during the first year of full implementation. Methods: We conducted in-depth qualitative interviews with 8 MLP students and 5 lecturers and 2 focus group discussions with 16 students to gain insights on perceptions of the usefulness, ease of use, and adequacy of self-directed e-learning and health care practice support accessible through the offline-based tablet. Participants were purposively sampled. Verbatim transcripts were analyzed following hypothesis coding. Results: The eHealth platform (e-platform), comprising e-learning for medical education and health care practice support, was positively received by students and medical lecturers and was seen as a step toward modernizing the MLP program. Tablets enabled equal access to offline learning contents, thus bridging the gap of slow or no internet connections. The study results indicated that the e-platform appears adequate to strengthen medical education within this low-resource setting. However, student self-reported usage was low, and medical lecturer usage was even lower. One stated reason was the lack of training in tablet usage and another was the quality of the tablets. The mediocre quality and quantity of most e-learning contents were perceived as a primary concern as materials were reported to be outdated, missing multimedia features, and addressing only part of the curriculum. Medical lecturers were noted to have little commitment to updating or creating new learning materials. Suggestions for improving the e-platform were given. Conclusions: To address identified major challenges, we plan to (1) introduce half-day training sessions at the beginning of each study year to better prepare users for tablet usage, (2) further update and expand e-learning content by fostering collaborations with MLP program stakeholders and nominating an e-platform coordinator, (3) set up an e-platform steering committee including medical lecturers, (4) incorporate e-learning and e-based health care practice support across the curriculum, as well as (5) implement processes to promote user-generated content. With these measures, we aim to sustainably strengthen the MLP program by implementing the tablet-based e-platform as a serious learning technology for medical education and health care practice support. %R 10.2196/12637 %U http://mhealth.jmir.org/2019/1/e12637/ %U https://doi.org/10.2196/12637 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 20 %N 5 %P e195 %T Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial %A Haubruck,Patrick %A Nickel,Felix %A Ober,Julian %A Walker,Tilman %A Bergdolt,Christian %A Friedrich,Mirco %A Müller-Stich,Beat Peter %A Forchheim,Franziska %A Fischer,Christian %A Schmidmaier,Gerhard %A Tanner,Michael C %+ Heidelberg Trauma Research Group, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200 a, Heidelberg, 69121, Germany, 49 06221 ext 5635987, patrick.haubruck@med.uni-heidelberg.de %K games, experimental %K education, professional %K general surgery %K emergency medicine %K problem-based learning %K chest tubes %K simulation training %K clinical competence %D 2018 %7 21.05.2018 %9 Original Paper %J J Med Internet Res %G English %X Background: The insertion of a chest tube should be as quick and accurate as possible to maximize the benefit and minimize possible complications for the patient. Therefore, comprehensive training and assessment before an emergency situation are essential for proficiency in chest tube insertion. Serious games have become more prevalent in surgical training because they enable students to study and train a procedure independently, and errors made have no effect on patients. However, up-to-date evidence regarding the effect of serious games on performance in procedures in emergency medicine remains scarce. Objective: The aim of this study was to investigate the serious gaming approach in teaching medical students an emergency procedure (chest tube insertion) using the app Touch Surgery and a modified objective structural assessment of technical skills (OSATS). Methods: In a prospective, rater-blinded, randomized controlled trial, medical students were randomized into two groups: intervention group or control group. Touch Surgery has been established as an innovative and cost-free app for mobile devices. The fully automatic software enables users to train medical procedures and afterwards self-assess their training effort. The module chest tube insertion teaches each key step in the insertion of a chest tube and enables users the meticulous application of a chest tube. In contrast, the module “Thoracocentesis” discusses a basic thoracocentesis. All students attended a lecture regarding chest tube insertion (regular curriculum) and afterwards received a Touch Surgery training lesson: intervention group used the module chest tube insertion and the control group used Thoracocentesis as control training. Participants’ performance in chest tube insertion on a porcine model was rated on-site via blinded face-to-face rating and via video recordings using a modified OSATS tool. Afterwards, every participant received an individual questionnaire for self-evaluation. Here, trainees gave information about their individual training level, as well as previous experiences, gender, and hobbies. Primary end point was operative performance during chest tube insertion by direct observance. Results: A total of 183 students enrolled, 116 students participated (63.4%), and 21 were excluded because of previous experiences in chest tube insertion. Students were randomized to the intervention group (49/95, 52%) and control group (46/95, 48%). The intervention group performed significantly better than the control group (Intervention group: 38.0 [I50=7.0] points; control group: 30.5 [I50=8.0] points; P<.001). The intervention group showed significantly improved economy of time and motion (P=.004), needed significantly less help (P<.001), and was more confident in handling of instruments (P<.001) than the control group. Conclusions: The results from this study show that serious games are a valid and effective tool in education of operative performance in chest tube insertion. We believe that serious games should be implemented in the surgical curriculum, as well as residency programs, in addition to traditional learning methods. Trial Registration: German Clinical Trials Register (DRKS) DRKS00009994; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00009994 (Archived by Webcite at http://www.webcitation.org/6ytWF1CWg) %M 29784634 %R 10.2196/jmir.9956 %U http://www.jmir.org/2018/5/e195/ %U https://doi.org/10.2196/jmir.9956 %U http://www.ncbi.nlm.nih.gov/pubmed/29784634 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 4 %N 1 %P e10 %T Improving Internal Medicine Residents’ Colorectal Cancer Screening Knowledge Using a Smartphone App: Pilot Study %A Khan,Zubair %A Darr,Umar %A Khan,Muhammad Ali %A Nawras,Mohamad %A Khalil,Basmah %A Abdel-Aziz,Yousef %A Alastal,Yaseen %A Barnett,William %A Sodeman,Thomas %A Nawras,Ali %+ Department of Internal Medicine, University of Toledo Medical Center, 3000 Arlington Avenue, Toledo, OH, 43614, United States, 1 4193834000, zubair.khan@utoledo.edu %K colorectal cancer %K cancer screening %K early detection of cancer %K residents’ education %K smartphone %K mobile apps %D 2018 %7 13.03.2018 %9 Original Paper %J JMIR Med Educ %G English %X Background: Colorectal cancer (CRC) is the third most common type of cancer and the second leading cause of cancer death in the United States. About one in three adults in the United States is not getting the CRC screening as recommended. Internal medicine residents are deficient in CRC screening knowledge. Objective: The objective of our study was to assess the improvement in internal medicine residents’ CRC screening knowledge via a pilot approach using a smartphone app. Methods: We designed a questionnaire based on the CRC screening guidelines of the American Cancer Society, American College of Gastroenterology, and US Preventive Services Task Force. We emailed the questionnaire via a SurveyMonkey link to all the residents of an internal medicine department to assess their knowledge of CRC screening guidelines. Then we designed an educational intervention in the form of a smartphone app containing all the knowledge about the CRC screening guidelines. The residents were introduced to the app and asked to download it onto their smartphones. We repeated the survey to test for changes in the residents’ knowledge after publication of the smartphone app and compared the responses with the previous survey. We applied the Pearson chi-square test and the Fisher exact test to look for statistical significance. Results: A total of 50 residents completed the first survey and 41 completed the second survey after publication of the app. Areas of CRC screening that showed statistically significant improvement (P<.05) were age at which CRC screening was started in African Americans, preventive tests being ordered first, identification of CRC screening tests, identification of preventive and detection methods, following up positive tests with colonoscopy, follow-up after colonoscopy findings, and CRC surveillance in diseases. Conclusions: In this modern era of smartphones and gadgets, developing a smartphone-based app or educational tool is a novel idea and can help improve residents’ knowledge about CRC screening. %M 29535080 %R 10.2196/mededu.9635 %U http://mededu.jmir.org/2018/1/e10/ %U https://doi.org/10.2196/mededu.9635 %U http://www.ncbi.nlm.nih.gov/pubmed/29535080 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 4 %N 1 %P e8 %T Mobile Technology in E-Learning for Undergraduate Medical Education on Emergent Otorhinolaryngology–Head and Neck Surgery Disorders: Pilot Randomized Controlled Trial %A Lee,Li-Ang %A Wang,Shu-Ling %A Chao,Yi-Ping %A Tsai,Ming-Shao %A Hsin,Li-Jen %A Kang,Chung-Jan %A Fu,Chia-Hsiang %A Chao,Wei-Chieh %A Huang,Chung-Guei %A Li,Hsueh-Yu %A Chuang,Cheng-Keng %+ Department of Surgery, Linkou Chang Gung Memorial Hospital, No 5, Fu-Hsing Street, Guishan District, Taoyuan, 33305, Taiwan, 886 33281200 ext 3971, chuang89@cgmh.org.tw %K e-learning %K gamification %K mobile technology %K randomized controlled trial %K video lecture %D 2018 %7 08.03.2018 %9 Original Paper %J JMIR Med Educ %G English %X Background: The use of mobile technology in e-learning (M-TEL) can add new levels of experience and significantly increase the attractiveness of e-learning in medical education. Whether an innovative interactive e-learning multimedia (IM) module or a conventional PowerPoint show (PPS) module using M-TEL to teach emergent otorhinolaryngology–head and neck surgery (ORL-HNS) disorders is feasible and efficient in undergraduate medical students is unknown. Objective: The aim of this study was to compare the impact of a novel IM module with a conventional PPS module using M-TEL for emergent ORL-HNS disorders with regard to learning outcomes, satisfaction, and learning experience. Methods: This pilot study was conducted at an academic teaching hospital and included 24 undergraduate medical students who were novices in ORL-HNS. The cognitive style was determined using the Group Embedded Figures Test. The participants were randomly allocated (1:1) to one of the two groups matched by age, sex, and cognitive style: the IM group and the PPS group. During the 100-min learning period, the participants were unblinded to use the IM or PPS courseware on a 7-inch tablet. Pretests and posttests using multiple-choice questions to evaluate knowledge and multimedia situational tests to evaluate competence were administered. Participants evaluated their satisfaction and learning experience by the AttrakDiff2 questionnaire, and provided feedback about the modules. Results: Overall, the participants had significant gains in knowledge (median of percentage change 71, 95% CI 1-100, P<.001) and competence (median of percentage change 25, 95% CI 0-33, P=.007) after 100 min of learning. Although there was no significant difference in knowledge gain between the two groups (median of difference of percentage change 24, 95% CI −75 to 36; P=.55), competence gain was significantly lower in the IM group compared with the PPS group (median of difference of percentage change −41, 95% CI −67 to −20; P=.008). However, the IM group had significantly higher scores of satisfaction (difference 2, 95% CI 2-4; P=.01), pragmatic quality (difference 1.7, 95% CI 0.1-2.7; P=.03), and hedonic stimulation (difference 1.9, 95% CI 0.3-3.1; P=.01) compared with the PPS group. Qualitative feedback indicated that the various games in the IM module attracted the participants’ attention but that the nonlinearly arranged materials affected their learning. Conclusions: Using M-TEL for undergraduate medical education on emergent ORL-HNS disorders, an IM module seems to be useful for gaining knowledge, but competency may need to occur elsewhere. While the small sample size reduces the statistical power of our results, its design seems to be appropriate to determine the effects of M-TEL using a larger group. Trial Registration: ClinicalTrials.gov NCT02971735; https://clinicaltrials.gov/ct2/show/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV) %M 29519776 %R 10.2196/mededu.9237 %U http://mededu.jmir.org/2018/1/e8/ %U https://doi.org/10.2196/mededu.9237 %U http://www.ncbi.nlm.nih.gov/pubmed/29519776 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 4 %N 1 %P e7 %T Self-Reflected Well-Being via a Smartphone App in Clinical Medical Students: Feasibility Study %A Berryman,Elizabeth K %A Leonard,Daniel J %A Gray,Andrew R %A Pinnock,Ralph %A Taylor,Barry %+ Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand, 64 274067940, berel235@student.otago.ac.nz %K mental health %K medical students %K medical education %K bullying %K teaching %K mhealth %D 2018 %7 07.03.2018 %9 Original Paper %J JMIR Med Educ %G English %X Background: Well-being in medical students has become an area of concern, with a number of studies reporting high rates of clinical depression, anxiety, burnout, and suicidal ideation in this population. Objective: The aim of this study was to increase awareness of well-being in medical students by using a smartphone app. The primary objective of this study was to determine the validity and feasibility of the Particip8 app for student self-reflected well-being data collection. Methods: Undergraduate medical students of the Dunedin School of Medicine were recruited into the study. They were asked to self-reflect daily on their well-being and to note what experiences they had encountered during that day. Qualitative data were also collected both before and after the study in the form of focus groups and “free-text” email surveys. All participants consented for the data collected to be anonymously reported to the medical faculty. Results: A total of 29 participants (69%, 20/29 female; 31%, 9/29 male; aged 21-30 years) were enrolled, with overall median compliance of 71% at the study day level. The self-reflected well-being scores were associated with both positive and negative experiences described by the participants, with most negative experiences associated with around 20% lower well-being scores for that day; the largest effect being “receiving feedback that was not constructive or helpful,” and the most positive experiences associated with around 20% higher scores for that day. Conclusions: The study of daily data collection via the Particip8 app was found to be feasible, and the self-reflected well-being scores showed validity against participant’s reflections of experiences during that day. %M 29514774 %R 10.2196/mededu.9128 %U http://mededu.jmir.org/2018/1/e7/ %U https://doi.org/10.2196/mededu.9128 %U http://www.ncbi.nlm.nih.gov/pubmed/29514774 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 20 %N 2 %P e56 %T Cognitive Style and Mobile E-Learning in Emergent Otorhinolaryngology-Head and Neck Surgery Disorders for Millennial Undergraduate Medical Students: Randomized Controlled Trial %A Lee,Li-Ang %A Chao,Yi-Ping %A Huang,Chung-Guei %A Fang,Ji-Tseng %A Wang,Shu-Ling %A Chuang,Cheng-Keng %A Kang,Chung-Jan %A Hsin,Li-Jen %A Lin,Wan-Ni %A Fang,Tuan-Jen %A Li,Hsueh-Yu %+ Department of Otorhinolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Guishan District, Taoyuan, 33305, Taiwan, 886 33281200 ext 3972, 5738@cgmh.org.tw %K cognitive style %K e-learning %K mobile technology %K randomized controlled trial %D 2018 %7 13.02.2018 %9 Original Paper %J J Med Internet Res %G English %X Background: Electronic learning (e-learning) through mobile technology represents a novel way to teach emergent otorhinolaryngology-head and neck surgery (ORL-HNS) disorders to undergraduate medical students. Whether a cognitive style of education combined with learning modules can impact learning outcomes and satisfaction in millennial medical students is unknown. Objective: The aim of this study was to assess the impact of cognitive styles and learning modules using mobile e-learning on knowledge gain, competence gain, and satisfaction for emergent ORL-HNS disorders. Methods: This randomized controlled trial included 60 undergraduate medical students who were novices in ORL-HNS at an academic teaching hospital. The cognitive style of the participants was assessed using the group embedded figures test. The students were randomly assigned (1:1) to a novel interactive multimedia (IM) group and conventional Microsoft PowerPoint show (PPS) group matched by age, sex, and cognitive style. The content for the gamified IM module was derived from and corresponded to the textbook-based learning material of the PPS module (video lectures). The participants were unblinded and used fully automated courseware containing the IM or PPS module on a 7-inch tablet for 100 min. Knowledge and competence were assessed using multiple-choice questions and multimedia situation tests, respectively. Each participant also rated their global satisfaction. Results: All of the participants (median age 23 years, range 22-26 years; 36 males and 24 females) received the intended intervention after randomization. Overall, the participants had significant gains in knowledge (median 50%, interquartile range [IQR]=17%-80%, P<.001) and competence (median 13%, IQR=0%-33%, P=.006). There were no significant differences in knowledge gain (40%, IQR=13%-76% vs 60%, IQR=20%-100%, P=.42) and competence gain (0%, IQR= −21% to 38% vs 25%, IQR=0%-33%, P=.16) between the IM and PPS groups. However, the IM group had a higher satisfaction score (8, IQR=6-9 vs 6, IQR=4-7, P=.01) compared with the PPS group. Using Friedman’s two-way nonparametric analysis of variance, cognitive styles (field-independent, field-intermediate, or field-dependent classification) and learning modules (IM or PPS) had significant effects on both knowledge gain (both adjusted P<.001) and satisfaction (both adjusted P<.001). Conclusions: Mobile e-learning is an effective modality to improve knowledge of emergent ORL-HNS in millennial undergraduate medical students. Our findings suggest the necessity of developing various modules for undergraduate medical students with different cognitive styles. Trial Registration: Clinicaltrials.gov NCT02971735; https://clinicaltrials.gov/ct2/show/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV) %M 29439943 %R 10.2196/jmir.8987 %U http://www.jmir.org/2018/2/e56/ %U https://doi.org/10.2196/jmir.8987 %U http://www.ncbi.nlm.nih.gov/pubmed/29439943 %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 e15 %T Mobile Apps for Teaching Intubation: Scoping Review and Critical Analysis in eLearning %A Matava,Clyde %A Leo,Anne-Marie %A Alam,Fahad %+ Hospital for Sick Children, Anesthesia and Pain Medicine, 555 University Avenue, Toronto, ON,, Canada, 1 416 813 7445, clyde.matava@sickkids.ca %K anesthesia %K apps %K eLearning %K mLearning %K intubation %K difficult airway %K residents %K anesthesiology %D 2017 %7 05.09.2017 %9 Original Paper %J JMIR Med Educ %G English %X Background: Airway management is a core skill in anesthesia ensuring adequate oxygenation and delivery of inhalational agents for the patient. Objective: The goals of this study were to critically evaluate the quality of airway management apps and target revised Bloom's Taxonomy cognitive levels. Methods: An electronic search using the keywords “airway” and “airway management” was conducted in May 2015 across the App Store, Google Play, BlackBerry World, and Windows Store. Apps were included in the study if their content was related to airway management. App content and characteristics were extracted into a standard form and evaluated. Results: A total of 65 apps met the inclusion criteria, and 73% (47/65) of apps were developed by companies or industry. Anesthesiology trainees were the target audience in only 20% (13/65) of apps. Bag mask ventilation and laryngeal mask airways were covered in only 20% (13/65) of apps. Only 2 apps were supported in the scientific literature. For Bloom’s Taxonomy, 37% (24/65) of apps targeted knowledge, 5% (3/65) comprehension, 22% (14/65) application, 28% (18/65) analysis, 9% (6/65) evaluation, and 0% synthesis. Multivariate analysis identified cost of apps, size of apps (MB), and apps targeting trainees and paramedics to be associated with higher levels of cognitive processing of revised Bloom’s Taxonomy. Conclusions: Apps developed for teaching intubation target lower levels of cognitive processing and are largely not validated by research. Cost, app size, and targeted user are associated with higher cognitive levels. Trainees and all users should be aware of the paucity of the published evidence behind the efficacy of some of these apps. %M 28874335 %R 10.2196/mededu.7919 %U http://mededu.jmir.org/2017/2/e15/ %U https://doi.org/10.2196/mededu.7919 %U http://www.ncbi.nlm.nih.gov/pubmed/28874335 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 3 %N 1 %P e6 %T The Coags Uncomplicated App: Fulfilling Educational Gaps Around Diagnosis and Laboratory Testing of Coagulation Disorders %A Kessler,Craig %A Peerschke,Ellinor I %A Chitlur,Meera B %A Kulkarni,Roshni %A Holot,Natalia %A Cooper,David L %+ Georgetown University Medical Center, Lombardi Cancer Center, Podium A, 3700 Reservoir Road, NW, Washington, DC, 20007, United States, 1 (202) 444 8676, KESSLERC@gunet.georgetown.edu %K blood coagulation disorders %K smartphone %K diagnosis %K hematology %K differential diagnosis %D 2017 %7 18.04.2017 %9 Original Paper %J JMIR Med Educ %G English %X Background: Patients with coagulation disorders may present to a variety of physician specialties; however, accurate and efficient diagnosis can be challenging for physicians not specialized in hematology, due to identified gaps in knowledge around appropriate laboratory assays and interpretation of test results. Coags Uncomplicated was developed to fill this unmet educational need by increasing practical knowledge of coagulation disorders among nonexpert physicians and other health care professionals (HCPs) in a point-of-care (POC) setting. Objective: The aim of this study was to assess patterns of use of the mobile app Coags Uncomplicated, a tool designed to support education regarding accurate and efficient diagnosis of bleeding disorders. Methods: App metrics were obtained by tracking registered user data. Additionally, a survey was distributed to registered users, to assess circumstances and frequency of use. Results: The most common specialties of 7596 registered US users were hematology-oncology (n=1534, 20.19%), hematology (n=1014, 13.35%), and emergency medicine (n=1222, 16.09%); most identified as physicians (n=4082, 53.74%). Specialties accounting for the greatest numbers of screen views were hematology-oncology (99,390 views), hematology (47,808 views), emergency medicine (23,121 views), and internal medicine (22,586 views). The most common diagnostic endpoints reached were disseminated intravascular coagulation (DIC; 2713 times), liver disease effect (2108 times), and vitamin K deficiency (1584 times). Of 3424 users asked to take the survey, 262 responded (7.65%); most were physicians in direct clinical care (71%) and specialized in hematology-oncology (39%) or emergency medicine (21%). Most frequent use was reported by hematologists (69%, ≥6 times) and hematologists-oncologists (38%, ≥6 times). Most physicians (89.2%) reported using the app for patient-case-related education around appropriate use of laboratory tests in diagnostic evaluation. Physicians rated Lab Value Analyzer (mean 4.43) and Lab Test Algorithm (mean 4.46) tools highly on a 5-point “how helpful” scale and were likely to recommend the app to colleagues. Conclusions: App use among physicians and other HCPs is consistent with value as a POC educational tool, which may facilitate differential diagnoses and appropriate early consultation with hematologists. %M 28420603 %R 10.2196/mededu.6858 %U http://mededu.jmir.org/2017/1/e6/ %U https://doi.org/10.2196/mededu.6858 %U http://www.ncbi.nlm.nih.gov/pubmed/28420603 %0 Journal Article %@ 2369-3762 %I JMIR Publications %V 2 %N 1 %P e7 %T Enabling Access to Medical and Health Education in Rwanda Using Mobile Technology: Needs Assessment for the Development of Mobile Medical Educator Apps %A Rusatira,Jean Christophe %A Tomaszewski,Brian %A Dusabejambo,Vincent %A Ndayiragije,Vincent %A Gonsalves,Snedden %A Sawant,Aishwarya %A Mumararungu,Angeline %A Gasana,George %A Amendezo,Etienne %A Haake,Anne %A Mutesa,Leon %+ College of Medicine and Health Sciences, University of Rwanda, KN 73 ST, Kigali, 3286, Rwanda, 250 788665979, rusatirac2001@gmail.com %K mobile medical education %K technology %K user-centered design %D 2016 %7 01.06.2016 %9 Original Paper %J JMIR Med Educ %G English %X Background: Lack of access to health and medical education resources for doctors in the developing world is a serious global health problem. In Rwanda, with a population of 11 million, there is only one medical school, hence a shortage in well-trained medical staff. The growth of interactive health technologies has played a role in the improvement of health care in developed countries and has offered alternative ways to offer continuous medical education while improving patient's care. However, low and middle-income countries (LMIC) like Rwanda have struggled to implement medical education technologies adapted to local settings in medical practice and continuing education. Developing a user-centered mobile computing approach for medical and health education programs has potential to bring continuous medical education to doctors in rural and urban areas of Rwanda and influence patient care outcomes. Objective: The aim of this study is to determine user requirements, currently available resources, and perspectives for potential medical education technologies in Rwanda. Methods: Information baseline and needs assessments data collection were conducted in all 44 district hospitals (DHs) throughout Rwanda. The research team collected qualitative data through interviews with 16 general practitioners working across Rwanda and 97 self-administered online questionnaires for rural areas. Data were collected and analyzed to address two key questions: (1) what are the currently available tools for the use of mobile-based technology for medical education in Rwanda, and (2) what are user's requirements for the creation of a mobile medical education technology in Rwanda? Results: General practitioners from different hospitals highlighted that none of the available technologies avail local resources such as the Ministry of Health (MOH) clinical treatment guidelines. Considering the number of patients that doctors see in Rwanda, an average of 32 patients per day, there is need for a locally adapted mobile education app that utilizes specific Rwandan medical education resources. Based on our results, we propose a mobile medical education app that could provide many benefits such as rapid decision making with lower error rates, increasing the quality of data management and accessibility, and improving practice efficiency and knowledge. In areas where Internet access is limited, the proposed mobile medical education app would need to run on a mobile device without Internet access. Conclusions: A user-centered design approach was adopted, starting with a needs assessment with representative end users, which provided recommendations for the development of a mobile medical education app specific to Rwanda. Specific app features were identified through the needs assessment and it was evident that there will be future benefits to ongoing incorporation of user-centered design methods to better inform the software development and improve its usability. Results of the user-centered design reported here can inform other medical education technology developments in LMIC to ensure that technologies developed are usable by all stakeholders. %M 27731861 %R 10.2196/mededu.5336 %U http://mededu.jmir.org/2016/1/e7/ %U https://doi.org/10.2196/mededu.5336 %U http://www.ncbi.nlm.nih.gov/pubmed/27731861 %0 Journal Article %@ 2291-5222 %I JMIR Publications Inc. %V 4 %N 2 %P e61 %T Mobile Phone Use Among Medical Residents: A Cross-Sectional Multicenter Survey in Saudi Arabia %A Jamal,Amr %A Temsah,Mohamad-Hani %A Khan,Samina A %A Al-Eyadhy,Ayman %A Koppel,Cristina %A Chiang,Michael F %+ College of Medicine, Department of Family and Community Medicine, King Saud University, PO Box 90714, Riyadh, 11623, Saudi Arabia, 966 114690822, amrjamal@ksu.edu.sa %K cell phones %K mobile phone %K telemedicine %K medical education %K medical residencies %K educational techniques %K patient care %K communication methods %K WhatsApp %K Saudi Arabia %K point of care technology %D 2016 %7 19.05.2016 %9 Original Paper %J JMIR Mhealth Uhealth %G English %X Background: Mobile phones have great potential for medical education, as they allow health care providers and students to access resources efficiently at the precise time at the point-of-care to help in informed decision making. Objective: The objective of the study was to evaluate the prevalence of mobile phone usage among medical residents and to explore their attitudes, perceptions, and the challenges they experience when using mobile phones in academic and clinical practice. Methods: A cross-sectional survey was conducted on all 133 residents in 17 different specialties across two large academic hospitals in Riyadh, Saudi Arabia. The Web-based validated questionnaire measured mobile phone platform preferences, and their uses in general and medical practice. The perception of confidentiality and safety impact of using mobile phones for communication and accessing patient’s data was also explored, alongside challenges of use and how residents learn to use their mobile phone. Results: With a response rate of 101/133 (75.9%) and mean age of 27.8 (SD 3.0) years, we found that 100/101 (99.0%) of participants were mobile phone users with mean duration of use of 5.12 (SD 2.4) years, and a range from 1 to 12 years. There was no significant difference in use between male and female respondents. A negative linear correlation was found between age and use duration (P=.004). The most common operating system used by participants was the iOS platform (55/101, 54.5%), with English the most commonly used language to operate residents’ mobile phones (96/100, 96.0%) despite their native language being Arabic. For communication outside medical practice, chatting applications such as WhatsApp matched phone calls as most commonly used tools (each 88/101, 87.1%). These were also the primary tools for medical communication, but used at a lower rate (each 65/101, 64.4%). In medical practice, drug (83/101, 82.2%) and medical (80/101, 79.2%) references and medical calculation applications (61/101, 60.4%) were the most commonly used. Short battery life (48/92, 52%) was the most common technical difficulty, and distraction at least on a weekly basis (54/92, 58%) was the most likely side effect of using a mobile phone in medical practice. Practically, all participants agreed with the idea of integrating medical staff mobile phones with the hospital information system. Most residents described themselves as self-learners, while half learned from peers, and a quarter learned from the Internet. Only 7/101 (6.9%) had received formal training on the medical use of mobile phones. Over half of residents thought it was safe to discuss patients over their personal, nonencrypted email. Conclusions: Mobile phone use among medical residents has become almost universal in academic and clinical settings. Thus, academic and health care institutions should support proper utilization of these devices in medical training and point-of-care decision making, while continuing to protect patient confidentiality. %M 27197618 %R 10.2196/mhealth.4904 %U http://mhealth.jmir.org/2016/2/e61/ %U https://doi.org/10.2196/mhealth.4904 %U http://www.ncbi.nlm.nih.gov/pubmed/27197618 %0 Journal Article %@ 2291-5222 %I JMIR Publications Inc. %V 4 %N 2 %P e55 %T Enhancing Pharmacy Student Learning and Perceptions of Medical Apps %A Rodis,Jennifer %A Aungst,Timothy Dy %A Brown,Nicole V %A Cui,Yan %A Tam,Leonard %+ The Ohio State University College of Pharmacy, Division of Pharmacy Practice and Science, 500 W. 12th Ave, Columbus, OH, 43210, United States, 1 614 247 8391, rodis.2@osu.edu %K mobile applications %K pharmacy %K students %K health care %D 2016 %7 12.05.2016 %9 Original Paper %J JMIR mHealth uHealth %G English %X Background: The use of mobile apps in health care is growing. Current and future practitioners must be equipped with the skills to navigate and utilize apps in patient care, yet few strategies exist for training health care professional students on the usage of apps. Objective: To characterize first-year pharmacy student use of medical apps, evaluate first-year pharmacy student's perception of skills in finding, evaluating, and using medical apps before and after a focused learning experience, and assess student satisfaction and areas for improvement regarding the learning experience. Methods: Students listened to a recorded, Web-based lecture on finding, evaluating, and using mobile apps in patient care. A 2-hour, interactive workshop was conducted during which students were led by an instructor through a discussion on strategies for finding and using apps in health care. The students practiced evaluating 6 different health care–related apps. Surveys were conducted before and after the focused learning experience to assess students' perceptions of medical apps and current use and perspectives on satisfaction with the learning experience and role of technology in health care. Results: This educational intervention is the first described formal, interactive method to educate student pharmacists on medical apps. With a 99% response rate, surveys conducted before and after the learning experience displayed perceived improvement in student skills related to finding (52/119, 44% before vs 114/120, 95% after), evaluating (18/119, 15% before vs 112/120, 93% after), and using medical apps in patient care (31/119, 26% before vs 108/120, 90% after) and the health sciences classroom (38/119, 32% before vs 104/120, 87% after). Students described satisfaction with the educational experience and agreed that it should be repeated in subsequent years (89/120, 74% agreed or strongly agreed). Most students surveyed possessed portable electronic devices (107/119, 90% mobile phone) and agreed with the concept of medical apps being an important part of the health care profession in the future (112/119, 94% before and 115/120, 96% after). Conclusions: Student pharmacists recognize the key role technology plays in the future of health care. A medical apps workshop was successful in improving student pharmacists' perceptions of ability to find, evaluate, and use medical apps. %M 27174684 %R 10.2196/mhealth.4843 %U http://mhealth.jmir.org/2016/2/e55/ %U https://doi.org/10.2196/mhealth.4843 %U http://www.ncbi.nlm.nih.gov/pubmed/27174684 %0 Journal Article %@ 2369-3762 %I JMIR Publications Inc. %V 1 %N 2 %P e10 %T Design of Mobile Augmented Reality in Health Care Education: A Theory-Driven Framework %A Zhu,Egui %A Lilienthal,Anneliese %A Shluzas,Lauren Aquino %A Masiello,Italo %A Zary,Nabil %+ Centre for Learning and Knowledge, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 3th Floor, Tomtebodavägen 18a, Stockholm, 171 77, Sweden, 46 8 524 83711, egui.zhu@ki.se %K augmented reality %K health care education %K antibiotics %K general practitioners %K learning environment %K learning theory %K mobile technology %D 2015 %7 18.09.2015 %9 Original Paper %J JMIR Medical Education %G English %X Background: Augmented reality (AR) is increasingly used across a range of subject areas in health care education as health care settings partner to bridge the gap between knowledge and practice. As the first contact with patients, general practitioners (GPs) are important in the battle against a global health threat, the spread of antibiotic resistance. AR has potential as a practical tool for GPs to combine learning and practice in the rational use of antibiotics. Objective: This paper was driven by learning theory to develop a mobile augmented reality education (MARE) design framework. The primary goal of the framework is to guide the development of AR educational apps. This study focuses on (1) identifying suitable learning theories for guiding the design of AR education apps, (2) integrating learning outcomes and learning theories to support health care education through AR, and (3) applying the design framework in the context of improving GPs’ rational use of antibiotics. Methods: The design framework was first constructed with the conceptual framework analysis method. Data were collected from multidisciplinary publications and reference materials and were analyzed with directed content analysis to identify key concepts and their relationships. Then the design framework was applied to a health care educational challenge. Results: The proposed MARE framework consists of three hierarchical layers: the foundation, function, and outcome layers. Three learning theories—situated, experiential, and transformative learning—provide foundational support based on differing views of the relationships among learning, practice, and the environment. The function layer depends upon the learners’ personal paradigms and indicates how health care learning could be achieved with MARE. The outcome layer analyzes different learning abilities, from knowledge to the practice level, to clarify learning objectives and expectations and to avoid teaching pitched at the wrong level. Suggestions for learning activities and the requirements of the learning environment form the foundation for AR to fill the gap between learning outcomes and medical learners’ personal paradigms. With the design framework, the expected rational use of antibiotics by GPs is described and is easy to execute and evaluate. The comparison of specific expected abilities with the GP personal paradigm helps solidify the GP practical learning objectives and helps design the learning environment and activities. The learning environment and activities were supported by learning theories. Conclusions: This paper describes a framework for guiding the design, development, and application of mobile AR for medical education in the health care setting. The framework is theory driven with an understanding of the characteristics of AR and specific medical disciplines toward helping medical education improve professional development from knowledge to practice. Future research will use the framework as a guide for developing AR apps in practice to validate and improve the design framework. %M 27731839 %R 10.2196/mededu.4443 %U http://mededu.jmir.org/2015/2/e10/ %U https://doi.org/10.2196/mededu.4443 %U http://www.ncbi.nlm.nih.gov/pubmed/27731839 %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 %0 Journal Article %@ 14388871 %I JMIR Publications Inc. %V 16 %N 3 %P e89 %T Smartphone Apps for Cardiopulmonary Resuscitation Training and Real Incident Support: A Mixed-Methods Evaluation Study %A Kalz,Marco %A Lenssen,Niklas %A Felzen,Marc %A Rossaint,Rolf %A Tabuenca,Bernardo %A Specht,Marcus %A Skorning,Max %+ Welten Institute-Research Centre for Learning, Teaching and Technology, Open University of the Netherlands, PO Box 2960, Heerlen, 6401 DL, Netherlands, 31 455762718, marco.kalz@ou.nl %K basic life support (BLS) %K cardiopulmonary resuscitation (CPR) %K external chest compression (ECC) %K smartphone apps %K mobile phone %K mobile health %D 2014 %7 19.03.2014 %9 Original Paper %J J Med Internet Res %G English %X Background: No systematic evaluation of smartphone/mobile apps for resuscitation training and real incident support is available to date. To provide medical, usability, and additional quality criteria for the development of apps, we conducted a mixed-methods sequential evaluation combining the perspective of medical experts and end-users. Objective: The study aims to assess the quality of current mobile apps for cardiopulmonary resuscitation (CPR) training and real incident support from expert as well as end-user perspective. Methods: Two independent medical experts evaluated the medical content of CPR apps from the Google Play store and the Apple App store. The evaluation was based on pre-defined minimum medical content requirements according to current Basic Life Support (BLS) guidelines. In a second phase, non-medical end-users tested usability and appeal of the apps that had at least met the minimum requirements. Usability was assessed with the System Usability Scale (SUS); appeal was measured with the self-developed ReactionDeck toolkit. Results: Out of 61 apps, 46 were included in the experts’ evaluation. A consolidated list of 13 apps resulted for the following layperson evaluation. The interrater reliability was substantial (kappa=.61). Layperson end-users (n=14) had a high interrater reliability (intraclass correlation 1 [ICC1]=.83, P<.001, 95% CI 0.75-0.882 and ICC2=.79, P<.001, 95% CI 0.695-0.869). Their evaluation resulted in a list of 5 recommendable apps. Conclusions: Although several apps for resuscitation training and real incident support are available, very few are designed according to current BLS guidelines and offer an acceptable level of usability and hedonic quality for laypersons. The results of this study are intended to optimize the development of CPR mobile apps. The app ranking supports the informed selection of mobile apps for training situations and CPR campaigns as well as for real incident support. %M 24647361 %R 10.2196/jmir.2951 %U http://www.jmir.org/2014/3/e89/ %U https://doi.org/10.2196/jmir.2951 %U http://www.ncbi.nlm.nih.gov/pubmed/24647361