TY - JOUR AU - Chevalier, Aline AU - Dosso, Cheyenne PY - 2025/4/17 TI - The Influence of Medical Expertise and Information Search Skills on Medical Information Searching: Comparative Analysis From a Free Data Set JO - JMIR Form Res SP - e62754 VL - 9 KW - information searching KW - credibility KW - internet KW - medicine KW - information search skills N2 - Background: Nowadays, the internet has become the primary source of information for physicians seeking answers to medical questions about their patients before consulting colleagues. However, many websites provide low-quality, unreliable information that lacks scientific validation. Therefore, physicians must develop strong information search skills to locate relevant, accurate, and evidence-based content. However, previous studies have shown that physicians often have poor search skills and struggle to find information on the web, which may have detrimental consequences for patient care. Objective: This study aims to determine how medical students and residents searched for medical information on the internet, the quality of the web resources they used (including their nature and credibility), and how they evaluated the reliability of these resources and the answers they provided. Given the importance of domain knowledge (in this case, medicine) and information search skills in the search process, we compared the search behaviors of medical students and residents with those of computer science students. While medical students and residents possess greater medical-related knowledge, computer science students have stronger information search skills. Methods: A total of 20 students participated in this study: 10 medical students and residents, and 10 computer science students. Data were extracted from a freely accessible data set in accordance with FAIR (Findable, Accessible, Interoperable, and Reusable) principles. All participants searched for medical information online to make a diagnosis, select a treatment, and enhance their knowledge of a medical condition?3 primary activities they commonly perform. We analyzed search performance metrics, including search time, the use of medical-related keywords, and the accuracy of the information found, as well as the nature and credibility of web resources used by medical students and residents compared with computer science students. Results: Medical students and residents provided more accurate answers than computer science students without requiring additional time. Their medical expertise also enabled them to better assess the reliability of resources and select high-quality web sources, primarily from hospital websites. However, it is noteworthy that they made limited use of evidence-based tools such as PubMed. Conclusions: Although medical students and residents generally outperformed computer science students, they did not frequently use evidence-based tools. As previously observed, they may avoid databases due to the risk of encountering too many irrelevant articles and difficulties in applying appropriate filters to locate relevant information. Nevertheless, clinical and practical evidence-based medicine plays a crucial role in updating physicians? knowledge, improving patient care, and enhancing physician-patient relationships. Therefore, information search skills should be an integral part of medical education and continuing professional development for physicians. UR - https://formative.jmir.org/2025/1/e62754 UR - http://dx.doi.org/10.2196/62754 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/62754 ER - TY - JOUR AU - Yao, Steven Michael AU - Huang, Lawrence AU - Leventhal, Emily AU - Sun, Clara AU - Stephen, J. Steve AU - Liou, Lathan PY - 2025/4/16 TI - Leveraging Datathons to Teach AI in Undergraduate Medical Education: Case Study JO - JMIR Med Educ SP - e63602 VL - 11 KW - data science education KW - datathon KW - machine learning KW - artificial intelligence KW - undergraduate medical education N2 - Background: As artificial intelligence and machine learning become increasingly influential in clinical practice, it is critical for future physicians to understand how such novel technologies will impact the delivery of patient care. Objective: We describe 2 trainee-led, multi-institutional datathons as an effective means of teaching key data science and machine learning skills to medical trainees. We offer key insights on the practical implementation of such datathons and analyze experiences gained and lessons learned for future datathon initiatives. Methods: We detail 2 recent datathons organized by MDplus, a national trainee-led nonprofit organization. To assess the efficacy of the datathon as an educational experience, an opt-in postdatathon survey was sent to all registered participants. Survey responses were deidentified and anonymized before downstream analysis to assess the quality of datathon experiences and areas for future work. Results: Our digital datathons between 2023 and 2024 were attended by approximately 200 medical trainees across the United States. A diverse array of medical specialty interests was represented among participants, with 43% (21/49) of survey participants expressing an interest in internal medicine, 35% (17/49) in surgery, and 22% (11/49) in radiology. Participant skills in leveraging Python for analyzing medical datasets improved after the datathon, and survey respondents enjoyed participating in the datathon. Conclusions: The datathon proved to be an effective and cost-effective means of providing medical trainees the opportunity to collaborate on data-driven projects in health care. Participants agreed that datathons improved their ability to generate clinically meaningful insights from data. Our results suggest that datathons can serve as valuable and effective educational experiences for medical trainees to become better skilled in leveraging data science and artificial intelligence for patient care. UR - https://mededu.jmir.org/2025/1/e63602 UR - http://dx.doi.org/10.2196/63602 ID - info:doi/10.2196/63602 ER - TY - JOUR AU - Munir, Mamoon Malik AU - Ahmed, Nabil PY - 2025/4/7 TI - Using Social Media Platforms to Raise Health Awareness and Increase Health Education in Pakistan: Structural Equation Modeling Analysis and Questionnaire Study JO - JMIR Hum Factors SP - e65745 VL - 12 KW - social media KW - health awareness KW - health education KW - innovation diffusion theory KW - structural equation modeling KW - disease burden KW - healthcare facilities KW - health professionals KW - misinformation KW - cost effective N2 - Background: Current health care education methods in Pakistan use traditional media (eg, television and radio), community health workers, and printed materials, which often fall short of reach and engagement among most of the population. The health care sector in Pakistan has not yet used social media effectively to raise awareness and provide education about diseases. Research on the impact social media can have on health care education in Pakistan may expand current efforts, engage a wider audience, and reduce the disease burden on health care facilities. Objective: This study aims to evaluate the perceptions of health care professionals and paramedic staff regarding social media use to raise awareness and educate people about diseases as a potential means of reducing the disease burden in Pakistan. Methods: The study used two-stage structural equation modeling (SEM). Data analysis used AMOS 26.0 software, adopting scales from previous literature. Four-item scales for each social media usefulness and health awareness construct and 8-item scales for health care education constructs were adopted on the basis of their higher loading in alignment with psychometric literature. A 7-point Likert scale was used to measure each item. Data collection used convenience sampling, with questionnaires distributed to more than 450 health care professionals and paramedic staff from 2 private hospitals in Lahore, Pakistan. There were 389 useful responses received. However, 340 completed questionnaires were included in the data analysis. Results: The study found that all the squared multiple correlation (SMC) values were greater than 0.30. Furthermore, convergent validity was measured using (1) standardized factor loading (found greater than 0.5), (2) average variance explained (found greater than 0.5), and (3) composite reliability (found greater than 0.7). The confirmatory factor analysis (CFA) of the measurement model indicated the fitness of the constructs (Chi-square minimum [CMIN]=357.62; CMIN/degrees of freedom [DF]=1.80; Goodness of Fit [GFI]=0.90; Adjusted Goodness of Fit Index [AGFI]=0.89; Buntler-Bonett Normed Fit Index [NFI]=0:915; Comparative Fit Index [CFI]=0:93; Root Mean Square Residual [RMR]=0:075; Root Mean Square Error of Approximation [RMSEA]=0:055). Moreover, the structural model fitness was also confirmed (CMIN=488.6; CMIN/DF=1.85; GFI=0.861; AGFI=0.893; NFI=0.987; CFI=0.945; RMR=0:079; RMSEA=0.053). Hence, the results indicated that social media usefulness has a positive and significant effect on health awareness (hypothesis 1: ?=.669, P<.001), and health awareness has a positive and significant effect on health care education in Pakistan (hypothesis 2: ?=.557, P<.001). Conclusions: This study concludes that health care professionals and paramedic staff in private hospitals support the use of social media to raise awareness and provide health care education. It is considered an effective tool for reducing the disease burden in Pakistan. The study results also revealed that young health care professionals are more inclined toward social media usage and express the need for legislation to support it and establish a monitoring process to avoid misinformation. UR - https://humanfactors.jmir.org/2025/1/e65745 UR - http://dx.doi.org/10.2196/65745 ID - info:doi/10.2196/65745 ER - TY - JOUR AU - Zhang, Zheyuan AU - Sun, Sijin AU - Moradbakhti, Laura AU - Hall, Andrew AU - Mougenot, Celine AU - Chen, Juan AU - Calvo, A. Rafael PY - 2025/4/4 TI - Health Care Professionals' Engagement With Digital Mental Health Interventions in the United Kingdom and China: Mixed Methods Study on Engagement Factors and Design Implications JO - JMIR Ment Health SP - e67190 VL - 12 KW - burnout KW - digital mental health interventions KW - engagement KW - eHealth KW - design KW - health care professional KW - health care workers KW - United Kingdom KW - UK KW - China KW - Chinese KW - occupational stress KW - mixed-methods KW - stigma KW - well-being KW - mental health KW - digital health KW - occupational health N2 - Background: Mental health issues like occupational stress and burnout, compounded with the after-effects of COVID-19, have affected health care professionals (HCPs) around the world. Digital mental health interventions (DMHIs) can be accessible and effective in supporting well-being among HCPs. However, low engagement rates of DMHIs are frequently reported, limiting the potential effectiveness. More evidence is needed to reveal the factors that impact HCPs? decision to adopt and engage with DMHIs. Objective: This study aims to explore HCPs? motivation to engage with DMHIs and identify key factors affecting their engagement. Amongst these, we include cultural factors impacting DMHI perception and engagement among HCPs. Methods: We used a mixed method approach, with a cross-sectional survey (n=438) and semistructured interviews (n=25) with HCPs from the United Kingdom and China. Participants were recruited from one major public hospital in each country. Results: Our results demonstrated a generally low engagement rate with DMHIs among HCPs from the 2 countries. Several key factors that affect DMHI engagement were identified, including belonging to underrepresented cultural and ethnic groups, limited mental health knowledge, low perceived need, lack of time, needs for relevance and personal-based support, and cultural elements like self-stigma. The results support recommendations for DMHIs for HCPs. Conclusions: Although DMHIs can be an ideal alternative mental health support for HCPs, engagement rates among HCPs in China and the United Kingdom are still low due to multiple factors and barriers. More research is needed to develop and evaluate tailored DMHIs with unique designs and content that HCPs can engage from various cultural backgrounds. UR - https://mental.jmir.org/2025/1/e67190 UR - http://dx.doi.org/10.2196/67190 ID - info:doi/10.2196/67190 ER - TY - JOUR AU - Govender, Samantha AU - Cochrane, Elizabeth Maria AU - Mogale, Mabina AU - Gordon, Reno AU - Tshephe, Tjodwapi PY - 2025/3/25 TI - Establishing a Digital Health Care Ecosystem in a Health Sciences University in South Africa: Protocol for a Mixed Methods Study JO - JMIR Res Protoc SP - e57821 VL - 14 KW - health sciences KW - digital ecosystem KW - curriculum KW - community engagement KW - tertiary education institutions N2 - Background: Comprehensive and formalized digital health care ecosystems in health sciences tertiary education in South Africa do not currently exist, but they have the potential to influence teaching and learning, research, and community engagement. Objective: A total of 3 key objectives underpin the study, that is, determining the health care curriculum needs and required content for the development of a formalized digital health ecosystem, determining the level of readiness of staff and students to participate in a digital health care ecosystem, and determining whether community engagement and strategic partnerships can contribute to the sustainability of a digital health care ecosystem. Methods: A multipronged approach will be used to address the objectives, with a mixed methods design being undertaken. The qualitative phases will be phenomenological in nature, and triangulation of information along with thematic analysis will be conducted on the collected data. Quantitative data will be collected prospectively and cross-sectionally and analyzed using descriptive analysis. Sampling will include subject experts for the Delphi technique, staff and students at the University, clinical training and education partners, and community leaders. This study has received ethical approval from the Sefako Makgatho Health Sciences University Research and Ethics Committee (SMUREC/H/260/2023:PG). Results: Data collection for the first phase will begin in January 2024 and conclude in December 2024. Phase 2 and 3 of the study will be conducted concurrently, with data collection starting in January 2025 and concluding in December 2026. Conclusions: The establishment of a digital health care ecosystem has the potential to benefit staff, students, and communities through stakeholder collaboration, educational opportunities, research projects, and improved service delivery. International Registered Report Identifier (IRRID): DERR1-10.2196/57821 UR - https://www.researchprotocols.org/2025/1/e57821 UR - http://dx.doi.org/10.2196/57821 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/57821 ER - TY - JOUR AU - Holetzek, Tim AU - Häusler, Andreas AU - Gödde, Kathrin AU - Rapp, Michael AU - Spallek, Jacob AU - Holmberg, Christine PY - 2025/3/24 TI - The Role of the Installed Base in Information Exchange Among General Practitioners in Germany: Mixed Methods Study JO - J Med Internet Res SP - e65241 VL - 27 KW - digitalization KW - general practitioners KW - Germany KW - information and communication technologies KW - information exchange KW - primary health care KW - digital transformation KW - mixed methods study KW - digital health KW - health application KW - qualitative interview N2 - Background: Digitalization is steadily advancing on a global scale, exerting a profound influence on health care systems. To facilitate acceptance of the digital transformation, guiding principles emphasize the need for digital health structures to be person-centered and promote high-quality care. This paper examines the implementation challenges within the German health care system, with a particular focus on how change initiatives engage with existing infrastructures and organizational modes of health care delivery. This approach provides a framework for analyzing how established infrastructure determines new developments while also highlighting the procedural dynamics of change and the integration of innovations within existing information infrastructures. These established infrastructures are referred to as the installed base. Objective: The aim of the study is to examine the installed base encountered by the digital transformation within the German health care system by investigating information exchange practices among general practitioners (GPs) and their communication with other health care actors. Methods: A mixed methods study including a quantitative survey and semistructured qualitative interviews was conducted. The study sample consisted of all publicly accessible GP practices (N=1348) situated in the state of Brandenburg, Germany. The survey captured demographic data, communication practices, and perceived barriers to digitalization. The interviews explored experiences with digital applications. Quantitative data were analyzed using R (R Foundation for Statistical Computing), and qualitative data were managed and analyzed in MAXQDA (VERBI Software GmbH) through content analysis. Results: A total of 250 questionnaires (response rate 18.5%) and 10 interviews with GPs were included in the analysis. GPs primarily use the telephone (n=138, 55.2%, SD 24.64), fax (n=109, 43.9%, SD 25.40), or post (n=50, 20.2%, SD 9.46) to exchange information. Newer digital communication channels such as messenger applications (n=2, 0.8%, SD 0.72) and Communication in the Medical Sector (n=1, 0.5%, SD 0.97) play a minor role. We identified three intertwined clusters displaying diverse barriers to the digitalization of GPs? communication practices: (1) incompatibility issues and technical immaturity, (2) lack of knowledge and technical requirements, and (3) additional technical, financial, and time-related burdens. These barriers were perceived as significant deterrents to the adoption of digital tools, with older GPs more reliant on analog systems and more likely to view digitalization as a source of frustration. Conclusions: Newly established communication channels in the German health care system compete with the existing information infrastructure, which is deeply integrated into GPs? practice routines and care processes. However, this installed base has been largely overlooked in digital transformation initiatives. While newer channels hold potential, they often malfunction and are incompatible with long-established, individualized GP workflows. Addressing these issues rather than imposing coercive measures is crucial for increasing adoption. Incorporating health care providers? perspectives and aligning new channels with established routines can prevent frustration and facilitate a smoother digital transformation. UR - https://www.jmir.org/2025/1/e65241 UR - http://dx.doi.org/10.2196/65241 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/65241 ER - TY - JOUR AU - Wu, J. Jennifer AU - Graham, Ross AU - Çelebi, Julie AU - Fraser, Kevin AU - Gin, T. Geneen AU - Dang, Laurel AU - Hatamy, Esmatullah AU - Walker, Amanda AU - Barbato, Courtney AU - Lunde, Ottar AU - Coles, Lisa AU - Agnihotri, Parag AU - Morn, Cassandra AU - Tai-Seale, Ming PY - 2025/3/24 TI - Factors Influencing Primary Care Physicians? Intent to Refer Patients With Hypertension to a Digital Remote Blood Pressure Monitoring Program: Mixed Methods Study JO - J Med Internet Res SP - e64933 VL - 27 KW - digital health KW - primary care KW - electronic health records KW - referral KW - hypertension KW - remote monitoring KW - remote blood pressure KW - digital technology KW - mobile phone KW - mixed method KW - quantitative analysis KW - linear regression KW - clinical information N2 - Background: Primary care physicians? (PCP) referral rates to digital health programs are highly variable. This study explores whether knowledge of the digital remote blood pressure monitoring (RBPM) program and information on referral patterns influence PCPs? intention to refer patients. Objective: This study aims to examine the relationship between PCPs? knowledge of the digital RBPM program and information on their own prior referral rates versus their own with their peers? referral rates and their likelihood to refer patients to the digital RBPM program. Methods: This is a mixed methods study integrating quantitative analysis of electronic health record data regarding the frequency of PCPs? referrals of patients with hypertension to a digital health program and quantitative and qualitative analyses of survey data about PCPs? knowledge of the program and their intention to refer patients. PCPs responded to a clinical vignette featuring an eligible patient. They were randomized to either receive their own referral rate or their own plus their peers? referral rate. They were assessed on their intent to refer eligible future patients. Descriptive and multivariable linear regression analyses examined participant characteristics and the factors associated with their intent to refer patients. Narrative reasons for their intention to refer were thematically analyzed. Results: Of the 242 eligible PCPs invited to participate, 31% (n=70) responded to the survey. From electronic health record data, the mean referral rate of patients per PCP was 11.80% (SD 13.30%). The mean self-reported knowledge of the digital health program was 6.47 (SD 1.81). The mean likelihood of referring an eligible patient (on a scale of 0 to 10, with 0 being not at all, and 10 being definitely) based on a vignette was 8.54 (SD 2.12). The own referral data group?s mean likelihood to refer was 8.91 (SD 1.28), whereas the own plus peer prior referral data group was 8.35 (SD 2.19). Regression analyses suggested the intention to refer the vignette patient was significantly associated with their knowledge (coefficient 0.46, 95% CI 0.20-0.73; P<.001), whereas the intention to refer future patients was significantly associated with their intent to refer the patient in the vignette (coefficient 0.62, 95% CI 0.46-0.78; P<.001). No evidence of association was found on receiving own plus peer referral data compared with own referral data and intent to refer future patients (coefficient 0.23, 95% CI ?0.43 to 0.89; P=.48). Conclusions: Physicians? intention to refer patients to a novel digital health program can be extrapolated by examining their intention to refer an eligible patient portrayed in a vignette, which was found to be significantly influenced by their knowledge of the program. Future efforts should engage PCPs to better inform them so that more patients can benefit from the digital health program. UR - https://www.jmir.org/2025/1/e64933 UR - http://dx.doi.org/10.2196/64933 UR - http://www.ncbi.nlm.nih.gov/pubmed/40126550 ID - info:doi/10.2196/64933 ER - TY - JOUR AU - Gao, Lu AU - Chen, Meilian AU - Wei, Jingxin AU - Wang, Jinni AU - Liao, Xiaoyan PY - 2025/3/21 TI - The Chinese Version of the DigiHealthCom (Digital Health Competence) Instrument for Assessing Digital Health Competence of Health Care Professionals: Translation, Adaptation, and Validation Study JO - JMIR Hum Factors SP - e65373 VL - 12 KW - competence KW - digital health KW - health care professionals KW - instrument KW - reliability KW - validity N2 - Background: Digital health competence is increasingly recognized as a core competence for health care professionals. A comprehensive evaluation of knowledge, skills, performance, values, and attitudes necessary to adapt to evolving digital health technologies is essential. DigiHealthCom (Digital Health Competence) is a well-established instrument designed to assess digital health competence across diverse health care professionals. Objective: This study aimed to translate and culturally adapt DigiHealthCom into simplified Chinese (Mandarin) and verify its reliability and validity in assessing digital health competence of Chinese health care professionals. Methods: DigiHealthCom was translated into Chinese following the guideline proposed by its original developers. The cultural adaptation involved expert review and cognitive interviewing. Internal consistency, test-retest reliability, content validity, convergent validity, discriminant validity, and factor structure were examined. Item analysis tested item discrimination, item correlation, and item homogeneity. Internal consistency was assessed using Cronbach ?, and test-retest reliability was measured using the intraclass correlation coefficient. Content validity was assessed through both item and scale content validity indices. Convergent validity was measured by the Average Variance Extracted and Composite Reliability, while discriminant validity was measured by the heterotrait-monotrait ratio. A five-dimension model of DigiHealthCom was confirmed using confirmatory factor analysis. Results: The finalized Chinese version of the DigiHealthCom was completed after addressing differences between the back-translations and the original version. No discrepancies affecting item clarity were reported during cognitive interviewing. The validation process involved 398 eligible health care professionals from 36 cities across 15 provinces in China, with 43 participants undergoing a retest after a 2-week interval. Critical ratio values (range 16.05?23.77, P<.001), item-total correlation coefficients (range 0.69?0.89), and Cronbach ? if the item deleted (range 0.91?0.96) indicated satisfactory item discrimination, item correlation, and item homogeneity. Cronbach ? for dimensions and the scale ranged from 0.94 to 0.98, indicating good internal consistency. The intraclass correlation coefficient was 0.90 (95% CI 0.81?0.95), indicating good test-retest reliability. Item content validity index ranged from 0.82 to 1.00, and the scale content validity index was 0.97, indicating satisfactory content validity. Convergent validity (average variance extracted: 0.60?0.79; composite reliability: 0.94?0.95) and divergent validity (heterotrait-monotrait ratio: 0.72?0.89) were satisfactory. Confirmatory factor analysis confirmed a well-fit five-dimension model (robust chi-square to df ratio=3.10, comparative fit index=0.91, Tucker-Lewis index=0.90, incremental fit index=0.91, root-mean-square error of approximation=0.07, standardized root-mean-square residual=0.05), with each item having a factor loading exceeding 0.40. Conclusions: The Chinese version of DigiHealthCom has been proved to be reliable and valid. It is now available for assessing digital health competence among Chinese health care professionals. This assessment can be used to guide health care policy makers and educators in designing comprehensive and implementable educational programs and interventions. UR - https://humanfactors.jmir.org/2025/1/e65373 UR - http://dx.doi.org/10.2196/65373 ID - info:doi/10.2196/65373 ER - TY - JOUR AU - Montagna, Marco AU - Chiabrando, Filippo AU - De Lorenzo, Rebecca AU - Rovere Querini, Patrizia AU - PY - 2025/3/18 TI - Impact of Clinical Decision Support Systems on Medical Students? Case-Solving Performance: Comparison Study with a Focus Group JO - JMIR Med Educ SP - e55709 VL - 11 KW - chatGPT KW - chatbot KW - machine learning KW - ML KW - artificial intelligence KW - AI KW - algorithm KW - predictive model KW - predictive analytics KW - predictive system KW - practical model KW - deep learning KW - large language models KW - LLMs KW - medical education KW - medical teaching KW - teaching environment KW - clinical decision support systems KW - CDSS KW - decision support KW - decision support tool KW - clinical decision-making KW - innovative teaching N2 - Background: Health care practitioners use clinical decision support systems (CDSS) as an aid in the crucial task of clinical reasoning and decision-making. Traditional CDSS are online repositories (ORs) and clinical practice guidelines (CPG). Recently, large language models (LLMs) such as ChatGPT have emerged as potential alternatives. They have proven to be powerful, innovative tools, yet they are not devoid of worrisome risks. Objective: This study aims to explore how medical students perform in an evaluated clinical case through the use of different CDSS tools. Methods: The authors randomly divided medical students into 3 groups, CPG, n=6 (38%); OR, n=5 (31%); and ChatGPT, n=5 (31%); and assigned each group a different type of CDSS for guidance in answering prespecified questions, assessing how students? speed and ability at resolving the same clinical case varied accordingly. External reviewers evaluated all answers based on accuracy and completeness metrics (score: 1?5). The authors analyzed and categorized group scores according to the skill investigated: differential diagnosis, diagnostic workup, and clinical decision-making. Results: Answering time showed a trend for the ChatGPT group to be the fastest. The mean scores for completeness were as follows: CPG 4.0, OR 3.7, and ChatGPT 3.8 (P=.49). The mean scores for accuracy were as follows: CPG 4.0, OR 3.3, and ChatGPT 3.7 (P=.02). Aggregating scores according to the 3 students? skill domains, trends in differences among the groups emerge more clearly, with the CPG group that performed best in nearly all domains and maintained almost perfect alignment between its completeness and accuracy. Conclusions: This hands-on session provided valuable insights into the potential perks and associated pitfalls of LLMs in medical education and practice. It suggested the critical need to include teachings in medical degree courses on how to properly take advantage of LLMs, as the potential for misuse is evident and real. UR - https://mededu.jmir.org/2025/1/e55709 UR - http://dx.doi.org/10.2196/55709 ID - info:doi/10.2196/55709 ER - TY - JOUR AU - Lau, Jerry AU - Bisht, Shivani AU - Horton, Robert AU - Crisan, Annamaria AU - Jones, John AU - Gantotti, Sandeep AU - Hermes-DeSantis, Evelyn PY - 2025/3/13 TI - Creation of Scientific Response Documents for Addressing Product Medical Information Inquiries: Mixed Method Approach Using Artificial Intelligence JO - JMIR AI SP - e55277 VL - 4 KW - AI KW - LLM KW - GPT KW - biopharmaceutical KW - medical information KW - content generation KW - artificial intelligence KW - pharmaceutical KW - scientific response KW - documentation KW - information KW - clinical data KW - strategy KW - reference KW - feasibility KW - development KW - machine learning KW - large language model KW - accuracy KW - context KW - traceability KW - accountability KW - survey KW - scientific response documentation KW - SRD KW - benefit KW - content generator KW - content analysis KW - Generative Pre-trained Transformer N2 - Background: Pharmaceutical manufacturers address health care professionals? information needs through scientific response documents (SRDs), offering evidence-based answers to medication and disease state questions. Medical information departments, staffed by medical experts, develop SRDs that provide concise summaries consisting of relevant background information, search strategies, clinical data, and balanced references. With an escalating demand for SRDs and the increasing complexity of therapies, medical information departments are exploring advanced technologies and artificial intelligence (AI) tools like large language models (LLMs) to streamline content development. While AI and LLMs show promise in generating draft responses, a synergistic approach combining an LLM with traditional machine learning classifiers in a series of human-supervised and -curated steps could help address limitations, including hallucinations. This will ensure accuracy, context, traceability, and accountability in the development of the concise clinical data summaries of an SRD. Objective: This study aims to quantify the challenges of SRD development and develop a framework exploring the feasibility and value addition of integrating AI capabilities in the process of creating concise summaries for an SRD. Methods: To measure the challenges in SRD development, a survey was conducted by phactMI, a nonprofit consortium of medical information leaders in the pharmaceutical industry, assessing aspects of SRD creation among its member companies. The survey collected data on the time and tediousness of various activities related to SRD development. Another working group, consisting of medical information professionals and data scientists, used AI to aid SRD authoring, focusing on data extraction and abstraction. They used logistic regression on semantic embedding features to train classification models and transformer-based summarization pipelines to generate concise summaries. Results: Of the 33 companies surveyed, 64% (21/33) opened the survey, and 76% (16/21) of those responded. On average, medical information departments generate 614 new documents and update 1352 documents each year. Respondents considered paraphrasing scientific articles to be the most tedious and time-intensive task. In the project?s second phase, sentence classification models showed the ability to accurately distinguish target categories with receiver operating characteristic scores ranging from 0.67 to 0.85 (all P<.001), allowing for accurate data extraction. For data abstraction, the comparison of the bilingual evaluation understudy (BLEU) score and semantic similarity in the paraphrased texts yielded different results among reviewers, with each preferring different trade-offs between these metrics. Conclusions: This study establishes a framework for integrating LLM and machine learning into SRD development, supported by a pharmaceutical company survey emphasizing the challenges of paraphrasing content. While machine learning models show potential for section identification and content usability assessment in data extraction and abstraction, further optimization and research are essential before full-scale industry implementation. The working group?s insights guide an AI-driven content analysis; address limitations; and advance efficient, precise, and responsive frameworks to assist with pharmaceutical SRD development. UR - https://ai.jmir.org/2025/1/e55277 UR - http://dx.doi.org/10.2196/55277 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/55277 ER - TY - JOUR AU - Doerr, J. Adam AU - Orwig, A. Taylor AU - McNulty, Matthew AU - Sison, M. Stephanie Denise AU - Paquette, R. David AU - Leung, Robert AU - Ding, Huitong AU - Erban, B. Stephen AU - Weinstein, R. Bruce AU - Guilarte-Walker, Yurima AU - Zai, H. Adrian AU - Walkey, J. Allan AU - Soni, Apurv AU - McManus, D. David AU - Lin, Honghuang PY - 2025/3/12 TI - Digital Assessment of Cognitive Health in Outpatient Primary Care: Usability Study JO - JMIR Form Res SP - e66695 VL - 9 KW - cognitive assessment KW - primary care KW - digital KW - cognitive impairment KW - digital assessment KW - assessment KW - cognitive health KW - cognition KW - cognitive evaluation KW - Core Cognitive Evaluation KW - CCE KW - cohort KW - impairment KW - cognitive KW - outpatient N2 - Background: Screening for cognitive impairment in primary care is important, yet primary care physicians (PCPs) report conducting routine cognitive assessments for less than half of patients older than 60 years of age. Linus Health?s Core Cognitive Evaluation (CCE), a tablet-based digital cognitive assessment, has been used for the detection of cognitive impairment, but its application in primary care is not yet studied. Objective: This study aimed to explore the integration of CCE implementation in a primary care setting. Methods: A cohort of participants was recruited from the upcoming schedules of participating PCPs at UMass Memorial Medical Center. Eligibility criteria included individuals aged ?65 years; ability to read, write, and speak in English or Spanish; no previous diagnosis of cognitive impairment; and no known untreated hearing or vision impairment. Research coordinators collected consent from participants and facilitated the screening process. PCPs reviewed reports in real time, immediately before the scheduled visits, and shared results at their discretion. A report was uploaded to each participant?s REDCap (Research Electronic Data Capture; Vanderbilt University) record and linked to the encounter in the electronic health record. Feedback from patients and their caregivers (if applicable) was collected by a tablet-based survey in the clinic before and after screening. Participating PCPs were interviewed following the completion of the study. Results: The screened cohort included 150 patients with a mean age of 74 (SD 7) years, of whom 65% (97/150) were female. The CCE identified 40 patients as borderline and 7 as positive for cognitive impairment. A total of 84 orders were placed for select laboratory tests or referrals to neurology and neuropsychology within 20 days of CCE administration. Before the assessment, 95% (143/150) of patients and all 15 caregivers expressed a desire to know if their or their loved one?s brain health was declining. All except one patient also completed the postassessment survey. Among them, 96% (143/149) of patients reported finding the CCE easy to complete, and 70% (105/149) felt that the experience was beneficial. In addition, 87% (130/149) of patients agreed or strongly agreed that they wanted to know their CCE results. Among the 7 participating PCPs, 6 stated that the CCE results influenced their patient care management, and all 7 indicated they would continue using the CCE if it were made available after the study. Conclusions: We explored the integration of the CCE into primary care visits, which showed minimal disruption to the practice workflow. Future studies will be warranted to further validate the implementation of digital cognitive impairment screening tools within primary care settings in the real world. UR - https://formative.jmir.org/2025/1/e66695 UR - http://dx.doi.org/10.2196/66695 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/66695 ER - TY - JOUR AU - May, Susann AU - Muehlensiepen, Felix AU - Wengemuth, Eileen AU - Seifert, Frances AU - Heinze, Martin AU - Bruch, Dunja AU - Spethmann, Sebastian PY - 2025/3/10 TI - Benefits and Barriers to mHealth in Hypertension Care: Qualitative Study With German Health Care Professionals JO - JMIR Hum Factors SP - e52544 VL - 12 KW - hypertension KW - mHealth apps KW - digital health KW - physicians KW - nurses KW - HCP KW - qualitative interviews KW - health care professional KW - cardiologists KW - mHealth KW - Germany KW - general practitioners KW - blood pressure monitoring KW - qualitative study KW - qualitative content analysis N2 - Background: Digital health technologies, particularly mobile health (mHealth) apps and wearable devices, have emerged as crucial assets in the battle against hypertension. By enabling lifestyle modifications, facilitating home blood pressure monitoring, and promoting treatment adherence, these technologies have significantly enhanced hypertension treatment. Objective: This study aims to explore the perspectives of health care professionals (HCPs) regarding the perceived benefits and barriers associated with the integration of mHealth apps into routine hypertension care. Additionally, strategies for overcoming these barriers will be identified. Methods: Through qualitative analysis via semistructured interviews, general practitioners (n=10), cardiologists (n=14), and nurses (n=3) were purposefully selected between October 2022 and March 2023. Verbatim transcripts were analyzed using qualitative content analysis. Results: The results unveiled 3 overarching themes highlighting the benefits of mHealth apps in hypertension care from the perspective of HCPs. First, these technologies possess the potential to enhance patient safety by facilitating continuous monitoring and early detection of abnormalities. Second, they can empower patients, fostering autonomy in managing their health conditions, thereby promoting active participation in their care. Lastly, mHealth apps may provide valuable support to medical care by offering real-time data that aids in decision-making and treatment adjustments. Despite these benefits, the study identified several barriers hindering the seamless integration of mHealth apps into hypertension care. Challenges predominantly revolved around data management, communication contexts, daily routines, and system handling. HCPs underscored the necessity for structural and procedural modifications in their daily practices to effectively address these challenges. Conclusions: In conclusion, the effective usage of digital tools such as mHealth apps necessitates overcoming various obstacles. This entails meeting the information needs of both HCPs and patients, tackling interoperability issues to ensure seamless data exchange between different systems, clarifying uncertainties surrounding reimbursement policies, and establishing the specific clinical benefits of these technologies. Active engagement of users throughout the design and implementation phases is crucial for ensuring the usability and acceptance of mHealth apps. Moreover, enhancing knowledge accessibility through the provision of easily understandable information about mHealth apps is essential for eliminating barriers and fostering their widespread adoption in hypertension care. Trial Registration: German Clinical Trials Register DRKS00029761; https://drks.de/search/de/trial/DRKS00029761 International Registered Report Identifier (IRRID): RR2-10.3389/fcvm.2022.1089968 UR - https://humanfactors.jmir.org/2025/1/e52544 UR - http://dx.doi.org/10.2196/52544 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/52544 ER - TY - JOUR AU - Zainal, Humairah AU - Xiao Hui, Xin AU - Thumboo, Julian AU - Kok Yong, Fong PY - 2025/3/7 TI - Organizational Leaders? Views on Digital Health Competencies in Medical Education: Qualitative Semistructured Interview Study JO - JMIR Med Educ SP - e64768 VL - 11 KW - technology KW - medical education KW - curriculum KW - clinical competence KW - digital competence KW - Singapore KW - digital health KW - qualitative study KW - medical school KW - risk KW - comprehensive framework KW - doctor KW - thematic analysis KW - information technology KW - evidence-based KW - undergraduate KW - healthcare systems KW - mobile phone N2 - Background: Digital technologies (DTs) have profoundly impacted health care delivery globally and are increasingly used in clinical practice. Despite this, there is a scarcity of guidelines for implementing training in digital health competencies (DHC) in medical schools, especially for clinical practice. A lack of sustained integration of DHC risks creating knowledge gaps due to a limited understanding of how DT should be used in health care. Furthermore, few studies have explored reasons for this lag, both within and beyond the medical school curriculum. Current frameworks to address these barriers are often specific to individual countries or schools and focus primarily on curriculum design and delivery. A comprehensive framework is therefore required to ensure consistent implementation of DHC across various contexts and times. Objective: This study aims to use Singapore as a case study and examine the perspectives of doctors in organizational leadership positions to identify and analyze the barriers to DHC implementation in the undergraduate curriculum of Singapore?s medical schools. It also seeks to apply the Normalization Process Theory (NPT) to address these barriers and bridge the gap between health care systems and digital health education (DHE) training. Methods: Individual semistructured interviews were conducted with doctors in executive and organizational leadership roles. Participants were recruited through purposive sampling, and the data were interpreted using qualitative thematic analysis. Results: A total of 33 doctors participated, 26 of whom are currently in organizational leadership roles and 7 of whom have previously held such positions. A total of 6 barriers were identified: bureaucratic inertia, lack of opportunities to pursue nontraditional career pathways, limited protective mechanisms for experiential learning and experimentation, lack of clear policy guidelines for clinical practice, insufficient integration between medical school education and clinical experience, and poor IT integration within the health care industry. Conclusions: These barriers are also present in other high-income countries experiencing health care digitalization, highlighting the need for a theoretical framework that broadens the generalizability of existing recommendations. Applying the NPT underscores the importance of addressing these barriers to effectively integrate DHC into the curriculum. The active involvement of multiple stakeholders and the incorporation of continuous feedback mechanisms are essential. Our proposed framework provides concrete, evidence-based, and step-by-step recommendations for implementation practice, supporting the introduction of DHC in undergraduate medical education. UR - https://mededu.jmir.org/2025/1/e64768 UR - http://dx.doi.org/10.2196/64768 UR - http://www.ncbi.nlm.nih.gov/pubmed/40053774 ID - info:doi/10.2196/64768 ER - TY - JOUR AU - Kammies, Chamandra AU - Archer, Elize AU - Engel-Hills, Penelope AU - Volschenk, Mariette PY - 2025/3/6 TI - Exploring Curriculum Considerations to Prepare Future Radiographers for an AI-Assisted Health Care Environment: Protocol for Scoping Review JO - JMIR Res Protoc SP - e60431 VL - 14 KW - artificial intelligence KW - machine learning KW - radiography KW - education KW - scoping review N2 - Background: The use of artificial intelligence (AI) technologies in radiography practice is increasing. As this advanced technology becomes more embedded in radiography systems and clinical practice, the role of radiographers will evolve. In the context of these anticipated changes, it may be reasonable to expect modifications to the competencies and educational requirements of current and future practitioners to ensure successful AI adoption. Objective: The aim of this scoping review is to explore and synthesize the literature on the adjustments needed in the radiography curriculum to prepare radiography students for the demands of AI-assisted health care environments. Methods: Using the Joanna Briggs Institute methodology, an initial search was run in Scopus to determine whether the search strategy that was developed with a library specialist would capture the relevant literature by screening the title and abstract of the first 50 articles. Additional search terms identified in the articles were added to the search strategy. Next, EBSCOhost, PubMed, and Web of Science databases were searched. In total, 2 reviewers will independently review the title, abstract, and full-text articles according to the predefined inclusion and exclusion criteria, with conflicts resolved by a third reviewer. Results: The search results will be reported using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. The final scoping review will present the data analysis as findings in tabular form and through narrative descriptions. The final database searches were completed in October 2024 and yielded 2224 records. Title and abstract screening of 1930 articles is underway after removing 294 duplicates. The scoping review is expected to be finalized by the end of March 2025. Conclusions: A scoping review aims to systematically map the evidence on the adjustments needed in the radiography curriculum to prepare radiography students for the integration of AI technologies in the health care environment. It is relevant to map the evidence because increased integration of AI-based technologies in clinical practice has been noted and changes in practice must be underpinned by appropriate education and training. The findings in this study will provide a better understanding of how the radiography curriculum should adapt to meet the educational needs of current and future radiographers to ensure competent and safe practice in response to AI technologies. Trial Registration: Open Science Framework 3nx2a; https://osf.io/3nx2a International Registered Report Identifier (IRRID): PRR1-10.2196/60431 UR - https://www.researchprotocols.org/2025/1/e60431 UR - http://dx.doi.org/10.2196/60431 UR - http://www.ncbi.nlm.nih.gov/pubmed/40053777 ID - info:doi/10.2196/60431 ER - TY - JOUR AU - Beerbaum, Julian AU - Robens, Sibylle AU - Fehring, Leonard AU - Mortsiefer, Achim AU - Meister, Sven PY - 2025/3/5 TI - Patient Adoption of Digital Use Cases in Family Medicine and a Nuanced Implementation Approach for Family Doctors: Quantitative Web-Based Survey Study JO - JMIR Form Res SP - e58867 VL - 9 KW - technology acceptance KW - UTAUT KW - family doctor KW - digital health KW - eHealth KW - video consultation KW - electronic health records KW - digital anamnesis KW - online appointment scheduling N2 - Background: Digital use cases describe the application of technology to achieve specific outcomes. Several studies in health care have examined patients? overall attitudes toward digitalization and specific use cases. However, these studies have failed to provide a comparison of patient acceptance criteria between inherently different digital use cases in family medicine. Objective: To address this research gap, this paper aimed to assist family doctors in selecting digital use cases by comparing the underlying patient adoption factors and in driving usage of these use cases by presenting a differentiated implementation approach. Methods: Adapting an established Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire to 4 digital use cases in family medicine, we surveyed a large cross-sectional sample of adults living in Germany. The results of the web-based survey were then analyzed via descriptive statistics, ANOVA, and hierarchical regression models to compare the effects of sociodemographic and technology acceptance factors on the intention to use a specific use case. Results: Our web-based survey included 1880 participants. Of these 1880 participants, only 304 (16.2%) agreed that the degree of digitalization is important when selecting a family practice. However, more digitally literate participants attributed greater importance to this criterion (B=0.226, SE 0.023; ?=.223; P<.001), and digital literacy was found to be dependent on age (Welch F3,968.29=53.441; P<.001). Regarding sociodemographic characteristics, only digital literacy demonstrated a significant effect on the intention to use for all use cases, particularly scheduling doctor appointments online (B=0.322, SE 0.033; ?=.408; P<.001). Furthermore, performance expectancy was the strongest predictor of the intention to use for all use cases, while further effects of technology acceptance factors depended on the use case (receiving medical consultations via video: B=0.603, SE 0.049; ?=.527; P<.001; scheduling doctor appointments online: B=0.566, SE 0.043; ?=.513; P<.001; storing personal medical information via electronic health records: B=0.405, SE 0.047; ?=.348; P<.001; and providing personal information before consultation digitally [digital anamnesis]: B=0.434, SE 0.048; ?=.410; P<.001). To illustrate, perceived privacy and security had an effect on the intention to use electronic health records (B=0.284, SE 0.040; ?=.243; P<.001) but no effect on the intention to use video consultations (B=0.068, SE 0.042; ?=.053; P=.10). Conclusions: In the selection and implementation of digital use cases, family doctors should always prioritize the perceived value of the digital use case for the patient, and further criteria might depend on the digital use case. Practice owners should therefore always harmonize the introduction of digital use cases with their own patient care strategies. Not every digital innovation fits every strategy and therefore every practice. UR - https://formative.jmir.org/2025/1/e58867 UR - http://dx.doi.org/10.2196/58867 UR - http://www.ncbi.nlm.nih.gov/pubmed/40053731 ID - info:doi/10.2196/58867 ER - TY - JOUR AU - Potter, Alison AU - Munsch, Chris AU - Watson, Elaine AU - Hopkins, Emily AU - Kitromili, Sofia AU - O'Neill, Cameron Iain AU - Larbie, Judy AU - Niittymaki, Essi AU - Ramsay, Catriona AU - Burke, Joshua AU - Ralph, Neil PY - 2025/2/19 TI - Identifying Research Priorities in Digital Education for Health Care: Umbrella Review and Modified Delphi Method Study JO - J Med Internet Res SP - e66157 VL - 27 KW - digital education KW - health professions education KW - research priorities KW - umbrella review KW - Delphi KW - artificial intelligence KW - AI N2 - 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. UR - https://www.jmir.org/2025/1/e66157 UR - http://dx.doi.org/10.2196/66157 UR - http://www.ncbi.nlm.nih.gov/pubmed/39969988 ID - info:doi/10.2196/66157 ER - TY - JOUR AU - Ichikawa, Tsunagu AU - Olsen, Elizabeth AU - Vinod, Arathi AU - Glenn, Noah AU - Hanna, Karim AU - Lund, C. Gregg AU - Pierce-Talsma, Stacey PY - 2025/2/11 TI - Generative Artificial Intelligence in Medical Education?Policies and Training at US Osteopathic Medical Schools: Descriptive Cross-Sectional Survey JO - JMIR Med Educ SP - e58766 VL - 11 KW - artificial intelligence KW - medical education KW - faculty development KW - policy KW - AI KW - training KW - United States KW - school KW - university KW - college KW - institution KW - osteopathic KW - osteopathy KW - curriculum KW - student KW - faculty KW - administrator KW - survey KW - cross-sectional N2 - Background: Interest has recently increased in generative artificial intelligence (GenAI), a subset of artificial intelligence that can create new content. Although the publicly available GenAI tools are not specifically trained in the medical domain, they have demonstrated proficiency in a wide range of medical assessments. The future integration of GenAI in medicine remains unknown. However, the rapid availability of GenAI with a chat interface and the potential risks and benefits are the focus of great interest. As with any significant medical advancement or change, medical schools must adapt their curricula to equip students with the skills necessary to become successful physicians. Furthermore, medical schools must ensure that faculty members have the skills to harness these new opportunities to increase their effectiveness as educators. How medical schools currently fulfill their responsibilities is unclear. Colleges of Osteopathic Medicine (COMs) in the United States currently train a significant proportion of the total number of medical students. These COMs are in academic settings ranging from large public research universities to small private institutions. Therefore, studying COMs will offer a representative sample of the current GenAI integration in medical education. Objective: This study aims to describe the policies and training regarding the specific aspect of GenAI in US COMs, targeting students, faculty, and administrators. Methods: Web-based surveys were sent to deans and Student Government Association (SGA) presidents of the main campuses of fully accredited US COMs. The dean survey included questions regarding current and planned policies and training related to GenAI for students, faculty, and administrators. The SGA president survey included only those questions related to current student policies and training. Results: Responses were received from 81% (26/32) of COMs surveyed. This included 47% (15/32) of the deans and 50% (16/32) of the SGA presidents (with 5 COMs represented by both the deans and the SGA presidents). Most COMs did not have a policy on the student use of GenAI, as reported by the dean (14/15, 93%) and the SGA president (14/16, 88%). Of the COMs with no policy, 79% (11/14) had no formal plans for policy development. Only 1 COM had training for students, which focused entirely on the ethics of using GenAI. Most COMs had no formal plans to provide mandatory (11/14, 79%) or elective (11/15, 73%) training. No COM had GenAI policies for faculty or administrators. Eighty percent had no formal plans for policy development. Furthermore, 33.3% (5/15) of COMs had faculty or administrator GenAI training. Except for examination question development, there was no training to increase faculty or administrator capabilities and efficiency or to decrease their workload. Conclusions: The survey revealed that most COMs lack GenAI policies and training for students, faculty, and administrators. The few institutions with policies or training were extremely limited in scope. Most institutions without current training or policies had no formal plans for development. The lack of current policies and training initiatives suggests inadequate preparedness for integrating GenAI into the medical school environment, therefore, relegating the responsibility for ethical guidance and training to the individual COM member. UR - https://mededu.jmir.org/2025/1/e58766 UR - http://dx.doi.org/10.2196/58766 ID - info:doi/10.2196/58766 ER - TY - JOUR AU - Kearns, Amanda AU - Moorhead, Anne AU - Mulvenna, Maurice AU - Bond, Raymond PY - 2025/2/10 TI - Assessing the Uses, Benefits, and Limitations of Digital Technologies Used by Health Professionals in Supporting Obesity and Mental Health Communication: Scoping Review JO - J Med Internet Res SP - e58434 VL - 27 KW - digital communication KW - digital technology KW - digital transformation KW - health professional KW - mental health KW - obesity KW - complex needs KW - artificial intelligence KW - AI KW - PRISMA N2 - Background: Obesity and mental health issues present interconnected public health challenges that impair physical, social, and mental well-being. Digital technologies offer potential for enhancing health care communication between health professionals (HPs) and individuals living with obesity and mental health issues, but their effectiveness is not fully understood. Objective: This scoping review aims to identify and understand the different types of technologies used by HPs in supporting obesity and mental health communication. Methods: A comprehensive scoping review, which followed a validated methodology, analyzed studies published between 2013 and 2023 across 8 databases. The data extraction focused on HPs? use of communication technologies, intervention types, biopsychosocial considerations, and perceptions of technology use. The review was guided by the following research question: ?What are the uses, benefits, and limitations of digital technologies in supporting communication between HPs and persons living with obesity and mental health issues?? Results: In total, 8 studies?featuring web-based platforms, social media, synchronous video calls, telephone calls, automated SMS text messaging, and email?met the inclusion criteria. Technologies such as virtual learning collaborative dashboards and videoconferencing, supported by automated SMS text messaging and social media (Facebook and WhatsApp groups), were commonly used. Psychologists, dietitians, social workers, and health coaches used digital tools to facilitate virtual appointments, diet and mental health monitoring, and motivational and educational support through group therapy, 1-on-1 sessions, and hybrid models. Benefits included enhanced access to care and engagement, personalized digital cognitive behavioral therapy, perceived stigma reduction, privacy, and improved physical health outcomes in weight reduction. However, improvements in mental health outcomes were not statistically significant in studies reporting P values (P?.05). The limitations included engagement difficulties due to conflicting personal family and work commitments; variable communication mode preferences, with some preferring in-person sessions; and misinterpretations of SMS text messaging prompts. Conflicts arose from cultural and individual differences, weight stigma, and confusion over HP roles in obesity and mental health care. Conclusions: Digital technologies have diversified the approaches HPs can take in delivering education, counseling, and motivation to individuals with obesity and mental health issues, facilitating private, stigma-reduced environments for personalized care. While the interventions were effective in obesity management, the review revealed a shortfall in addressing mental health needs. This highlights an urgent need for digital tools to serve as media for a deeper engagement with individuals? complex biopsychosocial needs. The integration of data science and technological advancements offers promising avenues for tailored digital solutions. The findings advocate the importance of continued innovation and adaptation in digital health care communication strategies, with clearer HP roles and an interdisciplinary, empathetic approach focused on individual needs. UR - https://www.jmir.org/2025/1/e58434 UR - http://dx.doi.org/10.2196/58434 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/58434 ER - TY - JOUR AU - Stroud, M. Austin AU - Curtis, H. Susan AU - Weir, B. Isabel AU - Stout, J. Jeremiah AU - Barry, A. Barbara AU - Bobo, V. William AU - Athreya, P. Arjun AU - Sharp, R. Richard PY - 2025/2/10 TI - Physician Perspectives on the Potential Benefits and Risks of Applying Artificial Intelligence in Psychiatric Medicine: Qualitative Study JO - JMIR Ment Health SP - e64414 VL - 12 KW - artificial intelligence KW - machine learning KW - digital health KW - mental health KW - psychiatry KW - depression KW - interviews KW - family medicine KW - physicians KW - qualitative KW - providers KW - attitudes KW - opinions KW - perspectives KW - ethics N2 - Background: As artificial intelligence (AI) tools are integrated more widely in psychiatric medicine, it is important to consider the impact these tools will have on clinical practice. Objective: This study aimed to characterize physician perspectives on the potential impact AI tools will have in psychiatric medicine. Methods: We interviewed 42 physicians (21 psychiatrists and 21 family medicine practitioners). These interviews used detailed clinical case scenarios involving the use of AI technologies in the evaluation, diagnosis, and treatment of psychiatric conditions. Interviews were transcribed and subsequently analyzed using qualitative analysis methods. Results: Physicians highlighted multiple potential benefits of AI tools, including potential support for optimizing pharmaceutical efficacy, reducing administrative burden, aiding shared decision-making, and increasing access to health services, and were optimistic about the long-term impact of these technologies. This optimism was tempered by concerns about potential near-term risks to both patients and themselves including misguiding clinical judgment, increasing clinical burden, introducing patient harms, and creating legal liability. Conclusions: Our results highlight the importance of considering specialist perspectives when deploying AI tools in psychiatric medicine. UR - https://mental.jmir.org/2025/1/e64414 UR - http://dx.doi.org/10.2196/64414 UR - http://www.ncbi.nlm.nih.gov/pubmed/39928397 ID - info:doi/10.2196/64414 ER - TY - JOUR AU - Kariotis, Timothy AU - Prictor, Megan AU - Gray, Kathleen AU - Chang, Shanton PY - 2025/2/7 TI - Patient-Accessible Electronic Health Records and Information Practices in Mental Health Care Contexts: Scoping Review JO - J Med Internet Res SP - e54973 VL - 27 KW - patient-accessible electronic health records KW - patient portals KW - psychiatry KW - mental health KW - health informatics KW - mental illness KW - scoping review N2 - Background: Patients are increasingly being provided with access to their electronic health records. However, in mental health care contexts, concerns have been raised due to a perception that such access would pose risks to patients, third parties, and the therapeutic relationship. These perceived risks may affect the information practices of health care professionals (HCPs) and patients, such as how they document, share, and use information in mental health care services with a patient-accessible electronic health record (PAEHR). Although there is growing research interest in PAEHRs, no study has specifically examined how they impact information practices. Understanding the impacts on information practices may help explain other outcomes of implementing PAEHRs and inform their design. Objective: This scoping review aimed to explore the research on PAEHRs in mental health care contexts and how PAEHRs affect information practices of HCPs and patients in this context. Methods: A scoping review was considered the most appropriate method due to the relatively recent adoption of PAEHRs in mental health care contexts and the heterogeneous nature of the evidence base. A comprehensive search of electronic databases was conducted for original empirical studies that described the use of PAEHRs or associated systems in mental health care contexts. One author reviewed all full texts, with 3 other authors reviewing a subset of studies. The study characteristics and findings were documented, and a thematic synthesis and textual narrative analysis were used to develop descriptive and analytical themes that addressed the research questions. Results: A total of 66 studies were considered eligible and included in the analysis. The impact of PAEHRs on information practices in mental health care contexts included the following: (1) they may change how HCPs document patient information, including a reduction in detail and a focus on information perceived by HCPs as objective rather than subjective; (2) they may negatively impact workflows due to changes in documentation practices and limited guidance for HCPs on how to use PAEHRs; and (3) they may contribute to improved communication between HCPs and patients, including constructive disagreements regarding what is documented in the health record. The changes to HCP information practices were influenced by a concern for the therapeutic relationship and patient safety. Furthermore, PAEHRs supported new information practices for patients, such as using their PAEHR to prepare for clinical encounters. Conclusions: We have identified several ways in which PAEHRs shape the information practices of HCPs and patients in the mental health context. These findings can inform the design of PAEHRs to promote information practices that contribute to improving the quality of mental health care. Further research is necessary to understand how changes in information practices due to the implementation of PAEHRs impact clinical outcomes and patient experiences of care. UR - https://www.jmir.org/2025/1/e54973 UR - http://dx.doi.org/10.2196/54973 UR - http://www.ncbi.nlm.nih.gov/pubmed/39918859 ID - info:doi/10.2196/54973 ER - TY - JOUR AU - Soltani, Nazli AU - Dietz, Thilo AU - Ochterbeck, Doris AU - Dierkes, Jens AU - Restel, Katja AU - Christianson, Lara AU - De Santis, Karolina Karina AU - Zeeb, Hajo PY - 2025/1/28 TI - Digital Information Exchange Between the Public and Researchers in Health Studies: Scoping Review JO - J Med Internet Res SP - e63373 VL - 27 KW - health information KW - information exchange KW - communication KW - knowledge translation KW - dissemination KW - digital technology KW - research participant KW - scoping review N2 - Background: Information exchange regarding the scope and content of health studies is becoming increasingly important. Digital methods, including study websites, can facilitate such an exchange. Objective: This scoping review aimed to describe how digital information exchange occurs between the public and researchers in health studies. Methods: This scoping review was prospectively registered and adheres to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Eligibility was defined using the population (public and researchers), concept (digital information exchange), and context (health studies) framework. Bibliographic databases (MEDLINE, PsycINFO, CINAHL, and Web of Science), bibliographies of the included studies, and Google Scholar were searched up to February 2024. Studies published in peer-reviewed journals were screened for inclusion based on the title, abstract, and full text. Data items charted from studies included bibliographic and PCC (Population, Concept, and Context) characteristics. Data were processed into categories that inductively emerged from the data and were synthesized into main themes using descriptive statistics. Results: Overall, 4072 records were screened, and 18 studies published between 2010 and 2021 were included. All studies evaluated or assessed the preferences for digital information exchange. The target populations included the public (mainly adults with any or specific diseases), researchers, or both. The digital information exchange methods included websites, emails, forums, platforms, social media, and portals. Interactivity (ie, if digital information exchange is or should be active or passive) was addressed in half of the studies. Exchange content included health information or data with the aim to inform, recruit, link, or gather innovative research ideas from participants in health studies. We identified 7 facilitators and 9 barriers to digital information exchange. The main facilitators were the consideration of any stakeholder perspectives and needs to clarify expectations and responsibilities, the use of modern or low-cost communication technologies and public-oriented language, and continuous communication of the health study process. The main barriers were that information exchange was not planned or not feasible due to inadequate resources, highly complex technical language was used, and ethical concerns (eg, breach of anonymity if study participants are brought together) were raised. Evidence gaps indicate that new studies should assess the methods and the receiver (ie, public) preferences and needs that are required to deliver and facilitate interactive digital information exchange. Conclusions: Few studies addressing digital information exchange in health studies could be identified in this review. There was little focus on interactivity in such an exchange. Digital information exchange was associated with more barriers than facilitators, suggesting that more effort is required to improve such an exchange between the public and researchers. Future studies should investigate interactive digital methods and the receiver preferences and needs required for such an exchange. UR - https://www.jmir.org/2025/1/e63373 UR - http://dx.doi.org/10.2196/63373 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/63373 ER - TY - JOUR AU - Sedlakova, Jana AU - Staniki?, Mina AU - Gille, Felix AU - Bernard, Jürgen AU - Horn, B. Andrea AU - Wolf, Markus AU - Haag, Christina AU - Floris, Joel AU - Morgenshtern, Gabriela AU - Schneider, Gerold AU - Zumbrunn Wojczy?ska, Aleksandra AU - Mouton Dorey, Corine AU - Ettlin, Alois Dominik AU - Gero, Daniel AU - Friemel, Thomas AU - Lu, Ziyuan AU - Papadopoulos, Kimon AU - Schläpfer, Sonja AU - Wang, Ning AU - von Wyl, Viktor PY - 2025/1/23 TI - Refining Established Practices for Research Question Definition to Foster Interdisciplinary Research Skills in a Digital Age: Consensus Study With Nominal Group Technique JO - JMIR Med Educ SP - e56369 VL - 11 KW - research question KW - digitalization KW - digital data KW - data science KW - health research KW - interdisciplinary N2 - Background: The increased use of digital data in health research demands interdisciplinary collaborations to address its methodological complexities and challenges. This often entails merging the linear deductive approach of health research with the explorative iterative approach of data science. However, there is a lack of structured teaching courses and guidance on how to effectively and constructively bridge different disciplines and research approaches. Objective: This study aimed to provide a set of tools and recommendations designed to facilitate interdisciplinary education and collaboration. Target groups are lecturers who can use these tools to design interdisciplinary courses, supervisors who guide PhD and master?s students in their interdisciplinary projects, and principal investigators who design and organize workshops to initiate and guide interdisciplinary projects. Methods: Our study was conducted in 3 steps: (1) developing a common terminology, (2) identifying established workflows for research question formulation, and (3) examining adaptations of existing study workflows combining methods from health research and data science. We also formulated recommendations for a pragmatic implementation of our findings. We conducted a literature search and organized 3 interdisciplinary expert workshops with researchers at the University of Zurich. For the workshops and the subsequent manuscript writing process, we adopted a consensus study methodology. Results: We developed a set of tools to facilitate interdisciplinary education and collaboration. These tools focused on 2 key dimensions? content and curriculum and methods and teaching style?and can be applied in various educational and research settings. We developed a glossary to establish a shared understanding of common terminologies and concepts. We delineated the established study workflow for research question formulation, emphasizing the ?what? and the ?how,? while summarizing the necessary tools to facilitate the process. We propose 3 clusters of contextual and methodological adaptations to this workflow to better integrate data science practices: (1) acknowledging real-life constraints and limitations in research scope; (2) allowing more iterative, data-driven approaches to research question formulation; and (3) strengthening research quality through reproducibility principles and adherence to the findable, accessible, interoperable, and reusable (FAIR) data principles. Conclusions: Research question formulation remains a relevant and useful research step in projects using digital data. We recommend initiating new interdisciplinary collaborations by establishing terminologies as well as using the concepts of research tasks to foster a shared understanding. Our tools and recommendations can support academic educators in training health professionals and researchers for interdisciplinary digital health projects. UR - https://mededu.jmir.org/2025/1/e56369 UR - http://dx.doi.org/10.2196/56369 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/56369 ER - TY - JOUR AU - Walzer, Stefan AU - Barthel, Carolin AU - Pazouki, Ronja AU - Marx, Helga AU - Ziegler, Sven AU - Koenig, Peter AU - Kugler, Christiane AU - Jobst, Stefan PY - 2025/1/15 TI - Teaching in the Digital Age?Developing a Support Program for Nursing Education Providers: Design-Based Research JO - JMIR Form Res SP - e66109 VL - 9 KW - digital competencies KW - nursing education KW - support program KW - needs assessment KW - design-based research KW - feasibility study KW - nursing education provider KW - qualitative research KW - nurse KW - health care KW - focus group KW - digital age KW - expert consultation KW - thematic content analysis KW - feasibility test KW - satisfaction KW - competency-based approach KW - workplace barrier KW - health care digitalization KW - digital technology N2 - Background: Health care systems and the nursing profession worldwide are being transformed by technology and digitalization. Nurses acquire digital competence through their own experience in daily practice, but also from education and training; nursing education providers thus play an important role. While nursing education providers have some level of digital competence, there is a need for ongoing training and support for them to develop more advanced skills and effectively integrate technology into their teaching. Objective: This study aims to develop a needs-based support program for nursing education providers to foster digital competencies and to test this intervention. Methods: We used a design-based research approach, incorporating iterative development with expert consultation to create and evaluate a support program for nursing education providers. Focus groups were conducted online to assess needs, and thematic content analysis was used to derive key insights. The support program was then refined through expert feedback and subjected to a feasibility and satisfaction test, with participant evaluations analyzed descriptively. Results: Six main categories emerged from the focus groups, highlighting key areas, including the use of digital technology, ongoing support needs, and the current state of digitalization in nursing education. The support program was developed based on these findings, with expert validation leading to adjustments in timing, content prioritization, and platform integration. Preliminary testing showed good overall satisfaction with the support program, although participants suggested improvements in content relevance and digital platform usability. Conclusions: Although the feasibility test showed high satisfaction with the support program, low participation rates and limited perceived knowledge gain were major concerns. The results suggest that while the program was well received, further refinements, including a focus on competency-based approaches and addressing workplace barriers, are needed to increase participation and effectiveness of such interventions. The findings of this research can be used as a basis for the development of similar programs in other educational and health care contexts. UR - https://formative.jmir.org/2025/1/e66109 UR - http://dx.doi.org/10.2196/66109 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/66109 ER - TY - JOUR AU - Nowell, Lorelli AU - Johnston, Sonja AU - Dolan, Sara AU - Jacobsen, Michele AU - Lorenzetti, L. Diane AU - Oddone Paolucci, Elizabeth PY - 2025/1/15 TI - Exploring Educators? Perceptions and Experiences of Online Teaching to Foster Caring Profession Students? Development of Virtual Caring Skills: Sequential Explanatory Mixed Methods Study JO - JMIR Nursing SP - e64548 VL - 8 KW - health care education KW - virtual care KW - telehealth KW - online teaching KW - mixed methods study KW - student KW - teaching KW - virtual caring skills KW - cross-sectional survey KW - interview N2 - Background: Professionals in caring disciplines have been pivotal in advancing virtual care, which leverages remote technologies to deliver effective support and services from a distance. Educators in these caring professions are required to teach students the skills and competencies needed to provide high-quality and effective care. As virtual care becomes more integral, educators must equip students in these fields with both interpersonal and technological skills, bridging traditional hands-on learning with digital literacy. However, there is a gap in evidence exploring educators? perceptions and experiences of teaching caring profession students about virtual caring skills within online environments. Objective: This study aims to better understand caring profession educators? online teaching experiences to foster student development of virtual caring skills and competencies. Methods: We used a sequential explanatory mixed methods approach that integrated a cross-sectional survey and individual interviews with educators from caring professions to better understand caring professional educators? online teaching experiences to foster student development of virtual caring skills and competencies. The survey?s primary objectives were to examine the various elements of existing e-learning opportunities, delve into educators? perspectives and encounters with these opportunities, and identify the factors that either facilitated or hindered online teaching practices to support students in developing virtual caring skills and competencies. The individual interview guides were based on survey findings and a systematic review of the evidence to gain deeper insights into educators? experiences and perspectives. Results: A total of 82 survey participants and 8 interview participants were drawn from educators in the fields of education, medicine, nursing, and social work. Various instructional methods were used to help students develop virtual caring skills, including reflections on learning, online modules, online discussion boards, demonstrations of remote care, and consultation with clients. There was a statistically significant difference between educators? level of experience teaching online and their satisfaction with online teaching and learning technologies (P<.001) and between educators? faculties (departments) and their satisfaction with online teaching and learning technologies (P=.001). Participants identified barriers (time constraints, underdeveloped curriculum, decreased student engagement, and limited access to virtual caring equipment and technology), facilitators (clearly defined learning objectives, technology software and support, teaching support, stakeholder engagement, and flexibility), and principles of teaching virtual caring skills in online environments (connection, interaction, compassion, empathy, care, and vulnerability). Conclusions: Our study identifies the barriers, facilitators, and principles in teaching virtual caring skills, offering practical strategies for educators in caring professions. This study contributes to the growing body of educational research on virtual caring skills by offering educator insights and suggestions for improved teaching and learning strategies in caring professions? programs. As educational practices evolve, future research should explore how traditionally in-person educators can effectively teach virtual caring skills across diverse contexts. UR - https://nursing.jmir.org/2025/1/e64548 UR - http://dx.doi.org/10.2196/64548 UR - http://www.ncbi.nlm.nih.gov/pubmed/39608377 ID - info:doi/10.2196/64548 ER - TY - JOUR AU - Dushyanthen, Sathana AU - Zamri, Izzati Nadia AU - Chapman, Wendy AU - Capurro, Daniel AU - Lyons, Kayley PY - 2025/1/14 TI - Evaluation of an Interdisciplinary Educational Program to Foster Learning Health Systems: Education Evaluation JO - JMIR Med Educ SP - e54152 VL - 11 KW - continuing professional development KW - learning health system KW - flipped classroom KW - digital health informatics KW - data science KW - health professions education KW - interdisciplinary education KW - foster KW - foster learning KW - health data KW - design KW - innovative KW - innovative solution KW - health care workforce KW - Australia KW - real time KW - teaching model N2 - Background: Learning health systems (LHS) have the potential to use health data in real time through rapid and continuous cycles of data interrogation, implementing insights to practice, feedback, and practice change. However, there is a lack of an appropriately skilled interprofessional informatics workforce that can leverage knowledge to design innovative solutions. Therefore, there is a need to develop tailored professional development training in digital health, to foster skilled interprofessional learning communities in the health care workforce in Australia. Objective: This study aimed to explore participants? experiences and perspectives of participating in an interprofessional education program over 13 weeks. The evaluation also aimed to assess the benefits, barriers, and opportunities for improvements and identify future applications of the course materials. Methods: We developed a wholly online short course open to interdisciplinary professionals working in digital health in the health care sector. In a flipped classroom model, participants (n=400) undertook 2 hours of preclass learning online and then attended 2.5 hours of live synchronous learning in interactive weekly Zoom workshops for 13 weeks. Throughout the course, they collaborated in small, simulated learning communities (n=5 to 8), engaging in various activities and problem-solving exercises, contributing their unique perspectives and diverse expertise. The course covered a number of topics including background on LHS, establishing learning communities, the design thinking process, data preparation and machine learning analysis, process modeling, clinical decision support, remote patient monitoring, evaluation, implementation, and digital transformation. To evaluate the purpose of the program, we undertook a mixed methods evaluation consisting of pre- and postsurveys rating scales for usefulness, engagement, value, and applicability for various aspects of the course. Participants also completed identical measures of self-efficacy before and after (n=200), with scales mapped to specific skills and tasks that should have been achievable following each of the topics covered. Further, they undertook voluntary weekly surveys to provide feedback on which aspects to continue and recommendations for improvements, via free-text responses. Results: From the evaluation, it was evident that participants found the teaching model engaging, useful, valuable, and applicable to their work. In the self-efficacy component, we observed a significant increase (P<.001) in perceived confidence for all topics, when comparing pre- and postcourse ratings. Overall, it was evident that the program gave participants a framework to organize their knowledge and a common understanding and shared language to converse with other disciplines, changed the way they perceived their role and the possibilities of data and technologies, and provided a toolkit through the LHS framework that they could apply in their workplaces. Conclusions: We present a program to educate the health workforce on integrating the LHS model into standard practice. Interprofessional collaborative learning was a major component of the value of the program. This evaluation shed light on the multifaceted challenges and expectations of individuals embarking on a digital health program. Understanding the barriers and facilitators of the audience is crucial for creating an inclusive and supportive learning environment. Addressing these challenges will not only enhance participant engagement but also contribute to the overall success of the program and, by extension, the broader integration of digital health solutions into health care practice and, ultimately, patient outcomes. UR - https://mededu.jmir.org/2025/1/e54152 UR - http://dx.doi.org/10.2196/54152 ID - info:doi/10.2196/54152 ER - TY - JOUR AU - Mun, Michelle AU - Byrne, Samantha AU - Shaw, Louise AU - Lyons, Kayley PY - 2025/1/8 TI - Digital Dentists: A Curriculum for the 21st Century JO - JMIR Med Educ SP - e54153 VL - 11 KW - digital health KW - digital transformation KW - informatics KW - ehealth KW - dentistry KW - dental informatics KW - curriculum KW - competence KW - capability KW - dental education UR - https://mededu.jmir.org/2025/1/e54153 UR - http://dx.doi.org/10.2196/54153 ID - info:doi/10.2196/54153 ER - TY - JOUR AU - Bierbooms, A. Joyce J. P. AU - Sluis-Thiescheffer, W. Wouter R. J. AU - Feijt, Anne Milou AU - Bongers, B. Inge M. PY - 2025/1/7 TI - Co-Design of an Escape Room for e-Mental Health Training of Mental Health Care Professionals: Research Through Design Study JO - JMIR Form Res SP - e58650 VL - 9 KW - serious gaming KW - mental health care professionals KW - e-mental health KW - skill enhancement KW - training N2 - Background: Many efforts to increase the uptake of e-mental health (eMH) have failed due to a lack of knowledge and skills, particularly among professionals. To train health care professionals in technology, serious gaming concepts such as educational escape rooms are increasingly used, which could also possibly be used in mental health care. However, such serious-game concepts are scarcely available for eMH training for mental health care professionals. Objective: This study aims to co-design an escape room for training mental health care professionals? eMH skills and test the escape room?s usability by exploring their experiences with this concept as a training method. Methods: This project used a research through design approach with 3 design stages. In the first stage, the purpose, expectations, and storylines for the escape room were formulated in 2 co-design sessions with mental health care professionals, game designers, innovation staff, and researchers. In the second stage, the results were translated into the first escape room, which was tested in 3 sessions, including one web version of the escape room. In the third stage, the escape room was tested with mental health care professionals outside the co-design team. First, 2 test sessions took place, followed by 3 field study sessions. In the field study sessions, a questionnaire was used in combination with focus groups to assess the usability of the escape room for eMH training in practice. Results: An escape room prototype was iteratively developed and tested by the co-design team, which delivered multiple suggestions for adaptations that were assimilated in each next version of the prototype. The field study showed that the escape room creates a positive mindset toward eMH. The suitability of the escape room to explore the possibilities of eMH was rated 4.7 out of 5 by the professionals who participated in the field study. In addition, it was found to be fun and educational at the same time, scoring 4.7 (SD 0.68) on a 5-point scale. Attention should be paid to the game?s complexity, credibility, and flexibility. This is important for the usefulness of the escape room in clinical practice, which was rated an average of 3.8 (SD 0.77) on a 5-point scale. Finally, implementation challenges should be addressed, including organizational policy and stimulation of eMH training. Conclusions: We can conclude that the perceived usability of an escape room for training mental health care professionals in eMH skills is promising. However, it requires additional effort to transfer the learnings into mental health care professionals? clinical practice. A straightforward implementation plan and testing the effectiveness of an escape room on skill enhancement in mental health care professionals are essential next steps to reach sustainable goals. UR - https://formative.jmir.org/2025/1/e58650 UR - http://dx.doi.org/10.2196/58650 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/58650 ER - TY - JOUR AU - Wang, Heng AU - Zheng, Danni AU - Wang, Mengying AU - Ji, Hong AU - Han, Jiangli AU - Wang, Yan AU - Shen, Ning AU - Qiao, Jie PY - 2025/1/3 TI - Artificial Intelligence?Powered Training Database for Clinical Thinking: App Development Study JO - JMIR Form Res SP - e58426 VL - 9 KW - artificial intelligence KW - clinical thinking ability KW - virtual medical records KW - distance education KW - medical education KW - online learning N2 - Background: With the development of artificial intelligence (AI), medicine has entered the era of intelligent medicine, and various aspects, such as medical education and talent cultivation, are also being redefined. The cultivation of clinical thinking abilities poses a formidable challenge even for seasoned clinical educators, as offline training modalities often fall short in bridging the divide between current practice and the desired ideal. Consequently, there arises an imperative need for the expeditious development of a web-based database, tailored to empower physicians in their quest to learn and hone their clinical reasoning skills. Objective: This study aimed to introduce an app named ?XueYiKu,? which includes consultations, physical examinations, auxiliary examinations, and diagnosis, incorporating AI and actual complete hospital medical records to build an online-learning platform using human-computer interaction. Methods: The ?XueYiKu? app was designed as a contactless, self-service, trial-and-error system application based on actual complete hospital medical records and natural language processing technology to comprehensively assess the ?clinical competence? of residents at different stages. Case extraction was performed at a hospital?s case data center, and the best-matching cases were differentiated through natural language processing, word segmentation, synonym conversion, and sorting. More than 400 teaching cases covering 65 kinds of diseases were released for students to learn, and the subjects covered internal medicine, surgery, gynecology and obstetrics, and pediatrics. The difficulty of learning cases was divided into four levels in ascending order. Moreover, the learning and teaching effects were evaluated using 6 dimensions covering systematicness, agility, logic, knowledge expansion, multidimensional evaluation indicators, and preciseness. Results: From the app?s first launch on the Android platform in May 2019 to the last version updated in May 2023, the total number of teacher and student users was 6209 and 1180, respectively. The top 3 subjects most frequently learned were respirology (n=606, 24.1%), general surgery (n=506, 20.1%), and urinary surgery (n=390, 15.5%). For diseases, pneumonia was the most frequently learned, followed by cholecystolithiasis (n=216, 14.1%), benign prostate hyperplasia (n=196, 12.8%), and bladder tumor (n=193, 12.6%). Among 479 students, roughly a third (n=168, 35.1%) scored in the 60 to 80 range, and half of them scored over 80 points (n=238, 49.7%). The app enabled medical students? learning to become more active and self-motivated, with a variety of formats, and provided real-time feedback through assessments on the platform. The learning effect was satisfactory overall and provided important precedence for establishing scientific models and methods for assessing clinical thinking skills in the future. Conclusions: The integration of AI and medical education will undoubtedly assist in the restructuring of education processes; promote the evolution of the education ecosystem; and provide new convenient ways for independent learning, interactive communication, and educational resource sharing. UR - https://formative.jmir.org/2025/1/e58426 UR - http://dx.doi.org/10.2196/58426 ID - info:doi/10.2196/58426 ER - TY - JOUR AU - Tang, Shuhan PY - 2025/1/3 TI - Enhancing Methodological Rigor in Mobile Health Care Research JO - JMIR Hum Factors SP - e68243 VL - 12 KW - letter to the editor KW - health care professionals KW - mobile health care KW - technical training KW - cross-sectional survey KW - mobile KW - China KW - web-based questionnaire KW - logistic regression KW - mhealth KW - mobile health UR - https://humanfactors.jmir.org/2025/1/e68243 UR - http://dx.doi.org/10.2196/68243 ID - info:doi/10.2196/68243 ER - TY - JOUR AU - Powell, Daniel AU - Asad, Laiba AU - Zavaglia, Elissa AU - Ferrari, Manuela PY - 2025/1/3 TI - Promoting Digital Health Data Literacy: The Datum Project JO - JMIR Form Res SP - e60832 VL - 9 KW - health data KW - digital data KW - medical records KW - legislation KW - ethics KW - knowledge dissemination KW - learning health system KW - data bank UR - https://formative.jmir.org/2025/1/e60832 UR - http://dx.doi.org/10.2196/60832 ID - info:doi/10.2196/60832 ER - TY - JOUR AU - Wang, Yining AU - Ren, Hui AU - Xiao, Shaotan AU - Meng, Tian AU - Sun, Shuyue AU - Yu, Siyu AU - Liu, Qing AU - Wang, Fan PY - 2024/12/20 TI - Factors Associated With Digital Capacity for Health Promotion Among Primary Care Workers: Cross-Sectional Survey Study JO - J Med Internet Res SP - e63054 VL - 26 KW - health promotion KW - digital capacity KW - primary care workers KW - Digital Capabilities Framework KW - online survey N2 - Background: Health education and promotion are recognized as effective strategies for fostering healthy ageing, reducing the disease burden, and addressing health inequalities, particularly when delivered through digital media. Primary care workers are often regarded as the key providers of these interventions. Despite the strong practical significance and substantial individual demand, the use of digital media for delivering health promotion practices was not widespread in China. One of the main challenges identified is the providers? inadequate capacities. However, little is known about the digital capacity for health promotion among primary care workers. Objective: This study aimed to investigate the levels of digital capacity for health promotion and its associated factors among community health workers. Methods: A total of 1346 community health workers were recruited from across 47 communities in Shanghai, China, through cluster-stratified random sampling. The digital capacity for health promotion was measured using the revised version of the Digital Capabilities Framework. Web-based questionnaires were distributed to collect data from March 20 to March 29, 2024. Data were analyzed using descriptive statistics, independent t tests, one-way ANOVA, and linear hierarchical regression using Stata MP (version 17.0; StataCorp). Results: We included 1199 participants. Among them, 47.5% (570/1199) had high digital media use for more than 19.6 hours per week, whereas 31.8% (381/1199) demonstrated high digital media trust. The average level of digital capacity for health promotion was 16.71 (SD 2.94) out of 25 points. Demographics, digital media usage?related characteristics, perceived usefulness and usability, attitudes, and behaviors were significant predictors of the capacities, explaining 44.4% of the total variance. Master?s degree or above (?=.077; P=.013), perceived usability (?=.235; P<.001), attitudes toward digital media health promotion (?=.095; P=.002), and past digital media health promotion practices (?=.377; P<.001) had significantly positive associations with digital capacities for health promotion. However, senior (?=?.076; P=.008) or median (?=?.074; P=.01) titles had a significant negative association with capacity levels. Conclusions: A digitally capable workforce is required for primary health care systems to take full advantage of digital media health promotion. Therefore, solutions are necessary to achieve enhanced capacities among health professionals, including public health policy making, community empowerment, and individual practices. UR - https://www.jmir.org/2024/1/e63054 UR - http://dx.doi.org/10.2196/63054 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/63054 ER - TY - JOUR AU - Wallraf, Simon AU - Dierks, Marie-Luise AU - John, Cosima AU - Lander, Jonas PY - 2024/12/20 TI - Patient Organizations? Digital Responses to the COVID-19 Pandemic: Scoping Review JO - J Med Internet Res SP - e58566 VL - 26 KW - patient organizations KW - COVID-19 KW - digital adaptation KW - digital transformation KW - scoping review N2 - Background: Patient organizations (POs) play a crucial role in supporting individuals with health conditions. Their activities range from counseling to support groups to advocacy. The COVID-19 pandemic and its related public health measures prompted rapid digital transformation efforts across multiple sectors, including health care. Objective: This study aimed to explore how POs digitally responded to pandemic-related circumstances, focusing on aspects such as the technologies used, positive outcomes, and challenges encountered. Methods: This scoping review followed the methodological guidance of the JBI (Joanna Briggs Institute) Scoping Review Methodology Group and adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting guidelines. A systematic search of PubMed, the Web of Science Core Collection, and the WHO (World Health Organization) COVID-19 database, supplemented by a citation search approach, was conducted. The initial search was performed on November 10, 2022, and updated on November 8, 2023. Publications were eligible if they were published after November 30, 2019, and addressed pandemic-related digitalization efforts of POs, defined as nonprofit organizations with a focus on health-related support. A 2-step screening process was used to identify relevant literature. Data were extracted using a standardized table to capture aspects such as digital adaptation activities (eg, types of technologies implemented, positive outcomes, challenges, and facilitating factors) and coded inductively to identify similarities across included publications, and the findings were synthesized narratively. Results: The search and its subsequent update yielded 2212 records, with 13 articles included in this review. These articles revealed a range of PO services that were digitally adapted during the pandemic, with videoconferencing software emerging as the most commonly used tool (n=9 articles). The digital adaptation of group-based support activities was the most frequently reported transformation (n=9). Other adaptations included the digitalization of counseling services (n=3) and the delivery of information and education (n=3), including educational workshops, weekly webinars, and the dissemination of information through digital newsletters. While the use of digital formats, particularly for POs? group activities, often increased accessibility by breaking down preexisting barriers (n=5), they also created new barriers for certain groups, such as those lacking digital skills or resources (n=4). Some participants experienced a loss of interpersonal aspects, like a sense of community (n=3). However, further findings suggest that the digital delivery of such group activities preserved essential interpersonal aspects (n=7) and a preference among some participants to continue digital group activities (n=4), suggesting the potential for sustainability of such options post the COVID-19 pandemic. Conclusions: The rapid digitalization efforts of POs demonstrate their adaptability and the potential of digital technologies to improve support services, despite some challenges. Future digitalization strategies should focus, among other things, on promoting digital literacy to ensure the accessibility and inclusiveness of digital services. Trial Registration: OSF Registries, https://osf.io/anvf4 UR - https://www.jmir.org/2024/1/e58566 UR - http://dx.doi.org/10.2196/58566 UR - http://www.ncbi.nlm.nih.gov/pubmed/39705075 ID - info:doi/10.2196/58566 ER - TY - JOUR AU - Ogundiya, Oluwadamilola AU - Rahman, Jasmine Thahmina AU - Valnarov-Boulter, Ioan AU - Young, Michael Tim PY - 2024/12/19 TI - Looking Back on Digital Medical Education Over the Last 25 Years and Looking to the Future: Narrative Review JO - J Med Internet Res SP - e60312 VL - 26 KW - digital health KW - digital medical education KW - health education KW - medical education KW - mobile phone KW - artificial intelligence KW - AI N2 - 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. UR - https://www.jmir.org/2024/1/e60312 UR - http://dx.doi.org/10.2196/60312 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/60312 ER - TY - JOUR AU - Han, Qing PY - 2024/12/11 TI - Topics and Trends of Health Informatics Education Research: Scientometric Analysis JO - JMIR Med Educ SP - e58165 VL - 10 KW - health informatics education KW - scientometric analysis KW - structural topic model KW - health informatics KW - medical informatics KW - medical education N2 - Background: Academic and educational institutions are making significant contributions toward training health informatics professionals. As research in health informatics education (HIE) continues to grow, it is useful to have a clearer understanding of this research field. Objective: This study aims to comprehensively explore the research topics and trends of HIE from 2014 to 2023. Specifically, it aims to explore (1) the trends of annual articles, (2) the prolific countries/regions, institutions, and publication sources, (3) the scientific collaborations of countries/regions and institutions, and (4) the major research themes and their developmental tendencies. Methods: Using publications in Web of Science Core Collection, a scientometric analysis of 575 articles related to the field of HIE was conducted. The structural topic model was used to identify topics discussed in the literature and to reveal the topic structure and evolutionary trends of HIE research. Results: Research interest in HIE has clearly increased from 2014 to 2023, and is continually expanding. The United States was found to be the most prolific country in this field. Harvard University was found to be the leading institution with the highest publication productivity. Journal of Medical Internet Research, Journal of The American Medical Informatics Association, and Applied Clinical Informatics were the top 3 journals with the highest articles in this field. Countries/regions and institutions having higher levels of international collaboration were more impactful. Research on HIE could be modeled into 7 topics related to the following areas: clinical (130/575, 22.6%), mobile application (123/575, 21.4%), consumer (99/575, 17.2%), teaching (61/575, 10.6%), public health (56/575, 9.7%), discipline (55/575, 9.6%), and nursing (51/575, 8.9%). The results clearly indicate the unique foci for each year, depicting the process of development for health informatics research. Conclusions: This is believed to be the first scientometric analysis exploring the research topics and trends in HIE. This study provides useful insights and implications, and the findings could be used as a guide for HIE contributors. UR - https://mededu.jmir.org/2024/1/e58165 UR - http://dx.doi.org/10.2196/58165 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/58165 ER - TY - JOUR AU - Wosny, Marie AU - Strasser, Maria Livia AU - Kraehenmann, Simone AU - Hastings, Janna PY - 2024/11/27 TI - Practical Recommendations for Navigating Digital Tools in Hospitals: Qualitative Interview Study JO - JMIR Med Educ SP - e60031 VL - 10 KW - health care KW - hospital KW - information system KW - information technology KW - technology implementation KW - training KW - medical education KW - digital literacy KW - curriculum development KW - health care workforce development KW - mobile phone N2 - Background: The digitalization of health care organizations is an integral part of a clinician?s daily life, making it vital for health care professionals (HCPs) to understand and effectively use digital tools in hospital settings. However, clinicians often express a lack of preparedness for their digital work environments. Particularly, new clinical end users, encompassing medical and nursing students, seasoned professionals transitioning to new health care environments, and experienced practitioners encountering new health care technologies, face critically intense learning periods, often with a lack of adequate time for learning digital tools, resulting in difficulties in integrating and adopting these digital tools into clinical practice. Objective: This study aims to comprehensively collect advice from experienced HCPs in Switzerland to guide new clinical end users on how to initiate their engagement with health ITs within hospital settings. Methods: We conducted qualitative interviews with 52 HCPs across Switzerland, representing 24 medical specialties from 14 hospitals. The interviews were transcribed verbatim and analyzed through inductive thematic analysis. Codes were developed iteratively, and themes and aggregated dimensions were refined through collaborative discussions. Results: Ten themes emerged from the interview data, namely (1) digital tool understanding, (2) peer-based learning strategies, (3) experimental learning approaches, (4) knowledge exchange and support, (5) training approaches, (6) proactive innovation, (7) an adaptive technology mindset, (8) critical thinking approaches, (9) dealing with emotions, and (10) empathy and human factors. Consequently, we devised 10 recommendations with specific advice to new clinical end users on how to approach new health care technologies, encompassing the following: take time to get to know and understand the tools you are working with; proactively ask experienced colleagues; simply try it out and practice; know where to get help and information; take sufficient training; embrace curiosity and pursue innovation; maintain an open and adaptable mindset; keep thinking critically and use your knowledge base; overcome your fears, and never lose the human and patient focus. Conclusions: Our study emphasized the importance of comprehensive training and learning approaches for health care technologies based on the advice and recommendations of experienced HCPs based in Swiss hospitals. Moreover, these recommendations have implications for medical educators and clinical instructors, providing advice on effective methods to instruct and support new end users, enabling them to use novel technologies proficiently. Therefore, we advocate for new clinical end users, health care institutions and clinical instructors, academic institutions and medical educators, and regulatory bodies to prioritize effective training and cultivating technological readiness to optimize IT use in health care. UR - https://mededu.jmir.org/2024/1/e60031 UR - http://dx.doi.org/10.2196/60031 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/60031 ER - TY - JOUR AU - Zhou, You AU - Li, Si-Jia AU - Tang, Xing-Yi AU - He, Yi-Chen AU - Ma, Hao-Ming AU - Wang, Ao-Qi AU - Pei, Run-Yuan AU - Piao, Mei-Hua PY - 2024/11/19 TI - Using ChatGPT in Nursing: Scoping Review of Current Opinions JO - JMIR Med Educ SP - e54297 VL - 10 KW - ChatGPT KW - large language model KW - nursing KW - artificial intelligence KW - scoping review KW - generative AI KW - nursing education N2 - Background: Since the release of ChatGPT in November 2022, this emerging technology has garnered a lot of attention in various fields, and nursing is no exception. However, to date, no study has comprehensively summarized the status and opinions of using ChatGPT across different nursing fields. Objective: We aim to synthesize the status and opinions of using ChatGPT according to different nursing fields, as well as assess ChatGPT?s strengths, weaknesses, and the potential impacts it may cause. Methods: This scoping review was conducted following the framework of Arksey and O?Malley and guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A comprehensive literature research was conducted in 4 web-based databases (PubMed, Embase, Web of Science, and CINHAL) to identify studies reporting the opinions of using ChatGPT in nursing fields from 2022 to September 3, 2023. The references of the included studies were screened manually to further identify relevant studies. Two authors conducted studies screening, eligibility assessments, and data extraction independently. Results: A total of 30 studies were included. The United States (7 studies), Canada (5 studies), and China (4 studies) were countries with the most publications. In terms of fields of concern, studies mainly focused on ?ChatGPT and nursing education? (20 studies), ?ChatGPT and nursing practice? (10 studies), and ?ChatGPT and nursing research, writing, and examination? (6 studies). Six studies addressed the use of ChatGPT in multiple nursing fields. Conclusions: As an emerging artificial intelligence technology, ChatGPT has great potential to revolutionize nursing education, nursing practice, and nursing research. However, researchers, institutions, and administrations still need to critically examine its accuracy, safety, and privacy, as well as academic misconduct and potential ethical issues that it may lead to before applying ChatGPT to practice. UR - https://mededu.jmir.org/2024/1/e54297 UR - http://dx.doi.org/10.2196/54297 ID - info:doi/10.2196/54297 ER - TY - JOUR AU - Oudshoorn, Cathelijn AU - Frielink, Noud AU - Riper, Heleen AU - Embregts, Petri PY - 2024/11/12 TI - Acceptance and Use of eHealth in Support and Psychological Therapy for People With Intellectual Disabilities: Two Cross-Sectional Studies of Health Care Professionals JO - JMIR Form Res SP - e52788 VL - 8 KW - acceptance KW - health care professionals KW - intellectual disabilities KW - eHealth KW - disability KW - psychological therapy KW - support KW - cross-sectional survey N2 - Background: Acceptance of health care professionals is of paramount importance for the uptake and implementation of eHealth. The Unified Theory of Acceptance and Use of Technology (UTAUT) model is a widely used framework for studying health care professionals? acceptance and actual use of eHealth among general client populations. However, there is limited understanding of the eHealth acceptance of health care professionals working with people with intellectual disabilities (ID). Objective: This study aimed to explore the applicability of the UTAUT model toward understanding the acceptance, intention to use, and actual use of eHealth among support staff and therapists working with people with ID. Methods: A total of 2 cross-sectional survey studies were conducted among health care professionals from 5 health care organizations for people with ID in the Netherlands in 2018 (n=311) and in 2021 during the COVID-19 pandemic (n=326). In addition to confirmatory and exploratory factor analyses to evaluate both the original UTAUT model and an extended version, descriptive analysis was used to explore participants? characteristics, acceptance levels, and eHealth usage. Moderator analysis and multiple regression analysis were also used. Results: A confirmatory factor analysis indicated a poor fit for both the original 4-factor UTAUT model and the extended version. An exploratory factor analysis was then conducted, resulting in a more satisfactory 5-factor model after removing 1 item with a factor loading <.40. Internal consistency of the 5 factors ranged from acceptable to good (Cronbach ?=.76-.85). Collectively, all factors predicted the intention to use eHealth in 2018 (R2=0.47; F5,305=54.885; P<.001) and in 2021 (R2=0.43; F5,320=49.32; P<.001). Participants scored moderately on all 5 acceptance factors in both 2018 and 2021. Moderator analysis indicated that age and voluntariness influence the relationship between factors that determined acceptance and intention to use eHealth. Conclusions: The findings from 2 cross-sectional studies conducted in 2018 and 2021, using an extended UTAUT model, gave a deeper understanding of eHealth acceptance among health care professionals who work with people with ID. UR - https://formative.jmir.org/2024/1/e52788 UR - http://dx.doi.org/10.2196/52788 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/52788 ER - TY - JOUR AU - Alli, Rabia Sauliha AU - Hossain, Qahh?r Soaad AU - Das, Sunit AU - Upshur, Ross PY - 2024/11/4 TI - The Potential of Artificial Intelligence Tools for Reducing Uncertainty in Medicine and Directions for Medical Education JO - JMIR Med Educ SP - e51446 VL - 10 KW - artificial intelligence KW - machine learning KW - uncertainty KW - clinical decision-making KW - medical education KW - generative AI KW - generative artificial intelligence UR - https://mededu.jmir.org/2024/1/e51446 UR - http://dx.doi.org/10.2196/51446 ID - info:doi/10.2196/51446 ER - TY - JOUR AU - Mun, Michelle AU - Chanchlani, Sonia AU - Lyons, Kayley AU - Gray, Kathleen PY - 2024/10/31 TI - Transforming the Future of Digital Health Education: Redesign of a Graduate Program Using Competency Mapping JO - JMIR Med Educ SP - e54112 VL - 10 KW - digital health KW - digital transformation KW - health care KW - clinical informatics KW - competencies KW - graduate education UR - https://mededu.jmir.org/2024/1/e54112 UR - http://dx.doi.org/10.2196/54112 ID - info:doi/10.2196/54112 ER - TY - JOUR AU - Tang, Yan AU - Yang, Juan AU - Wang, Ni AU - Wang, Xin AU - Hu, Wenli PY - 2024/10/24 TI - The Use of Mobile Health Care Among Medical Professionals in the Sichuan-Chongqing Region: Cross-Sectional Survey Study JO - JMIR Hum Factors SP - e59153 VL - 11 KW - health care professionals KW - mobile health care KW - technical training KW - cross-sectional survey KW - utilization KW - mobile KW - usage KW - China KW - web-based questionnaire KW - logistic regression KW - training KW - support N2 - Background: The emergence and integration of mobile health care technology have fundamentally transformed the health care industry, providing unprecedented opportunities to improve health care services and professional practice. Despite its immense potential, the adoption of mobile health care technology among health care professionals remains uneven, particularly in resource-limited regions. Objective: This study aims to explore the use and influencing factors of mobile health care among health care professionals in the Sichuan-Chongqing region of China and make recommendations. Methods: Convenience sampling was used in a cross-sectional study conducted from November 8 to November 14, 2023, to survey frontline clinical health care professionals at 5 district-level secondary public hospitals in the Sichuan-Chongqing region. A web-based questionnaire was used to investigate the use of mobile health care and its influencing factors among the participants. Descriptive analysis and logistic regression analysis were used in the study. Results: A total of 550 valid questionnaires were completed. Among the surveyed health care professionals, only 18.7% (103/550) used mobile health care, with a satisfaction rate of only 50.5% (52/103). Around 81.3% (447/550) did not use any form of mobile health care. The age group of 30?39 years was found to be a significant factor influencing the use of mobile health care by health care professionals (P=.03). The main reasons for not using mobile health care among health care professionals were lack of appropriate technical training and support (266/447, 59.5%), lack of suitable management-specific apps (204/447, 45.6%), and concerns about increased workload (180/447, 40.3%). There were significant differences in the single-factor analysis of the reasons for the nonuse of mobile health care among health care professionals from different specialties (P=.04). Logistic regression analysis indicated that age was the only significant factor influencing the use of mobile health care by health care professionals (P=.04). Conclusions: The utilization rate of mobile health care among health care professionals in the Sichuan-Chongqing region is low. Age is a significant factor that influences whether health care professionals use mobile health care. Providing appropriate technical training and support may help improve the enthusiasm of health care professionals in using mobile health care. UR - https://humanfactors.jmir.org/2024/1/e59153 UR - http://dx.doi.org/10.2196/59153 ID - info:doi/10.2196/59153 ER - TY - JOUR AU - van Westerhuis, Charlotte AU - Sanders, F. Astrid AU - Aarden, J. Jesse AU - Major, E. Mel AU - de Leeuwerk, E. Marijke AU - Florisson, Nadine AU - Wijbenga, H. Miriam AU - van der Schaaf, Marike AU - van der Leeden, Marike AU - van Egmond, A. Maarten PY - 2024/10/24 TI - Capabilities for Using Telemonitoring in Physiotherapy Treatment: Exploratory Qualitative Study JO - JMIR Rehabil Assist Technol SP - e56432 VL - 11 KW - telemedicine KW - telemonitoring KW - technology KW - physical therapy modalities KW - education KW - physiotherapist KW - physiotherapy KW - telehealth N2 - Background: Telemonitoring (TM), as part of telehealth, allows physiotherapists to monitor and coach their patients using remotely collected data. The use of TM requires a different approach compared with face-to-face treatment. Although a telehealth capability framework exists for health care professionals, it remains unclear what specific capabilities are required to use TM during physiotherapy treatments. Objective: This study aims to identify the capabilities required to use TM in physiotherapy treatment. Methods: An exploratory qualitative study was conducted following a constructivist semistructured grounded theory approach. Three heterogeneous focus groups were conducted with 15 lecturers of the School of Physiotherapy (Bachelor of Science Physiotherapy program) from the Amsterdam University of Applied Sciences. Focus group discussions were audiotaped and transcribed verbatim. Capabilities for using TM in physiotherapy treatment were identified during an iterative process of data collection and analysis, based on an existing framework with 4 different domains. Team discussions supported further conceptualization of the findings. Results: Sixteen capabilities for the use of TM in physiotherapy treatment were found addressing 3 different domains. Four capabilities were identified in the ?digital health technologies, systems, and policies? domain, 7 capabilities in the ?clinical practice and application? domain, and 5 capabilities in the ?data analysis and knowledge creation? domain. No capabilities were identified in the ?system and technology implementation? domain. Conclusions: The use of TM in physiotherapy treatment requires specific skills from physiotherapists. To best use TM in physiotherapy treatment, it is important to integrate these capabilities into the education of current and future physiotherapists. UR - https://rehab.jmir.org/2024/1/e56432 UR - http://dx.doi.org/10.2196/56432 ID - info:doi/10.2196/56432 ER - TY - JOUR AU - Saigí-Rubió, Francesc AU - Romeu, Teresa AU - Hernández Encuentra, Eulàlia AU - Guitert, Montse AU - Andrés, Erik AU - Reixach, Elisenda PY - 2024/10/17 TI - Design, Implementation, and Analysis of an Assessment and Accreditation Model to Evaluate a Digital Competence Framework for Health Professionals: Mixed Methods Study JO - JMIR Med Educ SP - e53462 VL - 10 KW - eHealth literacy KW - eHealth competencies KW - digital health KW - competencies KW - eHealth KW - health literacy KW - digital technology KW - health care professionals KW - health care workers N2 - Background: Although digital health is essential for improving health care, its adoption remains slow due to the lack of literacy in this area. Therefore, it is crucial for health professionals to acquire digital skills and for a digital competence assessment and accreditation model to be implemented to make advances in this field. Objective: This study had two objectives: (1) to create a specific map of digital competences for health professionals and (2) to define and test a digital competence assessment and accreditation model for health professionals. Methods: We took an iterative mixed methods approach, which included a review of the gray literature and consultation with local experts. We used the arithmetic mean and SD in descriptive statistics, P values in hypothesis testing and subgroup comparisons, the greatest lower bound in test diagnosis, and the discrimination index in study instrument analysis. Results: The assessment model designed in accordance with the competence content defined in the map of digital competences and based on scenarios had excellent internal consistency overall (greatest lower bound=0.91). Although most study participants (110/122, 90.2%) reported an intermediate self-perceived digital competence level, we found that the vast majority would not attain a level-2 Accreditation of Competence in Information and Communication Technologies. Conclusions: Knowing the digital competence level of health professionals based on a defined competence framework should enable such professionals to be trained and updated to meet real needs in their specific professional contexts and, consequently, take full advantage of the potential of digital technologies. These results have informed the Health Plan for Catalonia 2021-2025, thus laying the foundations for creating and offering specific training to assess and certify the digital competence of such professionals. UR - https://mededu.jmir.org/2024/1/e53462 UR - http://dx.doi.org/10.2196/53462 UR - http://www.ncbi.nlm.nih.gov/pubmed/39418092 ID - info:doi/10.2196/53462 ER - TY - JOUR AU - Sze, Ping Kai AU - Fong, Wei Qi AU - De Roza, Giovanna Jacqueline AU - Lee, Sing Eng AU - Tan, Yun Shu PY - 2024/10/15 TI - Exploring Physicians? Perceptions of Digital Health?s Impact on the Patient-Physician Relationship in the Primary Health Care Setting: Qualitative Descriptive Study JO - J Med Internet Res SP - e53705 VL - 26 KW - patient-physician relationship KW - patient communication KW - trust KW - primary care medicine KW - digital health KW - primary care KW - longitudinal care KW - policy KW - implementation N2 - Background: Digital health has become essential for effective clinical practice. However, the successful adoption of digital health is dependent on the strength of the patient-physician relationship. The patient-physician relationship shapes the quality of care and impacts health care outcomes, especially in primary care. However, the impact of the increasing use of digital health on the patient-physician relationship is uncertain. Objective: This study aims to explore the types of digital health primary care physicians use and understand their impact on the patient-physician relationship from their perspective. Methods: This exploratory qualitative descriptive study used individual in-depth interviews guided by a semistructured topic guide. We purposively sampled physicians from 6 general primary care clinics in Singapore and used thematic analysis to identify emergent themes. Results: We conducted 12 interviews. We found that primary care physicians in Singapore had minimal exposure to digital health beyond the scope of institutional implementation. The three key themes that emerged were as follows: (1) evolving roles of both physicians and patients; (2) impact on trust, knowledge acquisition, and longitudinal care; and (3) adoption and use factors of digital health impacting patient-physician relationships. The adoption and use factors comprised ?social and personal,? ?technical and material,? and ?organization and policy? factors. Conclusions: The study identified that, while primary care physicians held mostly positive views on adopting digital health in improving the patient-physician relationship, they were concerned that digital health might erode trust, hinder proper knowledge acquisition, and reduce humanistic interaction. These concerns called for a nuanced approach to ensure that digital health would not compromise the patient-physician relationship. This could be achieved by ensuring that physicians possess the necessary skills, knowledge, and positive attitude, while health care organizations would provide robust IT capabilities and support. We recommend that education be refined and government policies on digital health adoption and use be revised to align with the goal of strengthening the patient-physician relationship. UR - https://www.jmir.org/2024/1/e53705 UR - http://dx.doi.org/10.2196/53705 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/53705 ER - TY - JOUR AU - Seth, Puneet AU - Carretas, Romina AU - Rudzicz, Frank PY - 2024/10/4 TI - The Utility and Implications of Ambient Scribes in Primary Care JO - JMIR AI SP - e57673 VL - 3 KW - artificial intelligence KW - AI KW - large language model KW - LLM KW - digital scribe KW - ambient scribe KW - organizational efficiency KW - electronic health record KW - documentation burden KW - administrative burden UR - https://ai.jmir.org/2024/1/e57673 UR - http://dx.doi.org/10.2196/57673 UR - http://www.ncbi.nlm.nih.gov/pubmed/39365655 ID - info:doi/10.2196/57673 ER - TY - JOUR AU - Mielitz, Annabelle AU - Kulau, Ulf AU - Bublitz, Lucas AU - Bittner, Anja AU - Friederichs, Hendrik AU - Albrecht, Urs-Vito PY - 2024/9/30 TI - Teaching Digital Medicine to Undergraduate Medical Students With an Interprofessional and Interdisciplinary Approach: Development and Usability Study JO - JMIR Med Educ SP - e56787 VL - 10 KW - medical education KW - digital medicine KW - digital health N2 - Background: An integration of digital medicine into medical education can help future physicians shape the digital transformation of medicine. Objective: We aim to describe and evaluate a newly developed course for teaching digital medicine (the Bielefeld model) for the first time. Methods: The course was held with undergraduate medical students at Medical School Ostwestfalen-Lippe at Bielefeld University, Germany, in 2023 and evaluated via pretest-posttest surveys. The subjective and objective achievement of superordinate learning objectives and the objective achievement of subordinate learning objectives of the course, course design, and course importance were evaluated using 5-point Likert scales (1=strongly disagree; 5=strongly agree); reasons for absences were assessed using a multiple-choice format, and comments were collected. The superordinate objectives comprised (1) the understanding of factors driving the implementation of digital medical products and processes, (2) the application of this knowledge to a project, and (3) the empowerment to design such solutions in the future. The subordinate objectives comprised competencies related to the first superordinate objective. Results: In total, 10 undergraduate medical students (male: n=4, 40%; female: n=6, 60%; mean age 21.7, SD 2.1 years) evaluated the course. The superordinate objectives were achieved well to very well?the medians for the objective achievement were 4 (IQR 4-5), 4 (IQR 3-5), and 4 (IQR 4-4) scale units for the first, second, and third objectives, respectively, and the medians for the subjective achievement of the first, second, and third objectives were 4 (IQR 3-4), 4.5 (IQR 3-5), and 4 (IQR 3-5) scale units, respectively. Participants mastered the subordinate objectives, on average, better after the course than before (presurvey median 2.5, IQR 2-3 scale units; postsurvey median 4, IQR 3-4 scale units). The course concept was rated as highly suitable for achieving the superordinate objectives (median 5, IQR 4-5 scale units for the first, second, and third objectives). On average, the students strongly liked the course (median 5, IQR 4-5 scale units) and gained a benefit from it (median 4.5, IQR 4-5 scale units). All students fully agreed that the teaching staff was a strength of the course. The category positive feedback on the course or positive personal experience with the course received the most comments. Conclusions: The course framework shows promise in attaining learning objectives within the realm of digital medicine, notwithstanding the constraint of limited interpretability arising from a small sample size and further limitations. The course concept aligns with insights derived from teaching and learning research and the domain of digital medicine, albeit with identifiable areas for enhancement. A literature review indicates a dearth of publications pertaining to analogous courses in Germany. Future investigations should entail a more exhaustive evaluation of the course. In summary, this course constitutes a valuable contribution to incorporating digital medicine into medical education. UR - https://mededu.jmir.org/2024/1/e56787 UR - http://dx.doi.org/10.2196/56787 UR - http://www.ncbi.nlm.nih.gov/pubmed/39189929 ID - info:doi/10.2196/56787 ER - TY - JOUR AU - Lee, Hwa Kye AU - Lee, Ho Jae AU - Lee, Yura AU - Lee, Hyunna AU - Lee, Sung Ji AU - Jang, Jeon Hye AU - Lee, Hee Kun AU - Han, Hyun Jeong AU - Jang, SuJung PY - 2024/9/25 TI - Impact of Health Informatics Analyst Education on Job Role, Career Transition, and Skill Development: Survey Study JO - JMIR Med Educ SP - e54427 VL - 10 KW - health informatics KW - health informatics training KW - informatics training KW - professional development KW - training program KW - digital health technology KW - informatics workforce KW - informatics competencies KW - competencies KW - job skills KW - continuing education KW - data science N2 - Background: Professionals with expertise in health informatics play a crucial role in the digital health sector. Despite efforts to train experts in this field, the specific impact of such training, especially for individuals from diverse academic backgrounds, remains undetermined. Objective: This study therefore aims to evaluate the effectiveness of an intensive health informatics training program on graduates with respect to their job roles, transitions, and competencies and to provide insights for curriculum design and future research. Methods: A survey was conducted among 206 students who completed the Advanced Health Informatics Analyst program between 2018 and 2022. The questionnaire comprised four categories: (1) general information about the respondent, (2) changes before and after program completion, (3) the impact of the program on professional practice, and (4) continuing education requirements. Results: The study received 161 (78.2%) responses from the 206 students. Graduates of the program had diverse academic backgrounds and consequently undertook various informatics tasks after their training. Most graduates (117/161, 72.7%) are now involved in tasks such as data preprocessing, visualizing results for better understanding, and report writing for data processing and analysis. Program participation significantly improved job performance (P=.03), especially for those with a master?s degree or higher (odds ratio 2.74, 95% CI 1.08?6.95) and those from regions other than Seoul or Gyeonggi-do (odds ratio 10.95, 95% CI 1.08?6.95). A substantial number of respondents indicated that the training had a substantial influence on their career transitions, primarily by providing a better understanding of job roles and generating intrinsic interest in the field. Conclusions: The integrated practical education program was effective in addressing the diverse needs of trainees from various fields, enhancing their capabilities, and preparing them for the evolving industry demands. This study emphasizes the value of providing specialized training in health informatics for graduates regardless of their discipline. UR - https://mededu.jmir.org/2024/1/e54427 UR - http://dx.doi.org/10.2196/54427 ID - info:doi/10.2196/54427 ER - TY - JOUR AU - MacNeill, Luke A. AU - MacNeill, Lillian AU - Luke, Alison AU - Doucet, Shelley PY - 2024/9/25 TI - Health Professionals? Views on the Use of Conversational Agents for Health Care: Qualitative Descriptive Study JO - J Med Internet Res SP - e49387 VL - 26 KW - conversational agents KW - chatbots KW - health care KW - health professionals KW - health personnel KW - qualitative KW - interview N2 - Background: In recent years, there has been an increase in the use of conversational agents for health promotion and service delivery. To date, health professionals? views on the use of this technology have received limited attention in the literature. Objective: The purpose of this study was to gain a better understanding of how health professionals view the use of conversational agents for health care. Methods: Physicians, nurses, and regulated mental health professionals were recruited using various web-based methods. Participants were interviewed individually using the Zoom (Zoom Video Communications, Inc) videoconferencing platform. Interview questions focused on the potential benefits and risks of using conversational agents for health care, as well as the best way to integrate conversational agents into the health care system. Interviews were transcribed verbatim and uploaded to NVivo (version 12; QSR International, Inc) for thematic analysis. Results: A total of 24 health professionals participated in the study (19 women, 5 men; mean age 42.75, SD 10.71 years). Participants said that the use of conversational agents for health care could have certain benefits, such as greater access to care for patients or clients and workload support for health professionals. They also discussed potential drawbacks, such as an added burden on health professionals (eg, program familiarization) and the limited capabilities of these programs. Participants said that conversational agents could be used for routine or basic tasks, such as screening and assessment, providing information and education, and supporting individuals between appointments. They also said that health professionals should have some oversight in terms of the development and implementation of these programs. Conclusions: The results of this study provide insight into health professionals? views on the use of conversational agents for health care, particularly in terms of the benefits and drawbacks of these programs and how they should be integrated into the health care system. These collective findings offer useful information and guidance to stakeholders who have an interest in the development and implementation of this technology. UR - https://www.jmir.org/2024/1/e49387 UR - http://dx.doi.org/10.2196/49387 UR - http://www.ncbi.nlm.nih.gov/pubmed/39320936 ID - info:doi/10.2196/49387 ER - TY - JOUR AU - Sahan, Fatma AU - Guthardt, Lisa AU - Panitz, Karin AU - Siegel-Kianer, Anna AU - Eichhof, Isabel AU - Schmitt, D. Björn AU - Apolinario-Hagen, Jennifer PY - 2024/9/20 TI - Enhancing Digital Health Awareness and mHealth Competencies in Medical Education: Proof-of-Concept Study and Summative Process Evaluation of a Quality Improvement Project JO - JMIR Med Educ SP - e59454 VL - 10 KW - medical students KW - digital health KW - design thinking KW - digital health literacy KW - medical education KW - digital health competencies KW - mobile phone N2 - Background: Currently, there is a need to optimize knowledge on digital transformation in mental health care, including digital therapeutics (eg, prescription apps), in medical education. However, in Germany, digital health has not yet been systematically integrated into medical curricula and is taught in a relatively small number of electives. Challenges for lecturers include the dynamic field as well as lacking guidance on how to efficiently apply innovative teaching formats for these new digital competencies. Quality improvement projects provide options to pilot-test novel educational offerings, as little is known about the acceptability of participatory approaches in conventional medical education. Objective: This quality improvement project addressed the gap in medical school electives on digital health literacy by introducing and evaluating an elective scoping study on the systematic development of different health app concepts designed by students to cultivate essential skills for future health care professionals (ie, mobile health [mHealth] competencies). Methods: This proof-of-concept study describes the development, optimization, implementation, and evaluation of a web-based elective on digital (mental) health competencies in medical education. Implemented as part of a quality improvement project, the elective aimed to guide medical students in developing app concepts applying a design thinking approach at a German medical school from January 2021 to January 2024. Topics included defining digital (mental) health, quality criteria for health apps, user perspective, persuasive design, and critical reflection on digitization in medical practice. The elective was offered 6 times within 36 months, with continuous evaluation and iterative optimization using both process and outcome measures, such as web-based questionnaires. We present examples of app concepts designed by students and summarize the quantitative and qualitative evaluation results. Results: In total, 60 students completed the elective and developed 25 health app concepts, most commonly targeting stress management and depression. In addition, disease management and prevention apps were designed for various somatic conditions such as diabetes and chronic pain. The results indicated high overall satisfaction across the 6 courses according to the evaluation questionnaire, with lower scores indicating higher satisfaction on a scale ranging from 1 to 6 (mean 1.70, SD 0.68). Students particularly valued the content, flexibility, support, and structure. While improvements in group work, submissions, and information transfer were suggested, the results underscore the usefulness of the web-based elective. Conclusions: This quality improvement project provides insights into relevant features for the successful user-centered and creative integration of mHealth competencies into medical education. Key factors for the satisfaction of students involved the participatory mindset, focus on competencies, discussions with app providers, and flexibility. Future efforts should define important learning objectives for digital health literacy and provide recommendations for integration rather than debating the need for digital health integration. UR - https://mededu.jmir.org/2024/1/e59454 UR - http://dx.doi.org/10.2196/59454 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/59454 ER - TY - JOUR AU - Livesay, Karen AU - Walter, Ruby AU - Petersen, Sacha AU - Abdolkhani, Robab AU - Zhao, Lin AU - Butler-Henderson, Kerryn PY - 2024/9/13 TI - Challenges and Needs in Digital Health Practice and Nursing Education Curricula: Gap Analysis Study JO - JMIR Med Educ SP - e54105 VL - 10 KW - nursing KW - digital health KW - capability KW - workforce KW - framework KW - nursing education KW - education KW - digital health practice KW - clinicians KW - nurse KW - nurse graduates KW - clinical nurses KW - nurses KW - nurse educators KW - teach KW - teaching KW - learning KW - nursing students KW - student KW - students N2 - Background: Australian nursing programs aim to introduce students to digital health requirements for practice. However, innovation in digital health is more dynamic than education providers? ability to respond. It is uncertain whether what is taught and demonstrated in nursing programs meets the needs and expectations of clinicians with regard to the capability of the nurse graduates. Objective: This study aims to identify gaps in the National Nursing and Midwifery Digital Health Capability Framework , based on the perspectives of clinical nurses, and in nurse educators? confidence and knowledge to teach. The findings will direct a future co-design process. Methods: This study triangulated the findings from 2 studies of the Digital Awareness in Simulated Health project and the National Nursing and Midwifery Digital Capability Framework. The first was a qualitative study that considered the experiences of nurses with digital health technologies during the COVID-19 pandemic, and the second was a survey of nurse educators who identified their confidence and knowledge to teach and demonstrate digital health concepts. Results: The results were categorized by and presented from the perspectives of nurse clinicians, nurse graduates, and nurse educators. Findings were listed against each of the framework capabilities, and omissions from the framework were identified. A series of statements and questions were formulated from the gap analysis to direct a future co-design process with nursing stakeholders to develop a digital health capability curriculum for nurse educators. Conclusions: Further work to evaluate nursing digital health opportunities for nurse educators is indicated by the gaps identified in this study. UR - https://mededu.jmir.org/2024/1/e54105 UR - http://dx.doi.org/10.2196/54105 ID - info:doi/10.2196/54105 ER - TY - JOUR AU - Ramachandran, Swathi AU - Chang, Hsiu-Ju AU - Worthington, Catherine AU - Kushniruk, Andre AU - Ibáñez-Carrasco, Francisco AU - Davies, Hugh AU - McKee, Geoffrey AU - Brown, Adalsteinn AU - Gilbert, Mark AU - Iyamu, Ihoghosa PY - 2024/9/9 TI - Digital Competencies and Training Approaches to Enhance the Capacity of Practitioners to Support the Digital Transformation of Public Health: Rapid Review of Current Recommendations JO - JMIR Public Health Surveill SP - e52798 VL - 10 KW - digital public health KW - digital transformation KW - digital transformations KW - rapid review KW - rapid reviews KW - synthesis KW - review methods KW - review methodology KW - competencies KW - competency KW - training and practice recommendations KW - public health workforce KW - workforce KW - worker KW - workers KW - practitioner KW - practitioners KW - public health KW - digital health KW - training KW - continuing education KW - skills KW - skill KW - recommendation KW - recommendations KW - best practice KW - guideline KW - guidelines N2 - Background: The COVID-19 pandemic highlighted gaps in the public health workforce?s capacity to deploy digital technologies while upholding ethical, social justice, and health equity principles. Existing public health competency frameworks have not been updated to reflect the prominent role digital technologies play in contemporary public health, and public health training institutions are seeking to integrate digital technologies in their curricula. Objective: As a first step in a multiphase study exploring recommendations for updates to public health competency frameworks within the Canadian public health context, we conducted a rapid review of literature aiming to identify recommendations for digital competencies, training approaches, and inter- or transdisciplinary partnerships that can enhance public health practitioners? capacity to support the digital transformation of public health. Methods: Following the World Health Organization?s (2017) guidelines for rapid reviews, a systematic search was conducted on Ovid MEDLINE, Ovid Embase, ERIC (Education Resources Information Center), and Web of Science for peer-reviewed articles. We also searched Google Scholar and various public health agency and public health association websites for gray literature using search terms related to public health, digital health, practice competencies, and training approaches. We included articles with explicit practice competencies and training recommendations related to digital technologies among public health practitioners published between January 2010 and December 2022. We excluded articles describing these concepts in passing or from a solely clinical perspective. Results: Our search returned 2023 titles and abstracts, of which only 12 studies met the inclusion criteria. We found recommendations for new competencies to enable public health practitioners to appropriately use digital technologies that cut across all existing categories of the core competencies for public health framework of the Public Health Agency of Canada. We also identified a new competency category related to data, data systems management, and governance. Training approaches identified include adapted degree-awarding programs like combined public health and informatics or data science degree programs and ongoing professional certifications with integration of practice-based learning in multi- and interdisciplinary training. Disciplines suggested as important to facilitate practice competency and training recommendations included public health, public health informatics, data, information and computer sciences, biostatistics, health communication, and business. Conclusions: Despite the growth of digital technologies in public health, recommendations about practice competencies and training approaches necessary to effectively support the digital transformation of public health remain limited in the literature. Where available, evidence suggests the workforce requires new competencies that cut across and extend existing public health competencies, including new competencies related to the use and protection of new digital data sources, alongside facilitating health communication and promotion functions using digital media. Recommendations also emphasize the need for training approaches that focus on interdisciplinarity through adapted degree-awarding public health training programs and ongoing professional development. UR - https://publichealth.jmir.org/2024/1/e52798 UR - http://dx.doi.org/10.2196/52798 ID - info:doi/10.2196/52798 ER - TY - JOUR AU - Kraft, Bernhard AU - Kuscher, Thomas AU - Zawatzki, Susann AU - Hofstetter, Sebastian AU - Jahn, Patrick PY - 2024/9/4 TI - Evaluation of the Continuing Education Training ?Beratende für Digitale Gesundheitsversorgung? (?Consultant for Digital Healthcare?): Protocol for an Effectiveness Study JO - JMIR Res Protoc SP - e57860 VL - 13 KW - digitization KW - digital-assistive technologies KW - nursing and health care professionals KW - further training program KW - digital competence KW - digital healthcare KW - digital health KW - effectiveness study KW - training program KW - nursing KW - nursings KW - health professional KW - health professionals KW - transfer of learning KW - satisfaction KW - mixed-method KW - self-assessment KW - Teaching Analysis Poll KW - technology KW - technologies KW - innovation KW - exploratory KW - intervention N2 - Background: The digital transformation in health care requires training nursing and health professionals in the digitally competent use of digital assistive technologies (DAT). The continuing education training ?Beratende für digitale Gesundheitsversorgung? (?Consultant for Digital Healthcare?) was developed to fill this gap. The effectiveness of the training program will be assessed in this study. Objective: The primary objective is to record and measure the participants? learning success. We will assess whether the previously defined teaching intentions, learning objectives, competencies, and participants? expectations have been achieved and whether a transfer of learning occurred. The secondary objective is participant satisfaction and feasibility of the training. The tertiary objective is the successful transfer of DAT by participants in their institutions. Methods: Approximately 65 nursing and health care professionals will participate in the pilot phase of the further training and evaluation process, which is planned in a mixed methods design in a nonsequential manner. The different methods will be combined in the interpretation of the results to achieve a synaptic view of the training program. We plan to conduct pre-post surveys in the form of participant self-assessments about dealing with DAT and content-related knowledge levels. Exploratory individual interviews will also be conducted to build theory, to examine whether and to what extent competence (cognition) has increased, and whether dealing (affect) with DAT has changed. Furthermore, an interim evaluation within the framework of the Teaching Analysis Poll (TAP) will occur. The knowledge thereby gained will be used to revise and adapt the modules for future courses. To assess the transfer success, the participants create a practical project, which is carried out within the training framework, observed by the lecturers, and subsequently evaluated and adapted. Results: We expect that the learning objectives for the continuing education training will be met. The attendees are expected to increase their level of digital competence in different skills areas: (1) theoretical knowledge, (2) hands-on skills for planning the application and practical use of DAT, (3) reflective skills and applying ethical and legal considerations in their use, (4) applying all that in a structured process of technology implementation within their practical sphere of work. Conclusions: The aim of this study and appropriate further training program are to educate nursing and health care professionals in the use of DAT, thereby empowering them for a structured change process toward digitally aided care. This focus gives rise to the following research questions: First, how should further training programs be developed, and which focus is appropriate for addressee-appropriate learning goals, course structure, and general curriculum? Second, how should a training program with this specific content and area be evaluated? Third, what are the conditions to offer a continued program? International Registered Report Identifier (IRRID): PRR1-10.2196/57860 UR - https://www.researchprotocols.org/2024/1/e57860 UR - http://dx.doi.org/10.2196/57860 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/57860 ER - TY - JOUR AU - Lawrence, Katharine AU - Levine, L. Defne PY - 2024/8/29 TI - The Digital Determinants of Health: A Guide for Competency Development in Digital Care Delivery for Health Professions Trainees JO - JMIR Med Educ SP - e54173 VL - 10 KW - digital health KW - digital determinants of health KW - digital health competencies KW - medical education curriculum KW - competency development KW - digital health education KW - training competencies KW - digital health skills KW - digital care delivery KW - health professions training UR - https://mededu.jmir.org/2024/1/e54173 UR - http://dx.doi.org/10.2196/54173 ID - info:doi/10.2196/54173 ER - TY - JOUR AU - Zainal, Humairah AU - Hui, Xiao Xin AU - Thumboo, Julian AU - Fong, Warren AU - Yong, Kok Fong PY - 2024/8/27 TI - Patients? Expectations of Doctors? Clinical Competencies in the Digital Health Care Era: Qualitative Semistructured Interview Study Among Patients JO - JMIR Hum Factors SP - e51972 VL - 11 KW - digital health KW - clinical competence KW - patient engagement KW - qualitative research KW - Singapore KW - mobile phone N2 - Background: Digital technologies have impacted health care delivery globally, and are increasingly being deployed in clinical practice. However, there is limited research on patients? expectations of doctors? clinical competencies when using digital health care technologies (DHTs) in medical care. Understanding these expectations can reveal competency gaps, enhance patient confidence, and contribute to digital innovation initiatives. Objective: This study explores patients? perceptions of doctors? use of DHTs in clinical care. Using Singapore as a case study, it examines patients? expectations regarding doctors? communication, diagnosis, and treatment skills when using telemedicine, health apps, wearable devices, electronic health records, and artificial intelligence. Methods: Findings were drawn from individual semistructured interviews with patients from outpatient clinics. Participants were recruited using purposive sampling. Data were analyzed qualitatively using thematic analysis. Results: Twenty-five participants from different backgrounds and with various chronic conditions participated in the study. They expected doctors to be adept in handling medical data from apps and wearable devices. For telemedicine, participants expected a level of assessment of their medical conditions akin to in-person consultations. In addition, they valued doctors recognizing when a physical examination was necessary. Interestingly, eye contact was appreciated but deemed nonessential by participants across all age bands when electronic health records were used, as they valued the doctor?s efficiency more than eye contact. Nonetheless, participants emphasized the need for empathy throughout the clinical encounter regardless of DHT use. Furthermore, younger participants had a greater expectation for DHT use among doctors compared to older ones, who preferred DHTs as a complement rather than a replacement for clinical skills. The former expected doctors to be knowledgeable about the algorithms, principles, and purposes of DHTs such as artificial intelligence technologies to better assist them in diagnosis and treatment. Conclusions: By identifying patients? expectations of doctors amid increasing health care digitalization, this study highlights that while basic clinical skills remain crucial in the digital age, the role of clinicians needs to evolve with the introduction of DHTs. It has also provided insights into how DHTs can be integrated effectively into clinical settings, aligning with patients? expectations and preferences. Overall, the findings offer a framework for high-income countries to harness DHTs in enhancing health care delivery in the digital era. UR - https://humanfactors.jmir.org/2024/1/e51972 UR - http://dx.doi.org/10.2196/51972 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/51972 ER - TY - JOUR AU - Kleib, Manal AU - Arnaert, Antonia AU - Nagle, M. Lynn AU - Sugars, Rebecca AU - da Costa, Daniel PY - 2024/8/19 TI - Newly Qualified Canadian Nurses? Experiences With Digital Health in the Workplace: Comparative Qualitative Analysis JO - JMIR Med Educ SP - e53258 VL - 10 KW - digital health KW - new graduate nurses KW - nursing practice KW - workplace KW - informatics N2 - Background: Clinical practice settings have increasingly become dependent on the use of digital or eHealth technologies such as electronic health records. It is vitally important to support nurses in adapting to digitalized health care systems; however, little is known about nursing graduates? experiences as they transition to the workplace. Objective: This study aims to (1) describe newly qualified nurses? experiences with digital health in the workplace, and (2) identify strategies that could help support new graduates? transition and practice with digital health. Methods: An exploratory descriptive qualitative design was used. A total of 14 nurses from Eastern and Western Canada participated in semistructured interviews and data were analyzed using inductive content analysis. Results: Three themes were identified: (1) experiences before becoming a registered nurse, (2) experiences upon joining the workplace, and (3) suggestions for bridging the gap in transition to digital health practice. Findings revealed more similarities than differences between participants with respect to gaps in digital health education, technology-related challenges, and their influence on nursing practice. Conclusions: Digital health is the foundation of contemporary health care; therefore, comprehensive education during nursing school and throughout professional nursing practice, as well as organizational support and policy, are critical pillars. Health systems investing in digital health technologies must create supportive work environments for nurses to thrive in technologically rich environments and increase their capacity to deliver the digital health future. UR - https://mededu.jmir.org/2024/1/e53258 UR - http://dx.doi.org/10.2196/53258 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/53258 ER - TY - JOUR AU - Kleib, Manal AU - Arnaert, Antonia AU - Nagle, M. Lynn AU - Darko, Mirekuwaa Elizabeth AU - Idrees, Sobia AU - da Costa, Daniel AU - Ali, Shamsa PY - 2024/8/13 TI - Resources to Support Canadian Nurses to Deliver Virtual Care: Environmental Scan JO - JMIR Med Educ SP - e53254 VL - 10 KW - virtual care KW - digital health KW - nursing practice KW - environmental scan KW - telehealth KW - nurses KW - Canada KW - health care N2 - Background: Regulatory and professional nursing associations have an important role in ensuring that nurses provide safe, competent, and ethical care and are capable of adapting to emerging phenomena that influence society and population health needs. Telehealth and more recently virtual care are 2 digital health modalities that have gained momentum during the COVID-19 pandemic. Telehealth refers to telecommunications and digital communication technologies used to deliver health care, support health care provider and patient education, and facilitate self-care. Virtual care facilitates the delivery of health care services via any remote communication between patients and health care providers and among health care providers, either synchronously or asynchronously, through information and communication technologies. Despite nurses? adaptability to delivering virtual care, many have also reported challenges. Objective: This study aims to describe resources about virtual care, digital health, and nursing informatics (ie, practice guidelines and fact sheets) available to Canadian nurses through their regulatory and professional associations. Methods: An environmental scan was conducted between March and July 2023. The websites of nursing regulatory bodies across 13 Canadian provinces and territories and relevant nursing and a few nonnursing professional associations were searched. Data were extracted from the websites of these organizations to map out educational materials, training opportunities, and guidelines made available for nurses to learn and adapt to the ongoing digitalization of the health care system. Information from each source was summarized and analyzed using an inductive content analysis approach to identify categories and themes. The Virtual Health Competency Framework was applied to support the analysis process. Results: Seven themes were identified: (1) types of resources available about virtual care, (2) terminologies used in virtual care resources, (3) currency of virtual care resources identified, (4) requirements for providing virtual care between provinces, (5) resources through professional nursing associations and other relevant organizations, (6) regulatory guidance versus competency in virtual care, and (7) resources about digital health and nursing informatics. Results also revealed that practice guidance for delivering telehealth existed before the COVID-19 pandemic, but it was further expanded during the pandemic. Differences were noted across available resources with respect to terms used (eg, telenursing, telehealth, or virtual care), types of documents (eg, guideline vs fact sheet), and the depth of information shared. Only 2 associations provided comprehensive telenursing practice guidelines. Resources relative to digital health and nursing informatics exist, but variations between provinces were also noted. Conclusions: The use of telehealth and virtual care services is becoming mainstream in Canadian health care. Despite variations across jurisdictions, the existing nursing practice guidance resources for delivering telehealth and virtual care are substantial and can serve as a beginning step for developing a standardized set of practice requirements or competencies to inform nursing practice and the education of future nurses. UR - https://mededu.jmir.org/2024/1/e53254 UR - http://dx.doi.org/10.2196/53254 UR - http://www.ncbi.nlm.nih.gov/pubmed/39137026 ID - info:doi/10.2196/53254 ER - TY - JOUR AU - Dingel, Julius AU - Kleine, Anne-Kathrin AU - Cecil, Julia AU - Sigl, Leonie Anna AU - Lermer, Eva AU - Gaube, Susanne PY - 2024/8/5 TI - Predictors of Health Care Practitioners? Intention to Use AI-Enabled Clinical Decision Support Systems: Meta-Analysis Based on the Unified Theory of Acceptance and Use of Technology JO - J Med Internet Res SP - e57224 VL - 26 KW - Unified Theory of Acceptance and Use of Technology KW - UTAUT KW - artificial intelligence?enabled clinical decision support systems KW - AI-CDSSs KW - meta-analysis KW - health care practitioners N2 - Background: Artificial intelligence?enabled clinical decision support systems (AI-CDSSs) offer potential for improving health care outcomes, but their adoption among health care practitioners remains limited. Objective: This meta-analysis identified predictors influencing health care practitioners? intention to use AI-CDSSs based on the Unified Theory of Acceptance and Use of Technology (UTAUT). Additional predictors were examined based on existing empirical evidence. Methods: The literature search using electronic databases, forward searches, conference programs, and personal correspondence yielded 7731 results, of which 17 (0.22%) studies met the inclusion criteria. Random-effects meta-analysis, relative weight analyses, and meta-analytic moderation and mediation analyses were used to examine the relationships between relevant predictor variables and the intention to use AI-CDSSs. Results: The meta-analysis results supported the application of the UTAUT to the context of the intention to use AI-CDSSs. The results showed that performance expectancy (r=0.66), effort expectancy (r=0.55), social influence (r=0.66), and facilitating conditions (r=0.66) were positively associated with the intention to use AI-CDSSs, in line with the predictions of the UTAUT. The meta-analysis further identified positive attitude (r=0.63), trust (r=0.73), anxiety (r=?0.41), perceived risk (r=?0.21), and innovativeness (r=0.54) as additional relevant predictors. Trust emerged as the most influential predictor overall. The results of the moderation analyses show that the relationship between social influence and use intention becomes weaker with increasing age. In addition, the relationship between effort expectancy and use intention was stronger for diagnostic AI-CDSSs than for devices that combined diagnostic and treatment recommendations. Finally, the relationship between facilitating conditions and use intention was mediated through performance and effort expectancy. Conclusions: This meta-analysis contributes to the understanding of the predictors of intention to use AI-CDSSs based on an extended UTAUT model. More research is needed to substantiate the identified relationships and explain the observed variations in effect sizes by identifying relevant moderating factors. The research findings bear important implications for the design and implementation of training programs for health care practitioners to ease the adoption of AI-CDSSs into their practice. UR - https://www.jmir.org/2024/1/e57224 UR - http://dx.doi.org/10.2196/57224 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/57224 ER - TY - JOUR AU - Butler-Henderson, Kerryn AU - Gray, Kathleen AU - Arabi, Salma PY - 2024/7/25 TI - Roles and Responsibilities of the Global Specialist Digital Health Workforce: Analysis of Global Census Data JO - JMIR Med Educ SP - e54137 VL - 10 KW - workforce KW - functions KW - digital health KW - census KW - census data KW - workforce survey KW - survey KW - support KW - development KW - use KW - management KW - health data KW - health information KW - health knowledge KW - health technology KW - Australia KW - New Zealand KW - online content KW - digital data N2 - Background: The Global Specialist Digital Health Workforce Census is the largest workforce survey of the specialist roles that support the development, use, management, and governance of health data, health information, health knowledge, and health technology. Objective: This paper aims to present an analysis of the roles and functions reported by respondents in the 2023 census. Methods: The 2023 census was deployed using Qualtrics and was open from July 1 to August 13, 2023. A broad definition was provided to guide respondents about who is in the specialist digital health workforce. Anyone who self-identifies as being part of this workforce could undertake the survey. The data was analyzed using descriptive statistical analysis and thematic analysis of the functions respondents reported in their roles. Results: A total of 1103 respondents completed the census, with data reported about their demographic information and their roles. The majority of respondents lived in Australia (n=870, 78.9%) or New Zealand (n=130, 11.8%), with most (n=620, 56.3%) aged 35?54 years and identifying as female (n=720, 65.3%). The top four occupational specialties were health informatics (n=179, 20.2%), health information management (n=175, 19.8%), health information technology (n=128, 14.4%), and health librarianship (n=104, 11.7%). Nearly all (n=797, 90%) participants identified as a manager or professional. Less than half (430/1019, 42.2%) had a formal qualification in a specialist digital health area, and only one-quarter (244/938, 26%) held a credential in a digital health area. While two-thirds (502/763, 65.7%) reported undertaking professional development in the last year, most were self-directed activities, such as seeking information or consuming online content. Work undertaken by specialist digital health workers could be classified as either leadership, functional, occupational, or technological. Conclusions: Future specialist digital health workforce capability frameworks should include the aspects of leadership, function, occupation, and technology. This largely unqualified workforce is undertaking little formal professional development to upskill them to continue to support the safe delivery and management of health and care through the use of digital data and technology. UR - https://mededu.jmir.org/2024/1/e54137 UR - http://dx.doi.org/10.2196/54137 ID - info:doi/10.2196/54137 ER - TY - JOUR AU - Aisyah, Nur Dewi AU - Setiawan, Heri Agus AU - Lokopessy, Fawwaz Alfiano AU - Faradiba, Nadia AU - Setiaji, Setiaji AU - Manikam, Logan AU - Kozlakidis, Zisis PY - 2024/7/18 TI - The Information and Communication Technology Maturity Assessment at Primary Health Care Services Across 9 Provinces in Indonesia: Evaluation Study JO - JMIR Med Inform SP - e55959 VL - 12 KW - public health centers KW - Puskesmas KW - digital maturity KW - infrastructure KW - primary health care KW - district health office KW - primary care clinics KW - Asia KW - Asian KW - Indonesia KW - ICT KW - information and communication technologies KW - information and communication technology KW - maturity KW - adoption KW - readiness KW - implementation KW - eHealth KW - telehealth KW - telemedicine KW - cross sectional KW - survey KW - surveys KW - questionnaire KW - questionnaires KW - primary care N2 - Background: Indonesia has rapidly embraced digital health, particularly during the COVID-19 pandemic, with over 15 million daily health application users. To advance its digital health vision, the government is prioritizing the development of health data and application systems into an integrated health care technology ecosystem. This initiative involves all levels of health care, from primary to tertiary, across all provinces. In particular, it aims to enhance primary health care services (as the main interface with the general population) and contribute to Indonesia?s digital health transformation. Objective: This study assesses the information and communication technology (ICT) maturity in Indonesian health care services to advance digital health initiatives. ICT maturity assessment tools, specifically designed for middle-income countries, were used to evaluate digital health capabilities in 9 provinces across 5 Indonesian islands. Methods: A cross-sectional survey was conducted from February to March 2022, in 9 provinces across Indonesia, representing the country?s diverse conditions on its major islands. Respondents included staff from public health centers (Puskesmas), primary care clinics (Klinik Pratama), and district health offices (Dinas Kesehatan Kabupaten/Kota). The survey used adapted ICT maturity assessment questionnaires, covering human resources, software and system, hardware, and infrastructure. It was administered electronically and involved 121 public health centers, 49 primary care clinics, and 67 IT staff from district health offices. Focus group discussions were held to delve deeper into the assessment results and gain more descriptive insights. Results: In this study, 237 participants represented 3 distinct categories: 121 public health centers, 67 district health offices, and 49 primary clinics. These instances were selected from a sample of 9 of the 34 provinces in Indonesia. Collected data from interviews and focus group discussions were transformed into scores on a scale of 1 to 5, with 1 indicating low ICT readiness and 5 indicating high ICT readiness. On average, the breakdown of ICT maturity scores was as follows: 2.71 for human resources? capability in ICT use and system management, 2.83 for software and information systems, 2.59 for hardware, and 2.84 for infrastructure, resulting in an overall average score of 2.74. According to the ICT maturity level pyramid, the ICT maturity of health care providers in Indonesia fell between the basic and good levels. The need to pursue best practices also emerged strongly. Further analysis of the ICT maturity scores, when examined by province, revealed regional variations. Conclusions: The maturity of ICT use is influenced by several critical components. Enhancing human resources, ensuring infrastructure, the availability of supportive hardware, and optimizing information systems are imperative to attain ICT maturity in health care services. In the context of ICT maturity assessment, significant score variations were observed across health care levels in the 9 provinces, underscoring the diversity in ICT readiness and the need for regionally customized follow-up actions. UR - https://medinform.jmir.org/2024/1/e55959 UR - http://dx.doi.org/10.2196/55959 ID - info:doi/10.2196/55959 ER - TY - JOUR AU - Doll, Joy AU - Anzalone, Jerrod A. AU - Clarke, Martina AU - Cooper, Kathryn AU - Polich, Ann AU - Siedlik, Jacob PY - 2024/6/17 TI - A Call for a Health Data?Informed Workforce Among Clinicians JO - JMIR Med Educ SP - e52290 VL - 10 KW - health data?informed workforce KW - health data KW - health informaticist KW - data literacy KW - workforce development UR - https://mededu.jmir.org/2024/1/e52290 UR - http://dx.doi.org/10.2196/52290 ID - info:doi/10.2196/52290 ER - TY - JOUR AU - Wekenborg, Katharina Magdalena AU - Förster, Katharina AU - Schweden, Florian AU - Weidemann, Robin AU - Bechtolsheim, von Felix AU - Kirschbaum, Clemens AU - Weitz, Jürgen AU - Ditzen, Beate PY - 2024/6/17 TI - Differences in Physicians? Ratings of Work Stressors and Resources Associated With Digital Transformation: Cross-Sectional Study JO - J Med Internet Res SP - e49581 VL - 26 KW - physicians KW - digital transformation KW - chronic stress KW - hair cortisol concentration KW - work stressors KW - work resources N2 - Background: The emergence of the COVID-19 pandemic rapidly accelerated the need and implementation of digital innovations, especially in medicine. Objective: To gain a better understanding of the stress associated with digital transformation in physicians, this study aims to identify working conditions that are stress relevant for physicians and differ in dependence on digital transformation. In addition, we examined the potential role of individual characteristics (ie, age, gender, and actual implementation of a digital innovation within the last 3 years) in digitalization-associated differences in these working conditions. Methods: Cross-sectional web-based questionnaire data of 268 physicians (mean age 40.9, SD 12.3 y; n=150, 56% women) in Germany were analyzed. Physicians rated their chronic stress level and 11 relevant working conditions (ie, work stressors such as time pressure and work resources such as influence on sequence) both before and after either a fictional or real implementation of a relevant digital transformation at their workplace. In addition, a subsample of individuals (60; n=33, 55% women) submitted self-collected hair samples for cortisol analysis. Results: The stress relevance of the selected working conditions was confirmed by significant correlations with self-rated chronic stress and hair cortisol levels (hair F) within the sample, all of them in the expected direction (P values between .01 and <.001). Multilevel modeling revealed significant differences associated with digital transformation in the rating of 8 (73%) out of 11 working conditions. More precisely, digital transformation was associated with potentially stress-enhancing effects in 6 working conditions (ie, influence on procedures and complexity of tasks) and stress-reducing effects in 2 other working conditions (ie, perceived workload and time pressure). Younger individuals, women, and individuals whose workplaces have implemented digital innovations tended to perceive digitalization-related differences in working conditions as rather stress-reducing. Conclusions: Our study lays the foundation for future hypothesis-based longitudinal research by identifying those working conditions that are stress relevant for physicians and prone to differ as a function of digital transformation and individual characteristics. UR - https://www.jmir.org/2024/1/e49581 UR - http://dx.doi.org/10.2196/49581 UR - http://www.ncbi.nlm.nih.gov/pubmed/38885014 ID - info:doi/10.2196/49581 ER - TY - JOUR AU - Moldt, Julia-Astrid AU - Festl-Wietek, Teresa AU - Fuhl, Wolfgang AU - Zabel, Susanne AU - Claassen, Manfred AU - Wagner, Samuel AU - Nieselt, Kay AU - Herrmann-Werner, Anne PY - 2024/6/12 TI - Assessing AI Awareness and Identifying Essential Competencies: Insights From Key Stakeholders in Integrating AI Into Medical Education JO - JMIR Med Educ SP - e58355 VL - 10 KW - AI in medicine KW - artificial intelligence KW - medical education KW - medical students KW - qualitative approach KW - qualitative analysis KW - needs assessment N2 - Background: The increasing importance of artificial intelligence (AI) in health care has generated a growing need for health care professionals to possess a comprehensive understanding of AI technologies, requiring an adaptation in medical education. Objective: This paper explores stakeholder perceptions and expectations regarding AI in medicine and examines their potential impact on the medical curriculum. This study project aims to assess the AI experiences and awareness of different stakeholders and identify essential AI-related topics in medical education to define necessary competencies for students. Methods: The empirical data were collected as part of the TüKITZMed project between August 2022 and March 2023, using a semistructured qualitative interview. These interviews were administered to a diverse group of stakeholders to explore their experiences and perspectives of AI in medicine. A qualitative content analysis of the collected data was conducted using MAXQDA software. Results: Semistructured interviews were conducted with 38 participants (6 lecturers, 9 clinicians, 10 students, 6 AI experts, and 7 institutional stakeholders). The qualitative content analysis revealed 6 primary categories with a total of 24 subcategories to answer the research questions. The evaluation of the stakeholders? statements revealed several commonalities and differences regarding their understanding of AI. Crucial identified AI themes based on the main categories were as follows: possible curriculum contents, skills, and competencies; programming skills; curriculum scope; and curriculum structure. Conclusions: The analysis emphasizes integrating AI into medical curricula to ensure students? proficiency in clinical applications. Standardized AI comprehension is crucial for defining and teaching relevant content. Considering diverse perspectives in implementation is essential to comprehensively define AI in the medical context, addressing gaps and facilitating effective solutions for future AI use in medical studies. The results provide insights into potential curriculum content and structure, including aspects of AI in medicine. UR - https://mededu.jmir.org/2024/1/e58355 UR - http://dx.doi.org/10.2196/58355 ID - info:doi/10.2196/58355 ER - TY - JOUR AU - Landis-Lewis, Zach AU - Andrews, A. Chris AU - Gross, A. Colin AU - Friedman, P. Charles AU - Shah, J. Nirav PY - 2024/6/11 TI - Exploring Anesthesia Provider Preferences for Precision Feedback: Preference Elicitation Study JO - JMIR Med Educ SP - e54071 VL - 10 KW - audit and feedback KW - dashboard KW - motivation KW - visualization KW - anesthesia care KW - anesthesia KW - feedback KW - engagement KW - effectiveness KW - precision feedback KW - experimental design KW - design KW - clinical practice KW - motivational KW - performance KW - performance data N2 - Background: Health care professionals must learn continuously as a core part of their work. As the rate of knowledge production in biomedicine increases, better support for health care professionals? continuous learning is needed. In health systems, feedback is pervasive and is widely considered to be essential for learning that drives improvement. Clinical quality dashboards are one widely deployed approach to delivering feedback, but engagement with these systems is commonly low, reflecting a limited understanding of how to improve the effectiveness of feedback about health care. When coaches and facilitators deliver feedback for improving performance, they aim to be responsive to the recipient?s motivations, information needs, and preferences. However, such functionality is largely missing from dashboards and feedback reports. Precision feedback is the delivery of high-value, motivating performance information that is prioritized based on its motivational potential for a specific recipient, including their needs and preferences. Anesthesia care offers a clinical domain with high-quality performance data and an abundance of evidence-based quality metrics. Objective: The objective of this study is to explore anesthesia provider preferences for precision feedback. Methods: We developed a test set of precision feedback messages with balanced characteristics across 4 performance scenarios. We created an experimental design to expose participants to contrasting message versions. We recruited anesthesia providers and elicited their preferences through analysis of the content of preferred messages. Participants additionally rated their perceived benefit of preferred messages to clinical practice on a 5-point Likert scale. Results: We elicited preferences and feedback message benefit ratings from 35 participants. Preferences were diverse across participants but largely consistent within participants. Participants? preferences were consistent for message temporality (?=.85) and display format (?=.80). Ratings of participants? perceived benefit to clinical practice of preferred messages were high (mean rating 4.27, SD 0.77). Conclusions: Health care professionals exhibited diverse yet internally consistent preferences for precision feedback across a set of performance scenarios, while also giving messages high ratings of perceived benefit. A ?one-size-fits-most approach? to performance feedback delivery would not appear to satisfy these preferences. Precision feedback systems may hold potential to improve support for health care professionals? continuous learning by accommodating feedback preferences. UR - https://mededu.jmir.org/2024/1/e54071 UR - http://dx.doi.org/10.2196/54071 ID - info:doi/10.2196/54071 ER - TY - JOUR AU - Lu, Qianfeng AU - Schulz, Johannes Peter PY - 2024/6/6 TI - Physician Perspectives on Internet-Informed Patients: Systematic Review JO - J Med Internet Res SP - e47620 VL - 26 KW - internet-informed patients KW - physician-patient communication KW - health information?seeking KW - misinformation KW - digital health N2 - Background: The internet has become a prevalent source of health information for patients. However, its accuracy and relevance are often questionable. While patients seek physicians? expertise in interpreting internet health information, physicians? perspectives on patients? information-seeking behavior are less explored. Objective: This review aims to understand physicians? perceptions of patients? internet health information-seeking behavior as well as their communication strategies and the challenges and needs they face with internet-informed patients. Methods: An initial search in PubMed, Scopus, CINAHL, Communication and Mass Media Complete, and PsycINFO was conducted to collect studies published from January 1990 to August 1, 2022. A subsequent search on December 24, 2023, targeted recent studies published after the initial search cutoff date. Two reviewers independently performed title, abstract, and full-text screening, adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines. Thematic analysis was then used to identify key themes and systematically categorize evidence from both qualitative and quantitative studies under these themes. Results: A total of 22 qualifying articles were identified after the search and screening process. Physicians were found to hold diverse views on patients? internet searches, which can be viewed as a continuous spectrum of opinions ranging from positive to negative. While some physicians leaned distinctly toward either positive or negative perspectives, a significant number expressed more balanced views. These physicians recognized both the benefits, such as increased patient health knowledge and informed decision-making, and the potential harms, including misinformation and the triggering of negative emotions, such as patient anxiety or confusion, associated with patients? internet health information seeking. Two communicative strategies were identified: the participative and defensive approaches. While the former seeks to guide internet-informed patients to use internet information with physicians? expertise, the latter aims to discourage patients from using the internet to seek health information. Physicians? perceptions were linked to their strategies: those holding positive views tended to adopt a participative approach, while those with negative views favored a defensive strategy. Some physicians claimed to shift between the 2 approaches depending on their interaction with a certain patient. We also identified several challenges and needs of physicians in dealing with internet-informed patients, including the time pressure to address internet-informed patient demands, a lack of structured training, and being uninformed about trustworthy internet sites that can be recommended to internet-informed patients. Conclusions: This review highlights the diverse perceptions that physicians hold toward internet-informed patients, as well as the interplay between their perceptions, communication strategies, and their interactions with individual patients. Incorporating elements into the medical teaching curriculum that introduce physicians to reliable internet health resources for patient guidance, coupled with providing updates on technological advancements, could be instrumental in equipping physicians to more effectively manage internet-informed patients. Trial Registration: PROSPERO CRD42022356317; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=356317 UR - https://www.jmir.org/2024/1/e47620 UR - http://dx.doi.org/10.2196/47620 UR - http://www.ncbi.nlm.nih.gov/pubmed/38842920 ID - info:doi/10.2196/47620 ER - TY - JOUR AU - Sawyer, Chelsea AU - Carney, Rebekah AU - Hassan, Lamiece AU - Bucci, Sandra AU - Sainsbury, John AU - Lovell, Karina AU - Torous, John AU - Firth, Joseph PY - 2024/6/5 TI - Digital Lifestyle Interventions for Young People With Mental Illness: A Qualitative Study Among Mental Health Care Professionals JO - JMIR Hum Factors SP - e53406 VL - 11 KW - digital health KW - behavior change KW - mental health care professionals KW - physical health KW - lifestyle intervention KW - qualitative KW - thematic analysis KW - service optimization KW - mobile phone N2 - Background: Given the physical health disparities associated with mental illness, targeted lifestyle interventions are required to reduce the risk of cardiometabolic disease. Integrating physical health early in mental health treatment among young people is essential for preventing physical comorbidities, reducing health disparities, managing medication side effects, and improving overall health outcomes. Digital technology is increasingly used to promote fitness, lifestyle, and physical health among the general population. However, using these interventions to promote physical health within mental health care requires a nuanced understanding of the factors that affect their adoption and implementation. Objective: Using a qualitative design, we explored the attitudes of mental health care professionals (MHCPs) toward digital technologies for physical health with the goal of illuminating the opportunities, development, and implementation of the effective use of digital tools for promoting healthier lifestyles in mental health care. Methods: Semistructured interviews were conducted with MHCPs (N=13) using reflexive thematic analysis to explore their experiences and perspectives on using digital health to promote physical health in youth mental health care settings. Results: Three overarching themes from the qualitative analysis are reported: (1) motivation will affect implementation, (2) patients? readiness and capability, and (3) reallocation of staff roles and responsibilities. The subthemes within, and supporting quotes, are described. Conclusions: The use of digital means presents many opportunities for improving the provision of physical health interventions in mental health care settings. However, given the limited experience of many MHCPs with these technologies, formal training and additional support may improve the likelihood of implementation. Factors such as patient symptomatology, safety, and access to technology, as well as the readiness, acceptability, and capability of both MHCPs and patients to engage with digital tools, must also be considered. In addition, the potential benefits of data integration must be carefully weighed against the associated risks. UR - https://humanfactors.jmir.org/2024/1/e53406 UR - http://dx.doi.org/10.2196/53406 UR - http://www.ncbi.nlm.nih.gov/pubmed/38837191 ID - info:doi/10.2196/53406 ER - TY - JOUR AU - Guardado, Sharon AU - Karampela, Maria AU - Isomursu, Minna AU - Grundstrom, Casandra PY - 2024/5/31 TI - Use of Patient-Generated Health Data From Consumer-Grade Devices by Health Care Professionals in the Clinic: Systematic Review JO - J Med Internet Res SP - e49320 VL - 26 KW - patient-generated health data KW - mHealth KW - health care professionals KW - mobile technologies KW - self-management N2 - Background: Mobile health (mHealth) uses mobile technologies to promote wellness and help disease management. Although mHealth solutions used in the clinical setting have typically been medical-grade devices, passive and active sensing capabilities of consumer-grade devices like smartphones and activity trackers have the potential to bridge information gaps regarding patients? behaviors, environment, lifestyle, and other ubiquitous data. Individuals are increasingly adopting mHealth solutions, which facilitate the collection of patient-generated health data (PGHD). Health care professionals (HCPs) could potentially use these data to support care of chronic conditions. However, there is limited research on real-life experiences of HPCs using PGHD from consumer-grade mHealth solutions in the clinical context. Objective: This systematic review aims to analyze existing literature to identify how HCPs have used PGHD from consumer-grade mobile devices in the clinical setting. The objectives are to determine the types of PGHD used by HCPs, in which health conditions they use them, and to understand the motivations behind their willingness to use them. Methods: A systematic literature review was the main research method to synthesize prior research. Eligible studies were identified through comprehensive searches in health, biomedicine, and computer science databases, and a complementary hand search was performed. The search strategy was constructed iteratively based on key topics related to PGHD, HCPs, and mobile technologies. The screening process involved 2 stages. Data extraction was performed using a predefined form. The extracted data were summarized using a combination of descriptive and narrative syntheses. Results: The review included 16 studies. The studies spanned from 2015 to 2021, with a majority published in 2019 or later. Studies showed that HCPs have been reviewing PGHD through various channels, including solutions portals and patients? devices. PGHD about patients? behavior seem particularly useful for HCPs. Our findings suggest that PGHD are more commonly used by HCPs to treat conditions related to lifestyle, such as diabetes and obesity. Physicians were the most frequently reported users of PGHD, participating in more than 80% of the studies. Conclusions: PGHD collection through mHealth solutions has proven beneficial for patients and can also support HCPs. PGHD have been particularly useful to treat conditions related to lifestyle, such as diabetes, cardiovascular diseases, and obesity, or in domains with high levels of uncertainty, such as infertility. Integrating PGHD into clinical care poses challenges related to privacy and accessibility. Some HCPs have identified that though PGHD from consumer devices might not be perfect or completely accurate, their perceived clinical value outweighs the alternative of having no data. Despite their perceived value, our findings reveal their use in clinical practice is still scarce. International Registered Report Identifier (IRRID): RR2-10.2196/39389 UR - https://www.jmir.org/2024/1/e49320 UR - http://dx.doi.org/10.2196/49320 UR - http://www.ncbi.nlm.nih.gov/pubmed/38820580 ID - info:doi/10.2196/49320 ER - TY - JOUR AU - Timpka, Toomas PY - 2024/5/24 TI - Time for Medicine and Public Health to Leave Platform X JO - JMIR Med Educ SP - e53810 VL - 10 KW - internet KW - social media KW - medical informatics KW - knowledge translation KW - digital technology KW - clinical decision support KW - health services research KW - public health KW - digital health KW - perspective KW - medicine UR - https://mededu.jmir.org/2024/1/e53810 UR - http://dx.doi.org/10.2196/53810 ID - info:doi/10.2196/53810 ER - TY - JOUR AU - Kuziemsky, E. Craig AU - Chrimes, Dillon AU - Minshall, Simon AU - Mannerow, Michael AU - Lau, Francis PY - 2024/5/22 TI - AI Quality Standards in Health Care: Rapid Umbrella Review JO - J Med Internet Res SP - e54705 VL - 26 KW - artificial intelligence KW - health care artificial intelligence KW - health care AI KW - rapid review KW - umbrella review KW - quality standard N2 - Background: In recent years, there has been an upwelling of artificial intelligence (AI) studies in the health care literature. During this period, there has been an increasing number of proposed standards to evaluate the quality of health care AI studies. Objective: This rapid umbrella review examines the use of AI quality standards in a sample of health care AI systematic review articles published over a 36-month period. Methods: We used a modified version of the Joanna Briggs Institute umbrella review method. Our rapid approach was informed by the practical guide by Tricco and colleagues for conducting rapid reviews. Our search was focused on the MEDLINE database supplemented with Google Scholar. The inclusion criteria were English-language systematic reviews regardless of review type, with mention of AI and health in the abstract, published during a 36-month period. For the synthesis, we summarized the AI quality standards used and issues noted in these reviews drawing on a set of published health care AI standards, harmonized the terms used, and offered guidance to improve the quality of future health care AI studies. Results: We selected 33 review articles published between 2020 and 2022 in our synthesis. The reviews covered a wide range of objectives, topics, settings, designs, and results. Over 60 AI approaches across different domains were identified with varying levels of detail spanning different AI life cycle stages, making comparisons difficult. Health care AI quality standards were applied in only 39% (13/33) of the reviews and in 14% (25/178) of the original studies from the reviews examined, mostly to appraise their methodological or reporting quality. Only a handful mentioned the transparency, explainability, trustworthiness, ethics, and privacy aspects. A total of 23 AI quality standard?related issues were identified in the reviews. There was a recognized need to standardize the planning, conduct, and reporting of health care AI studies and address their broader societal, ethical, and regulatory implications. Conclusions: Despite the growing number of AI standards to assess the quality of health care AI studies, they are seldom applied in practice. With increasing desire to adopt AI in different health topics, domains, and settings, practitioners and researchers must stay abreast of and adapt to the evolving landscape of health care AI quality standards and apply these standards to improve the quality of their AI studies. UR - https://www.jmir.org/2024/1/e54705 UR - http://dx.doi.org/10.2196/54705 UR - http://www.ncbi.nlm.nih.gov/pubmed/38776538 ID - info:doi/10.2196/54705 ER - TY - JOUR AU - De Martinis, Massimo AU - Ginaldi, Lia PY - 2024/5/1 TI - Digital Skills to Improve Levels of Care and Renew Health Care Professions JO - JMIR Med Educ SP - e58743 VL - 10 KW - digital competence KW - telehealth KW - nursing KW - health care workforce KW - health care professionals KW - informatics KW - education KW - curriculum KW - interdisciplinary education KW - health care education UR - https://mededu.jmir.org/2024/1/e58743 UR - http://dx.doi.org/10.2196/58743 ID - info:doi/10.2196/58743 ER - TY - JOUR AU - Cano, Mireia AU - Ruiz-Postigo, A. José AU - Macharia, Paul AU - Ampem Amoako, Yaw AU - Odame Phillips, Richard AU - Kinyeru, Esther AU - Carrion, Carme PY - 2024/4/30 TI - Evaluating the World Health Organization?s SkinNTDs App as a Training Tool for Skin Neglected Tropical Diseases in Ghana and Kenya: Cross-Sectional Study JO - J Med Internet Res SP - e51628 VL - 26 KW - SkinNTDs app KW - mHealth KW - mobile health KW - neglected tropical diseases KW - NTDs KW - skin neglected tropical diseases KW - low- and middle-income countries KW - tropical disease KW - app KW - training tool KW - digital health KW - intervention KW - decision support tool KW - mobile phone N2 - Background: Neglected tropical diseases (NTDs) affect over 1.5 billion people worldwide, primarily impoverished populations in low- and middle-income countries. Skin NTDs, a significant subgroup, manifest primarily as skin lesions and require extensive diagnosis and treatment resources, including trained personnel and financial backing. The World Health Organization has introduced the SkinNTDs app, a mobile health tool designed to train and be used as a decision support tool for frontline health care workers. As most digital health guidelines prioritize the thorough evaluation of mobile health interventions, it is essential to conduct a rigorous and validated assessment of this app. Objective: This study aims to assess the usability and user experience of World Health Organization SkinNTDs app (version 3) as a capacity-building tool and decision-support tool for frontline health care workers. Methods: A cross-sectional study was conducted in Ghana and Kenya. Frontline health care workers dealing with skin NTDs were recruited through snowball sampling. They used the SkinNTDs app for at least 5 days before completing a web-based survey containing demographic variables and the user version of the Mobile Application Rating Scale (uMARS), a validated scale for assessing health apps. A smaller group of participants took part in semistructured interviews and one focus group. Quantitative data were analyzed using SPSS with a 95% CI and P?.05 for statistical significance and qualitative data using ATLAS.ti to identify attributes, cluster themes, and code various dimensions that were explored. Results: Overall, 60 participants participated in the quantitative phase and 17 in the qualitative phase. The SkinNTDs app scored highly on the uMARS questionnaire, with an app quality mean score of 4.02 (SD 0.47) of 5, a subjective quality score of 3.82 (SD 0.61) of 5, and a perceived impact of 4.47 (SD 0.56) of 5. There was no significant association between the app quality mean score and any of the categorical variables examined, according to Pearson correlation analysis; app quality mean score vs age (P=.37), sex (P=.70), type of health worker (P=.35), country (P=.94), work context (P=.17), frequency of dealing with skin NTDs (P=.09), and dermatology experience (P=.63). Qualitative results echoed the quantitative outcomes, highlighting the ease of use, the offline functionality, and the potential utility for frontline health care workers in remote and resource-constrained settings. Areas for improvement were identified, such as enhancing the signs and symptoms section. Conclusions: The SkinNTDs app demonstrates notable usability and user-friendliness. The results indicate that the app could play a crucial role in improving capacity building of frontline health care workers dealing with skin NTDs. It could be improved in the future by including new features such as epidemiological context and direct contact with experts. The possibility of using the app as a diagnostic tool should be considered. International Registered Report Identifier (IRRID): RR2-10.2196/39393 UR - https://www.jmir.org/2024/1/e51628 UR - http://dx.doi.org/10.2196/51628 UR - http://www.ncbi.nlm.nih.gov/pubmed/38687587 ID - info:doi/10.2196/51628 ER - TY - JOUR AU - Dallora, Luiza Ana AU - Andersson, Kazimiera Ewa AU - Gregory Palm, Bruna AU - Bohman, Doris AU - Björling, Gunilla AU - Marcinowicz, Ludmi?a AU - Stjernberg, Louise AU - Anderberg, Peter PY - 2024/4/29 TI - Nursing Students? Attitudes Toward Technology: Multicenter Cross-Sectional Study JO - JMIR Med Educ SP - e50297 VL - 10 KW - nursing education KW - technophilia KW - eHealth KW - technology anxiety KW - technology enthusiasm KW - mobile phone N2 - Background: The growing presence of digital technologies in health care requires the health workforce to have proficiency in subjects such as informatics. This has implications in the education of nursing students, as their preparedness to use these technologies in clinical situations is something that course administrators need to consider. Thus, students? attitudes toward technology could be investigated to assess their needs regarding this proficiency. Objective: This study aims to investigate attitudes (enthusiasm and anxiety) toward technology among nursing students and to identify factors associated with those attitudes. Methods: Nursing students at 2 universities in Sweden and 1 university in Poland were invited to answer a questionnaire. Data about attitudes (anxiety and enthusiasm) toward technology, eHealth literacy, electronic device skills, and frequency of using electronic devices and sociodemographic data were collected. Descriptive statistics were used to characterize the data. The Spearman rank correlation coefficient and Mann-Whitney U test were used for statistical inferences. Results: In total, 646 students answered the questionnaire?342 (52.9%) from the Swedish sites and 304 (47.1%) from the Polish site. It was observed that the students? technology enthusiasm (techEnthusiasm) was on the higher end of the Technophilia instrument (score range 1-5): 3.83 (SD 0.90), 3.62 (SD 0.94), and 4.04 (SD 0.78) for the whole sample, Swedish students, and Polish students, respectively. Technology anxiety (techAnxiety) was on the midrange of the Technophilia instrument: 2.48 (SD 0.96), 2.37 (SD 1), and 2.60 (SD 0.89) for the whole sample, Swedish students, and Polish students, respectively. Regarding techEnthusiasm among the nursing students, a negative correlation with age was found for the Swedish sample (P<.001; ?Swedish=?0.201) who were generally older than the Polish sample, and positive correlations with the eHealth Literacy Scale score (P<.001; ?all=0.265; ?Swedish=0.190; ?Polish=0.352) and with the perceived skill in using computer devices (P<.001; ?all=0.360; ?Swedish=0.341; ?Polish=0.309) were found for the Swedish, Polish, and total samples. Regarding techAnxiety among the nursing students, a positive correlation with age was found in the Swedish sample (P<.001; ?Swedish=0.184), and negative correlations with eHealth Literacy Scale score (P<.001; ?all=?0.196; ?Swedish=?0.262; ?Polish=?0.133) and with the perceived skill in using computer devices (P<.001; ?all=?0.209; ?Swedish=?0.347; ?Polish=?0.134) were found for the Swedish, Polish, and total samples and with the semester only for the Swedish sample (P<.001; ?Swedish=?0.124). Gender differences were found regarding techAnxiety in the Swedish sample, with women exhibiting a higher mean score than men (2.451, SD 1.014 and 1.987, SD 0.854, respectively). Conclusions: This study highlights nursing students? techEnthusiasm and techAnxiety, emphasizing correlations with various factors. With health care?s increasing reliance on technology, integrating health technology?related topics into education is crucial for future professionals to address health care challenges effectively. International Registered Report Identifier (IRRID): RR2-10.2196/14643 UR - https://mededu.jmir.org/2024/1/e50297 UR - http://dx.doi.org/10.2196/50297 UR - http://www.ncbi.nlm.nih.gov/pubmed/38683660 ID - info:doi/10.2196/50297 ER - TY - JOUR AU - Chang, Lynne Christel AU - Sinha, Chaitali AU - Roy, Madhavi AU - Wong, Meng John Chee PY - 2024/4/19 TI - AI-Led Mental Health Support (Wysa) for Health Care Workers During COVID-19: Service Evaluation JO - JMIR Form Res SP - e51858 VL - 8 KW - AI KW - app KW - application KW - artificial intelligence KW - COVID-19 KW - digital KW - health care workers KW - mental health KW - pandemic KW - Wysa N2 - Background: The impact that the COVID-19 pandemic has had on health care workers? mental health, in particular, cannot be ignored. Not only did the pandemic exacerbate mental health challenges through elevated stress, anxiety, risk of infection, and social isolation, but regulations to minimize infection additionally hindered the conduct of traditional in-person mental health care. Objective: This study explores the feasibility of using Wysa, an artificial intelligence?led mental health app, among health care workers. Methods: A national tertiary health care cluster in Singapore piloted the use of Wysa among its own health care workers to support the management of their mental well-being during the pandemic (July 2020-June 2022). The adoption of this digital mental health intervention circumvented the limitations of in-person contact and enabled large-scale access to evidence-based care. Rates and patterns of user engagement were evaluated. Results: Overall, the opportunity to use Wysa was well-received. Out of the 527 staff who were onboarded in the app, 80.1% (422/527) completed a minimum of 2 sessions. On average, users completed 10.9 sessions over 3.80 weeks. The interventions most used were for sleep and anxiety, with a strong repeat-use rate. In this sample, 46.2% (73/158) of health care workers reported symptoms of anxiety (Generalized Anxiety Disorder Assessment-7 [GAD-7]), and 15.2% (24/158) were likely to have symptoms of depression (Patient Health Questionnaire-2 [PHQ-2]). Conclusions: Based on the present findings, Wysa appears to strongly engage those with none to moderate symptoms of anxiety. This evaluation demonstrates the viability of implementing Wysa as a standard practice among this sample of health care workers, which may support the use of similar digital interventions across other communities. UR - https://formative.jmir.org/2024/1/e51858 UR - http://dx.doi.org/10.2196/51858 UR - http://www.ncbi.nlm.nih.gov/pubmed/38640476 ID - info:doi/10.2196/51858 ER - TY - JOUR AU - O'Brien, Niki AU - Fernandez Crespo, Roberto AU - O'Driscoll, Fiona AU - Prendergast, Mabel AU - Chana, Deeph AU - Darzi, Ara AU - Ghafur, Saira PY - 2024/4/11 TI - Usability and Feasibility Evaluation of a Web-Based and Offline Cybersecurity Resource for Health Care Organizations (The Essentials of Cybersecurity in Health Care Organizations Framework Resource): Mixed Methods Study JO - JMIR Form Res SP - e50968 VL - 8 KW - acceptability KW - cross sectional KW - cybersecurity KW - digital health KW - digital transformation KW - education KW - feasibility KW - framework KW - frameworks KW - global health KW - health systems KW - implementation KW - organization KW - organizational KW - organizations KW - patient safety KW - SWOT KW - TAM KW - usability N2 - Background: Cybersecurity is a growing challenge for health systems worldwide as the rapid adoption of digital technologies has led to increased cyber vulnerabilities with implications for patients and health providers. It is critical to develop workforce awareness and training as part of a safety culture and continuous improvement within health care organizations. However, there are limited open-access, health care?specific resources to help organizations at different levels of maturity develop their cybersecurity practices. Objective: This study aims to assess the usability and feasibility of the Essentials of Cybersecurity in Health Care Organizations (ECHO) framework resource and evaluate the strengths, weaknesses, opportunities, and threats associated with implementing the resource at the organizational level. Methods: A mixed methods, cross-sectional study of the acceptability and usability of the ECHO framework resource was undertaken. The research model was developed based on the technology acceptance model. Members of the Imperial College Leading Health Systems Network and other health care organizations identified through the research teams? networks were invited to participate. Study data were collected through web-based surveys 1 month and 3 months from the date the ECHO framework resource was received by the participants. Quantitative data were analyzed using R software (version 4.2.1). Descriptive statistics were calculated using the mean and 95% CIs. To determine significant differences between the distribution of answers by comparing results from the 2 survey time points, 2-tailed t tests were used. Qualitative data were analyzed using Microsoft Excel. Thematic analysis used deductive and inductive approaches to capture themes and concepts. Results: A total of 16 health care organizations participated in the study. The ECHO framework resource was well accepted and useful for health care organizations, improving their understanding of cybersecurity as a priority area, reducing threats, and enabling organizational planning. Although not all participants were able to implement the resource as part of information computing technology (ICT) cybersecurity activities, those who did were positive about the process of change. Learnings from the implementation process included the usefulness of the resource for raising awareness and ease of use based on familiarity with other standards, guidelines, and tools. Participants noted that several sections of the framework were difficult to operationalize due to costs or budget constraints, human resource limitations, leadership support, stakeholder engagement, and limited time. Conclusions: The research identified the acceptability and usability of the ECHO framework resource as a health-focused cybersecurity resource for health care organizations. As cybersecurity in health care organizations is everyone?s responsibility, there is potential for the framework resource to be used by staff with varied job roles. Future research needs to explore how it can be updated for ICT staff and implemented in practice and how educational materials on different aspects of the framework could be developed. UR - https://formative.jmir.org/2024/1/e50968 UR - http://dx.doi.org/10.2196/50968 UR - http://www.ncbi.nlm.nih.gov/pubmed/38603777 ID - info:doi/10.2196/50968 ER - TY - JOUR AU - Chamouard, Valérie AU - Freyssenge, Julie AU - Clairaz-Mahiou, Béatrice AU - Ferrera Bibas, Felicia AU - Fraticelli, Laurie PY - 2024/4/4 TI - Evaluation of an e-Learning Program for Community Pharmacists for Dispensing Emicizumab (Hemlibra) in France: Nationwide Cross-Sectional Study JO - JMIR Form Res SP - e54656 VL - 8 KW - hemophilia KW - care pathway KW - emicizumab KW - Kirkpatrick model KW - pharmacy KW - survey KW - Hemlibra KW - France KW - e-learning program KW - pharmacists KW - pharmacist KW - hemophilia A KW - hospital KW - HEMOPHAR KW - methodology KW - community KW - engagement KW - pharmaceutical KW - rare disease KW - digital health KW - intervention N2 - Background: Since June 2021, patients with hemophilia A with antifactor VIII inhibitors and those with severe hemophilia A without antifactor VIII inhibitors treated with Hemlibra have had to choose between a community or hospital pharmacy. The French reference center for hemophilia developed the HEMOPHAR e-learning program for community pharmacists for dispensing emicizumab.  Objective: This study aims to evaluate the efficiency and safety of this new care pathway by assessing the HEMOPHAR e-learning program.  Methods: The methodology is based on Kirkpatrick?s model for evaluating the immediate reaction of trained community pharmacists (level 1), their level of acquired knowledge (level 2), and their professional practice after 3 months of dispensation (level 3).  Results: The HEMOPHAR e-learning program reached a large audience, with 67% (337/502) of the eligible community pharmacists following it. The immediate reaction was overall satisfying. High rates of engagement were reported with 63.5% (214/337) to 73.3% (247/337) of completed training modules, along with high rates of success with quizzes of 61.5% (174/337) to 95.7% (244/337). We observed that 83.9% (193/230) of the community pharmacists needed less than 2 attempts to pass the quiz of the module related to professional practice, while the other quizzes required more attempts. Advice on compliance and drug interactions were most frequently provided to patients by the community pharmacists.  Conclusions: This study suggests ways to improve the training of community pharmacists and to optimize coordination with treatment centers. This study also reports on the feasibility of switching to a community pharmacy in a secure pharmaceutical circuit, including in the context of a rare bleeding disease.  Trial Registration: ClinicalTrials.gov NCT05449197; https://clinicaltrials.gov/study/NCT05449197 International Registered Report Identifier (IRRID): RR2-10.2196/43091 UR - https://formative.jmir.org/2024/1/e54656 UR - http://dx.doi.org/10.2196/54656 UR - http://www.ncbi.nlm.nih.gov/pubmed/38574351 ID - info:doi/10.2196/54656 ER - TY - JOUR AU - Mainz, Anne AU - Nitsche, Julia AU - Weirauch, Vera AU - Meister, Sven PY - 2024/3/29 TI - Measuring the Digital Competence of Health Professionals: Scoping Review JO - JMIR Med Educ SP - e55737 VL - 10 KW - digital competence KW - digital literacy KW - digital health KW - health care KW - health care professional KW - health care professionals KW - scoping review N2 - Background: Digital competence is listed as one of the key competences for lifelong learning and is increasing in importance not only in private life but also in professional life. There is consensus within the health care sector that digital competence (or digital literacy) is needed in various professional fields. However, it is still unclear what exactly the digital competence of health professionals should include and how it can be measured. Objective: This scoping review aims to provide an overview of the common definitions of digital literacy in scientific literature in the field of health care and the existing measurement instruments. Methods: Peer-reviewed scientific papers from the last 10 years (2013-2023) in English or German that deal with the digital competence of health care workers in both outpatient and inpatient care were included. The databases ScienceDirect, Scopus, PubMed, EBSCOhost, MEDLINE, OpenAIRE, ERIC, OAIster, Cochrane Library, CAMbase, APA PsycNet, and Psyndex were searched for literature. The review follows the JBI methodology for scoping reviews, and the description of the results is based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. Results: The initial search identified 1682 papers, of which 46 (2.73%) were included in the synthesis. The review results show that there is a strong focus on technical skills and knowledge with regard to both the definitions of digital competence and the measurement tools. A wide range of competences were identified within the analyzed works and integrated into a validated competence model in the areas of technical, methodological, social, and personal competences. The measurement instruments mainly used self-assessment of skills and knowledge as an indicator of competence and differed greatly in their statistical quality. Conclusions: The identified multitude of subcompetences illustrates the complexity of digital competence in health care, and existing measuring instruments are not yet able to reflect this complexity. UR - https://mededu.jmir.org/2024/1/e55737 UR - http://dx.doi.org/10.2196/55737 UR - http://www.ncbi.nlm.nih.gov/pubmed/38551628 ID - info:doi/10.2196/55737 ER - TY - JOUR AU - Grosjean, Julien AU - Benis, Arriel AU - Dufour, Jean-Charles AU - Lejeune, Émeline AU - Disson, Flavien AU - Dahamna, Badisse AU - Cieslik, Hélène AU - Léguillon, Romain AU - Faure, Matthieu AU - Dufour, Frank AU - Staccini, Pascal AU - Darmoni, Jacques Stéfan PY - 2024/3/4 TI - Sharing Digital Health Educational Resources in a One-Stop Shop Portal: Tutorial on the Catalog and Index of Digital Health Teaching Resources (CIDHR) Semantic Search Engine JO - JMIR Med Educ SP - e48393 VL - 10 KW - digital health KW - medical informatics KW - medical education KW - search engine KW - knowledge management KW - semantic web KW - language KW - teaching KW - vocabulary KW - controlled KW - students KW - educational personnel KW - French KW - curriculum N2 - Background: Access to reliable and accurate digital health web-based resources is crucial. However, the lack of dedicated search engines for non-English languages, such as French, is a significant obstacle in this field. Thus, we developed and implemented a multilingual, multiterminology semantic search engine called Catalog and Index of Digital Health Teaching Resources (CIDHR). CIDHR is freely accessible to everyone, with a focus on French-speaking resources. CIDHR has been initiated to provide validated, high-quality content tailored to the specific needs of each user profile, be it students or professionals. Objective: This study?s primary aim in developing and implementing the CIDHR is to improve knowledge sharing and spreading in digital health and health informatics and expand the health-related educational community, primarily French speaking but also in other languages. We intend to support the continuous development of initial (ie, bachelor level), advanced (ie, master and doctoral levels), and continuing training (ie, professionals and postgraduate levels) in digital health for health and social work fields. The main objective is to describe the development and implementation of CIDHR. The hypothesis guiding this research is that controlled vocabularies dedicated to medical informatics and digital health, such as the Medical Informatics Multilingual Ontology (MIMO) and the concepts structuring the French National Referential on Digital Health (FNRDH), to index digital health teaching and learning resources, are effectively increasing the availability and accessibility of these resources to medical students and other health care professionals. Methods: First, resource identification is processed by medical librarians from websites and scientific sources preselected and validated by domain experts and surveyed every week. Then, based on MIMO and FNRDH, the educational resources are indexed for each related knowledge domain. The same resources are also tagged with relevant academic and professional experience levels. Afterward, the indexed resources are shared with the digital health teaching and learning community. The last step consists of assessing CIDHR by obtaining informal feedback from users. Results: Resource identification and evaluation processes were executed by a dedicated team of medical librarians, aiming to collect and curate an extensive collection of digital health teaching and learning resources. The resources that successfully passed the evaluation process were promptly included in CIDHR. These resources were diligently indexed (with MIMO and FNRDH) and tagged for the study field and degree level. By October 2023, a total of 371 indexed resources were available on a dedicated portal. Conclusions: CIDHR is a multilingual digital health education semantic search engine and platform that aims to increase the accessibility of educational resources to the broader health care?related community. It focuses on making resources ?findable,? ?accessible,? ?interoperable,? and ?reusable? by using a one-stop shop portal approach. CIDHR has and will have an essential role in increasing digital health literacy. UR - https://mededu.jmir.org/2024/1/e48393 UR - http://dx.doi.org/10.2196/48393 UR - http://www.ncbi.nlm.nih.gov/pubmed/38437007 ID - info:doi/10.2196/48393 ER - TY - JOUR AU - Mareli?, Marko AU - Klasni?, Ksenija AU - Vuku?i? Rukavina, Tea PY - 2024/2/27 TI - Measuring e-Professional Behavior of Doctors of Medicine and Dental Medicine on Social Networking Sites: Indexes Construction With Formative Indicators JO - JMIR Med Educ SP - e50156 VL - 10 KW - e-professionalism KW - social media KW - formative index KW - social networking KW - doctors KW - medical KW - dental medicine N2 - Background: Previous studies have predominantly measured e-professionalism through perceptions or attitudes, yet there exists no validated measure specifically targeting the actual behaviors of health care professionals (HCPs) in this realm. This study addresses this gap by constructing a normative framework, drawing from 3 primary sources to define e-professional behavior across 6 domains. Four domains pertain to the dangers of social networking sites (SNSs), encompassing confidentiality, privacy, patient interaction, and equitable resource allocation. Meanwhile, 2 domains focus on the opportunities of SNSs, namely, the proactive dissemination of public health information and maintaining scientific integrity. Objective: This study aims to develop and validate 2 new measures assessing the e-professional behavior of doctors of medicine (MDs) and doctors of dental medicine (DMDs), focusing on both the dangers and opportunities associated with SNSs. Methods: The study used a purposive sample of MDs and DMDs in Croatia who were users of at least one SNS. Data collection took place in 2021 through an online survey. Validation of both indexes used a formative approach, which involved a 5-step methodology: content specification, indicators definition with instructions for item coding and index construction, indicators collinearity check using the variance inflation factor (VIF), external validity test using multiple indicators multiple causes (MIMIC) model, and external validity test by checking the relationships of the indexes with the scale of attitude toward SNSs using Pearson correlation coefficients. Results: A total of 753 responses were included in the analysis. The first e-professionalism index, assessing the dangers associated with SNSs, comprises 14 items. During the indicators collinearity check, all indicators displayed acceptable VIF values below 2.5. The MIMIC model showed good fit (?213=9.4, P=.742; ?2/df=0.723; root-mean-square error of approximation<.001; goodness-of-fit index=0.998; comparative fit index=1.000). The external validity of the index is supported by a statistically significant negative correlation with the scale measuring attitudes toward SNSs (r=?0.225, P<.001). Following the removal of 1 item, the second e-professionalism index, focusing on the opportunities associated with SNSs, comprises 5 items. During the indicators collinearity check, all indicators exhibited acceptable VIF values below 2.5. Additionally, the MIMIC model demonstrated a good fit (?24=2.5, P=.718; ?2/df=0.637; root-mean-square error of approximation<0.001; goodness-of-fit index=0.999; comparative fit index=1.000). The external validity of the index is supported by a statistically significant positive correlation with the scale of attitude toward SNSs (r=0.338; P<.001). Conclusions: Following the validation process, the instrument designed for gauging the e-professional behavior of MDs and DMDs consists of 19 items, which contribute to the formation of 2 distinct indexes: the e-professionalism index, focusing on the dangers associated with SNSs, comprising 14 items, and the e-professionalism index, highlighting the opportunities offered by SNSs, consisting of 5 items. These indexes serve as valid measures of the e-professional behavior of MDs and DMDs, with the potential for further refinement to encompass emerging forms of unprofessional behavior that may arise over time. UR - https://mededu.jmir.org/2024/1/e50156 UR - http://dx.doi.org/10.2196/50156 UR - http://www.ncbi.nlm.nih.gov/pubmed/38412021 ID - info:doi/10.2196/50156 ER - TY - JOUR AU - Acharya, Amish AU - Black, Claire Ruth AU - Smithies, Alisdair AU - Darzi, Ara PY - 2024/2/21 TI - Evaluating the Impact of the National Health Service Digital Academy on Participants? Perceptions of Their Identity as Leaders of Digital Health Change: Mixed Methods Study JO - JMIR Med Educ SP - e46740 VL - 10 KW - digital leadership KW - professional identity KW - dissertation of practice N2 - Background: The key to the digital leveling-up strategy of the National Health Service is the development of a digitally proficient leadership. The National Health Service Digital Academy (NHSDA) Digital Health Leadership program was designed to support emerging digital leaders to acquire the necessary skills to facilitate transformation. This study examined the influence of the program on professional identity formation as a means of creating a more proficient digital health leadership. Objective: This study aims to examine the impact of the NHSDA program on participants? perceptions of themselves as digital health leaders. Methods: We recruited 41 participants from 2 cohorts of the 2-year NHSDA program in this mixed methods study, all of whom had completed it >6 months before the study. The participants were initially invited to complete a web-based scoping questionnaire. This involved both quantitative and qualitative responses to prompts. Frequencies of responses were aggregated, while free-text comments from the questionnaire were analyzed inductively. The content of the 30 highest-scoring dissertations was also reviewed by 2 independent authors. A total of 14 semistructured interviews were then conducted with a subset of the cohort. These focused on individuals? perceptions of digital leadership and the influence of the course on the attainment of skills. In total, 3 in-depth focus groups were then conducted with participants to examine shared perceptions of professional identity as digital health leaders. The transcripts from the interviews and focus groups were aligned with a previously published examination of leadership as a framework. Results: Of the 41 participants, 42% (17/41) were in clinical roles, 34% (14/41) were in program delivery or management roles, 20% (8/41) were in data science roles, and 5% (2/41) were in ?other? roles. Interviews and focus groups highlighted that the course influenced 8 domains of professional identity: commitment to the profession, critical thinking, goal orientation, mentoring, perception of the profession, socialization, reflection, and self-efficacy. The dissertation of the practice model, in which candidates undertake digital projects within their organizations supported by faculty, largely impacted metacognitive skill acquisition and goal orientation. However, the program also affected participants? values and direction within the wider digital health community. According to the questionnaire, after graduation, 59% (24/41) of the participants changed roles in search of more prominence within digital leadership, with 46% (11/24) reporting that the course was a strong determinant of this change. Conclusions: A digital leadership course aimed at providing attendees with the necessary attributes to guide transformation can have a significant impact on professional identity formation. This can create a sense of belonging to a wider health leadership structure and facilitate the attainment of organizational and national digital targets. This effect is diminished by a lack of locoregional support for professional development. UR - https://mededu.jmir.org/2024/1/e46740 UR - http://dx.doi.org/10.2196/46740 UR - http://www.ncbi.nlm.nih.gov/pubmed/38381477 ID - info:doi/10.2196/46740 ER - TY - JOUR AU - Tohme, Pia AU - Abi Fadel, Nour AU - Yaktine, Nour AU - Abi-Habib, Rudy PY - 2024/2/8 TI - Predictors of Mental Health Literacy in a Sample of Health Care Major Students: Pilot Evaluation Study JO - JMIR Form Res SP - e43770 VL - 8 KW - awareness KW - COVID-19 KW - digital health literacy KW - digital health KW - disorder KW - empathy KW - health literacy KW - literacy KW - mental health literacy KW - mental health KW - mentalizing KW - questionnaire KW - students N2 - Background: The numerous mental health awareness campaigns during the COVID-19 pandemic have shifted our understanding and perception of mental health. Objective: The purpose of this study is to evaluate predictors of mental health literacy (MHL), that is, one?s knowledge and beliefs about mental disorders. We evaluate whether digital health literacy, empathy, and mentalizing contribute to MHL. Methods: Our sample consisted of 89 health care major students, aged between 17 and 32 years, studying at a university in Lebanon. The Mental Health Literacy Scale for Healthcare Students (MHLS-HS), the eHealth Literacy Questionnaire (eHLQ), the Basic Empathy Scale (BES), and the Reflective Functioning Questionnaire-8 (RFQ-8) were used. Results: Multiple regression analyses revealed that the Engagement in Own Health subscale of digital health literacy constituted a predictor of MHL. While empathy and mentalizing did not directly predict MHL, they were found to predict components of MHL. Conclusions: This is the first study to evaluate digital health literacy, empathy, and mentalizing as predictors of MHL in Lebanon, a country where mental health is still considered taboo. Moreover, this pilot study is the first to provide some support for the predictive role of some digital health literacy subscales on MHL in light of the rise of the digital era following the COVID-19 pandemic. UR - https://formative.jmir.org/2024/1/e43770 UR - http://dx.doi.org/10.2196/43770 UR - http://www.ncbi.nlm.nih.gov/pubmed/38329801 ID - info:doi/10.2196/43770 ER - TY - JOUR AU - Ang, Darryl Wei How AU - Lim, Grace Zhi Qi AU - Lau, Tiang Siew AU - Dong, Jie AU - Lau, Ying PY - 2024/1/31 TI - Unpacking the Experiences of Health Care Professionals About the Web-Based Building Resilience At Work Program During the COVID-19 Pandemic: Framework Analysis JO - JMIR Med Educ SP - e49551 VL - 10 KW - resilience KW - intent to stay KW - employability KW - health care professionals KW - process evaluation KW - framework analysis KW - framework KW - stress KW - mental health disorder KW - prevention KW - training KW - qualitative study KW - web-based tool KW - tool KW - sustainability N2 - Background: The COVID-19 pandemic has resulted in a greater workload in the health care system. Therefore, health care professionals (HCPs) continue to experience high levels of stress, resulting in mental health disorders. From a preventive perspective, building resilience has been associated with reduced stress and mental health disorders and promotes HCPs? intent to stay. Despite the benefits of resilience training, few studies provided an in-depth understanding of the contextual factors, implementation, and mechanisms of impact that influences the sustainability of resilience programs. Therefore, examining target users? experiences of the resilience program is important. This will provide meaningful information to refine and improve future resilience programs. Objective: This qualitative study aims to explore HCPs? experiences of participating in the web-based Building Resilience At Work (BRAW) program. In particular, this study aims to explore the contextual and implementational factors that would influence participants? interaction and outcome from the program. Methods: A descriptive qualitative approach using individual semistructured Zoom interviews was conducted with participants of the web-based resilience program. A framework analysis was conducted, and it is guided by the process evaluation framework. Results: A total of 33 HCPs participated in this qualitative study. Three themes depicting participants? experiences, interactions, and impacts from the BRAW program were elucidated from the framework analysis: learning from web-based tools, interacting with the BRAW program, and promoting participants? workforce readiness. Conclusions: Findings show that a web-based asynchronous and self-paced resilience program is an acceptable and feasible approach for HCPs. The program also led to encouraging findings on participants? resilience, intent to stay, and employability. However, continued refinements in the components of the web-based resilience program should be carried out to ensure the sustainability of this intervention. Trial Registration: ClinicalTrials.gov NCT05130879; https://clinicaltrials.gov/ct2/show/NCT05130879 UR - https://mededu.jmir.org/2024/1/e49551 UR - http://dx.doi.org/10.2196/49551 UR - http://www.ncbi.nlm.nih.gov/pubmed/38294866 ID - info:doi/10.2196/49551 ER - TY - JOUR AU - Zaleski, L. Amanda AU - Berkowsky, Rachel AU - Craig, Thomas Kelly Jean AU - Pescatello, S. Linda PY - 2024/1/11 TI - Comprehensiveness, Accuracy, and Readability of Exercise Recommendations Provided by an AI-Based Chatbot: Mixed Methods Study JO - JMIR Med Educ SP - e51308 VL - 10 KW - exercise prescription KW - health literacy KW - large language model KW - patient education KW - artificial intelligence KW - AI KW - chatbot N2 - Background: Regular physical activity is critical for health and disease prevention. Yet, health care providers and patients face barriers to implement evidence-based lifestyle recommendations. The potential to augment care with the increased availability of artificial intelligence (AI) technologies is limitless; however, the suitability of AI-generated exercise recommendations has yet to be explored. Objective: The purpose of this study was to assess the comprehensiveness, accuracy, and readability of individualized exercise recommendations generated by a novel AI chatbot. Methods: A coding scheme was developed to score AI-generated exercise recommendations across ten categories informed by gold-standard exercise recommendations, including (1) health condition?specific benefits of exercise, (2) exercise preparticipation health screening, (3) frequency, (4) intensity, (5) time, (6) type, (7) volume, (8) progression, (9) special considerations, and (10) references to the primary literature. The AI chatbot was prompted to provide individualized exercise recommendations for 26 clinical populations using an open-source application programming interface. Two independent reviewers coded AI-generated content for each category and calculated comprehensiveness (%) and factual accuracy (%) on a scale of 0%-100%. Readability was assessed using the Flesch-Kincaid formula. Qualitative analysis identified and categorized themes from AI-generated output. Results: AI-generated exercise recommendations were 41.2% (107/260) comprehensive and 90.7% (146/161) accurate, with the majority (8/15, 53%) of inaccuracy related to the need for exercise preparticipation medical clearance. Average readability level of AI-generated exercise recommendations was at the college level (mean 13.7, SD 1.7), with an average Flesch reading ease score of 31.1 (SD 7.7). Several recurring themes and observations of AI-generated output included concern for liability and safety, preference for aerobic exercise, and potential bias and direct discrimination against certain age-based populations and individuals with disabilities. Conclusions: There were notable gaps in the comprehensiveness, accuracy, and readability of AI-generated exercise recommendations. Exercise and health care professionals should be aware of these limitations when using and endorsing AI-based technologies as a tool to support lifestyle change involving exercise. UR - https://mededu.jmir.org/2024/1/e51308 UR - http://dx.doi.org/10.2196/51308 UR - http://www.ncbi.nlm.nih.gov/pubmed/38206661 ID - info:doi/10.2196/51308 ER - TY - JOUR AU - Long, Chen AU - Zheng, Lin AU - Liu, Runhua AU - Duan, Zhongxian PY - 2023/12/13 TI - Structural Validation and Measurement Invariance Testing of the Chinese Version of the eHealth Literacy Scale Among Undergraduates: Cross-Sectional Study JO - J Med Internet Res SP - e48838 VL - 25 KW - eHealth literacy KW - eHEALS KW - factor structure KW - measurement invariance KW - undergraduates KW - health literacy KW - cross-sectional survey KW - digital health literacy KW - measurement N2 - Background: The eHealth Literacy Scale (eHEALS) was introduced in China in 2013 as one of the most important electronic health literacy measurement instruments. After a decade of development in China, it has received widespread attention, although its theoretical underpinnings have been challenged, thus demanding more robust research evidence of factorial validity and multigroup measurement properties. Objective: This study aimed to evaluate the Chinese version of the eHEALS in terms of its measurement properties. Methods: A cross-sectional survey was conducted in a university setting in China. Item statistics were checked for response distributions and floor and ceiling effects. Internal consistency reliability was confirmed with Cronbach ?, split-half reliability, Cronbach ? if an item was deleted, and item-total correlation. A total of 5 representative eHEALS factor structures were examined and contrasted using confirmatory factor analysis. The study used the item-level content validity index (I-CVI) and the average of the I-CVI scores of all items on the scale to assess the content validity of the dominance model. Furthermore, the validated dominance model was subsequently used to evaluate the relevance and representation of elements in the instrument and to assess measurement invariance across genders. Results: A total of 972 respondents were identified, with a Cronbach ? of .92, split-half reliability of 0.88, and item-total score correlation coefficients ranging from 0.715 to 0.781. Cronbach ? if an item was deleted showed that all items should be retained. Acceptable content validity was supported by I-CVIs ?0.80. The confirmatory factor analysis confirmed that the 3-factor model was acceptable. The measurement model met all relevant fit indices: average variance extracted from 0.663 to 0.680, composite reliability from 0.810 to 0.857, chi-square divided by the df of 4.768, root mean square error of approximation of 0.062, standardized root mean squared residual of 0.020, comparative fit index (CFI) of 0.987, and Tucker-Lewis index of 0.979. In addition, the scale demonstrated error variance invariance (?normed fit index=?0.016, ?incremental fit index=?0.012, ?Tucker-Lewis index=0.005, ?comparative fit index=?0.012, ?relative fit index=0.005, and ?root mean square error of approximation=0.005). Conclusions: A 3-factor model of the Chinese version of the eHEALS fits best, and our findings provide evidence for the strict measurement invariance of the instrument regarding gender. UR - https://www.jmir.org/2023/1/e48838 UR - http://dx.doi.org/10.2196/48838 UR - http://www.ncbi.nlm.nih.gov/pubmed/37990370 ID - info:doi/10.2196/48838 ER - TY - JOUR AU - Kaihlanen, Anu-Marja AU - Virtanen, Lotta AU - Kainiemi, Emma AU - Heponiemi, Tarja PY - 2023/11/30 TI - Professionals Evaluating Clients? Suitability for Digital Health and Social Care: Scoping Review of Assessment Instruments JO - J Med Internet Res SP - e51450 VL - 25 KW - access KW - accessibility KW - assessment KW - clients KW - digital health KW - digital social care KW - eHealth KW - evaluation tool KW - evaluation KW - evaluator KW - instrument KW - knowledge synthesis KW - patients KW - professionals KW - review methodology KW - review methods KW - scoping KW - social care KW - suitability N2 - Background: Increased digital health and social care services are generally considered to improve people?s access to services. However, not everyone can equally access and use these resources. Health and social care professionals should assess clients? suitability for digital solutions, but to succeed, they need information about what to evaluate and how. Objective: This scoping review aimed to identify evaluation tools that professionals can use when assessing clients? suitability for digital health and social care. We summarized the dimensions and the practical usefulness of the instruments. Methods: The MEDLINE (Ovid), CINAHL, Web of Science, and ASSIA databases were searched in February 2023 following the Joanna Briggs Institute?s Manual for Evidence Synthesis. Studies were included if they focused on health and social care clients and professionals, examined clients? suitability for using digital health or social care, and applied related assessment methods in the direct client work of professionals. Studies focusing primarily on instruments intended for research use without clear applicability to professionals? practical contexts were excluded. Details of the eligible studies were extracted, and qualitative content analysis according to the research objectives was performed. Results: A total of 19 articles introducing 12 different assessment instruments intended for the health care context were included in the review. No instruments were found for evaluating the suitability for digital social care. The instruments contained 60 dimensions of the client?s suitability for digital health, which reflected four perspectives: (1) skill-based suitability, (2) suitability based on general ability to maintain health, (3) suitability based on attitude and experience, and (4) suitability based on practical matters. The described practical usefulness of the instruments included professionals? possibility to (1) identify clients most in need of education and support, (2) direct and recommend the right clients for the right digital services, (3) ensure that clients can use digital health, (4) improve effectiveness and maximize the provision of digital health, (5) develop and redesign services, and (6) empower clients. Conclusions: Based on the diverse assessment instruments available and the dimensions they measure, there seems to be no comprehensive evaluation tool for assessing clients? prerequisites to use digital solutions. It is important to further develop comprehensive screening tools applicable to professionals? busy work (both in health and social care) with defined threshold values for suitability. UR - https://www.jmir.org/2023/1/e51450 UR - http://dx.doi.org/10.2196/51450 UR - http://www.ncbi.nlm.nih.gov/pubmed/38032707 ID - info:doi/10.2196/51450 ER - TY - JOUR AU - Wosny, Marie AU - Strasser, Maria Livia AU - Hastings, Janna PY - 2023/10/17 TI - Experience of Health Care Professionals Using Digital Tools in the Hospital: Qualitative Systematic Review JO - JMIR Hum Factors SP - e50357 VL - 10 KW - health information technology KW - electronic health record KW - electronic medical records KW - clinical decision support KW - health care professionals KW - burnout KW - qualitative research N2 - Background: The digitalization of health care has many potential benefits, but it may also negatively impact health care professionals? well-being. Burnout can, in part, result from inefficient work processes related to the suboptimal implementation and use of health information technologies. Although strategies to reduce stress and mitigate clinician burnout typically involve individual-based interventions, emerging evidence suggests that improving the experience of using health information technologies can have a notable impact. Objective: The aim of this systematic review was to collect evidence of the benefits and challenges associated with the use of digital tools in hospital settings with a particular focus on the experiences of health care professionals using these tools. Methods: We conducted a systematic literature review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to explore the experience of health care professionals with digital tools in hospital settings. Using a rigorous selection process to ensure the methodological quality and validity of the study results, we included qualitative studies with distinct data that described the experiences of physicians and nurses. A panel of 3 independent researchers performed iterative data analysis and identified thematic constructs. Results: Of the 1175 unique primary studies, we identified 17 (1.45%) publications that focused on health care professionals? experiences with various digital tools in their day-to-day practice. Of the 17 studies, 10 (59%) focused on clinical decision support tools, followed by 6 (35%) studies focusing on electronic health records and 1 (6%) on a remote patient-monitoring tool. We propose a theoretical framework for understanding the complex interplay between the use of digital tools, experience, and outcomes. We identified 6 constructs that encompass the positive and negative experiences of health care professionals when using digital tools, along with moderators and outcomes. Positive experiences included feeling confident, responsible, and satisfied, whereas negative experiences included frustration, feeling overwhelmed, and feeling frightened. Positive moderators that may reinforce the use of digital tools included sufficient training and adequate workflow integration, whereas negative moderators comprised unfavorable social structures and the lack of training. Positive outcomes included improved patient care and increased workflow efficiency, whereas negative outcomes included increased workload, increased safety risks, and issues with information quality. Conclusions: Although positive and negative outcomes and moderators that may affect the use of digital tools were commonly reported, the experiences of health care professionals, such as their thoughts and emotions, were less frequently discussed. On the basis of this finding, this study highlights the need for further research specifically targeting experiences as an important mediator of clinician well-being. It also emphasizes the importance of considering differences in the nature of specific tools as well as the profession and role of individual users. Trial Registration: PROSPERO CRD42023393883; https://tinyurl.com/2htpzzxj UR - https://humanfactors.jmir.org/2023/1/e50357 UR - http://dx.doi.org/10.2196/50357 UR - http://www.ncbi.nlm.nih.gov/pubmed/37847535 ID - info:doi/10.2196/50357 ER - TY - JOUR AU - Miró Catalina, Queralt AU - Femenia, Joaquim AU - Fuster-Casanovas, Aïna AU - Marin-Gomez, X. Francesc AU - Escalé-Besa, Anna AU - Solé-Casals, Jordi AU - Vidal-Alaball, Josep PY - 2023/10/13 TI - Knowledge and Perception of the Use of AI and its Implementation in the Field of Radiology: Cross-Sectional Study JO - J Med Internet Res SP - e50728 VL - 25 KW - artificial intelligence KW - perception KW - knowledge KW - survey KW - digital health KW - radiology KW - public health N2 - Background: Artificial Intelligence (AI) has been developing for decades, but in recent years its use in the field of health care has experienced an exponential increase. Currently, there is little doubt that these tools have transformed clinical practice. Therefore, it is important to know how the population perceives its implementation to be able to propose strategies for acceptance and implementation and to improve or prevent problems arising from future applications. Objective: This study aims to describe the population?s perception and knowledge of the use of AI as a health support tool and its application to radiology through a validated questionnaire, in order to develop strategies aimed at increasing acceptance of AI use, reducing possible resistance to change and identifying possible sociodemographic factors related to perception and knowledge. Methods: A cross-sectional observational study was conducted using an anonymous and voluntarily validated questionnaire aimed at the entire population of Catalonia aged 18 years or older. The survey addresses 4 dimensions defined to describe users? perception of the use of AI in radiology, (1) ?distrust and accountability,? (2) ?personal interaction,? (3) ?efficiency,? and (4) ?being informed,? all with questions in a Likert scale format. Results closer to 5 refer to a negative perception of the use of AI, while results closer to 1 express a positive perception. Univariate and bivariate analyses were performed to assess possible associations between the 4 dimensions and sociodemographic characteristics. Results: A total of 379 users responded to the survey, with an average age of 43.9 (SD 17.52) years and 59.8% (n=226) of them identified as female. In addition, 89.8% (n=335) of respondents indicated that they understood the concept of AI. Of the 4 dimensions analyzed, ?distrust and accountability? obtained a mean score of 3.37 (SD 0.53), ?personal interaction? obtained a mean score of 4.37 (SD 0.60), ?efficiency? obtained a mean score of 3.06 (SD 0.73) and ?being informed? obtained a mean score of 3.67 (SD 0.57). In relation to the ?distrust and accountability? dimension, women, people older than 65 years, the group with university studies, and the population that indicated not understanding the AI concept had significantly more distrust in the use of AI. On the dimension of ?being informed,? it was observed that the group with university studies rated access to information more positively and those who indicated not understanding the concept of AI rated it more negatively. Conclusions: The majority of the sample investigated reported being familiar with the concept of AI, with varying degrees of acceptance of its implementation in radiology. It is clear that the most conflictive dimension is ?personal interaction,? whereas ?efficiency? is where there is the greatest acceptance, being the dimension in which there are the best expectations for the implementation of AI in radiology. UR - https://www.jmir.org/2023/1/e50728 UR - http://dx.doi.org/10.2196/50728 UR - http://www.ncbi.nlm.nih.gov/pubmed/37831495 ID - info:doi/10.2196/50728 ER - TY - JOUR AU - Stara, Vera AU - Soraci, Luca AU - Takano, Eiko AU - Kondo, Izumi AU - Möller, Johanna AU - Maranesi, Elvira AU - Luzi, Riccardo AU - Riccardi, Renato Giovanni AU - Browne, Ryan AU - Dacunha, Sébastien AU - Palmier, Cecilia AU - Wieching, Rainer AU - Ogawa, Toshimi AU - Bevilacqua, Roberta PY - 2023/10/12 TI - Intrinsic Capacity and Active and Healthy Aging Domains Supported by Personalized Digital Coaching: Survey Study Among Geriatricians in Europe and Japan on eHealth Opportunities for Older Adults JO - J Med Internet Res SP - e41035 VL - 25 KW - intrinsic capacity KW - functional ability, active and healthy aging KW - digital coaching KW - eHealth interventions KW - older adults N2 - Background: The worldwide aging trend requires conceptually new prevention, care, and innovative living solutions to support human-based care using smart technology, and this concerns the whole world. Enabling access to active and healthy aging through personalized digital coaching services like physical activity coaching, cognitive training, emotional well-being, and social connection for older adults in real life could offer valuable advantages to both individuals and societies. A starting point might be the analysis of the perspectives of different professionals (eg, geriatricians) on such technologies. The perspectives of experts in the sector may allow the individualization of areas of improvement of clinical interventions, supporting the positive perspective pointed out by the intrinsic capacity framework. Objective: The overall aim of this study was to explore the cross-national perspectives and experiences of different professionals in the field of intrinsic capacity, and how it can be supported by eHealth interventions. To our knowledge, this is the first study to explore geriatric care providers? perspectives about technology-based interventions to support intrinsic capacity. Methods: A survey involving 20 geriatricians or clinical experts in the fields of intrinsic capacity and active and healthy aging was conducted in Italy, France, Germany, and Japan between August and September 2021. Results: The qualitative findings pointed out relevant domains for eHealth interventions and provided examples for successful practices that support subjective well-being under the intrinsic capacity framework (the benefits offered by personalized interventions, especially by promoting health literacy but avoiding intrusiveness). Moreover, eHealth interventions could be used as a bridge that facilitates and enables social engagement; an instrument that facilitates communication between doctors and patients; and a tool to enrich the monitoring actions of medical staff. Conclusions: There is an unexplored and significant role for such geriatric perspectives to help the development process and evaluate the evidence-based results on the effectiveness of technologies for older people. This is possible only when clinicians collaborate with data scientists, engineers, and developers in order to match the complex daily needs of older adults. UR - https://www.jmir.org/2023/1/e41035 UR - http://dx.doi.org/10.2196/41035 UR - http://www.ncbi.nlm.nih.gov/pubmed/37824183 ID - info:doi/10.2196/41035 ER - TY - JOUR AU - Benton, Mark PY - 2023/9/7 TI - Experience and Impact of COVID-19 on a Newly Formed Rural University Medical Office: Survey Study JO - JMIR Form Res SP - e48299 VL - 7 KW - remote KW - access KW - COVID-19 KW - learning KW - survey KW - office KW - HOPE KW - administration KW - administrative KW - medical education KW - education system KW - education systems N2 - Background: The COVID-19 pandemic had large social effects, particularly in the fields of medicine and medical education. Medical organizations in the United States operate in overlapping contexts with interrelated goals inside multiple organizations, and the context of work strongly influenced how organizations were able to respond to COVID-19 restrictions. Objective: This research examines the experience and impact of COVID-19 on the implementation of a Health Resources and Services Administration grant in a newly formed university medical office with the interrelated goals of health policy, health outreach, and medical education. The goal is to understand how COVID-19 created different experiences and challenges for leaders and their collaborators working in medical education compared to those working in public health outreach or health policy. Methods: A survey about COVID-19 opportunities and challenges was administered to work unit leaders and their project collaborators. The most common experiences and challenges are shown, direct educational and other respondents? experiences and challenges are compared, and open-ended comment segments are analyzed. Results: Helping others adjust to digital work, remoteness, and coordination were common experiences during COVID-19. Common challenges include coordination and an inability to make comparisons to previous program years. On average, respondents had 11.3 (SD 7.8) experiences and 8.3 (SD 6.9) challenges considered in the survey. While all units were influenced by COVID-19 restrictions, medical education units had more experiences and challenges. Those involved directly in medical education experienced 69% (18.6/27) of their possible experiences and 54% (14.7/27) of their possible challenges on average compared to 35% (7/20) and 21% (4.2/20) among other respondents (P<.001). COVID-19 restrictions increased the complexity of project work and presented challenges, especially in terms of coordinating responses and access to locations. Conclusions: The findings suggest that COVID-19 made the overall administration of programs more complex and drew attention from other medical and public health programs. While remoteness is appropriate for some medical education tasks, it is less appropriate for clinical learning. Remoteness presents an especially large challenge to clinical education. Employees now have expectations for remoteness to be built into programs and workplaces. Program administrators will have to integrate remoteness? benefits and drawbacks into their organization for the foreseeable future. UR - https://formative.jmir.org/2023/1/e48299 UR - http://dx.doi.org/10.2196/48299 UR - http://www.ncbi.nlm.nih.gov/pubmed/37676708 ID - info:doi/10.2196/48299 ER - TY - JOUR AU - AL-Rumhi, Alya AU - AL-Rasbi, Samira AU - Momani, M. Aaliyah PY - 2023/8/24 TI - The Use of Social Media by Clinical Nurse Specialists at a Tertiary Hospital: Mixed Methods Study JO - JMIR Nursing SP - e45150 VL - 6 KW - social media KW - clinical nurse specialist KW - cross-sectional KW - tertiary hospital KW - Oman KW - health education tool N2 - Background: Recently, many health care professionals, who use social media to communicate with patients and colleagues, share information about medical research and promote public health campaigns. Objective: This study aimed to examine the motives, barriers, and implementation of social media use among clinical nurse specialists in Oman. Methods: A mixed methods study was conducted among 47 clinical nurse specialists at Sultan Qaboos University Hospital between November and December 2020. Qualitative data were collected using an open-ended questionnaire and analyzed using thematic analysis, and quantitative data were collected with a questionnaire and analyzed using SPSS (version 21.0; IBM Corp). Results: Of the 47 clinical nurse specialists surveyed, 43 (91.5%) responded. All respondents reported using social media applications, with WhatsApp being the most commonly used platform. Most respondents (n=18, 41.9%) spent 1-2 hours per day on social media. The main motives for using social media were increasing knowledge, communication, reaching patients easily, and reducing the number of hospital visits. The main barriers to social media use were privacy concerns, time constraints, and a lack of awareness of legal guidelines for social media use in the workplace. All participants requested clear rules and regulations regarding the use of social media among health care providers in the future. Conclusions: Social media has the option to be a powerful institutional communication and health education tool for clinical nurse specialists in Oman. However, several obstacles must be addressed, including privacy concerns and the need for clear guidelines on social media use in the workplace. Our findings suggest that health care institutions and clinical nurse specialists must work together to overcome these impediments and leverage the benefits of social media for health care.Bottom of Form UR - https://nursing.jmir.org/2023/1/e45150 UR - http://dx.doi.org/10.2196/45150 UR - http://www.ncbi.nlm.nih.gov/pubmed/37616026 ID - info:doi/10.2196/45150 ER - TY - JOUR AU - Wilson, Sarah AU - Tolley, Clare AU - Mc Ardle, Riona AU - Beswick, Emily AU - Slight, P. Sarah PY - 2023/8/22 TI - Key Considerations When Developing and Implementing Digital Technology for Early Detection of Dementia-Causing Diseases Among Health Care Professionals: Qualitative Study JO - J Med Internet Res SP - e46711 VL - 25 KW - qualitative KW - health care professional KW - early detection of disease KW - dementia KW - digital technology KW - early detection of dementia KW - digital health KW - health care worker KW - digital tool N2 - Background: The World Health Organization (WHO) promotes using digital technologies to accelerate global attainment of health and well-being. This has led to a growth in research exploring the use of digital technology to aid early detection and preventative interventions for dementia-causing diseases such as Alzheimer disease. The opinions and perspectives of health care professionals must be incorporated into the development and implementation of technology to promote its successful adoption in clinical practice. Objective: This study aimed to explore health care professionals? perspectives on the key considerations of developing and implementing digital technologies for the early detection of dementia-causing diseases in the National Health Service (NHS). Methods: Health care professionals with patient-facing roles in primary or secondary care settings in the NHS were recruited through various web-based NHS clinical networks. Participants were interviewed to explore their experiences of the current dementia diagnostic practices, views on early detection and use of digital technology to aid these practices, and the challenges of implementing such interventions in health care. An inductive thematic analysis approach was applied to identify central concepts and themes in the interviews, allowing the data to determine our themes. A list of central concepts and themes was applied systematically to the whole data set using NVivo (version 1.6.1; QSR International). Using the constant comparison technique, the researchers moved backward and forward between these data and evolving explanations until a fit was made. Results: Eighteen semistructured interviews were conducted, with 11 primary and 7 secondary care health care professionals. We identified 3 main categories of considerations relevant to health care service users, health care professionals, and the digital health technology itself. Health care professionals recognized the potential of using digital technology to collect real-time data and the possible benefits of detecting dementia-causing diseases earlier if an effective intervention were available. However, some were concerned about postdetection management, questioning the point of an early detection of dementia-causing diseases if an effective intervention cannot be provided and feared this would only lead to increased anxiety in patients. Health care professionals also expressed mixed opinions on who should be screened for early detection. Some suggested it should be available to everyone to mitigate the chance of excluding those who are not in touch with their health care or are digitally excluded. Others were concerned about the resources that would be required to make the technology available to everyone. Conclusions: This study highlights the need to design digital health technology in a way that is accessible to all and does not add burden to health care professionals. Further work is needed to ensure inclusive strategies are used in digital research to promote health equity. UR - https://www.jmir.org/2023/1/e46711 UR - http://dx.doi.org/10.2196/46711 UR - http://www.ncbi.nlm.nih.gov/pubmed/37606986 ID - info:doi/10.2196/46711 ER - TY - JOUR AU - Livesay, Karen AU - Petersen, Sacha AU - Walter, Ruby AU - Zhao, Lin AU - Butler-Henderson, Kerryn AU - Abdolkhani, Robab PY - 2023/8/16 TI - Sociotechnical Challenges of Digital Health in Nursing Practice During the COVID-19 Pandemic: National Study JO - JMIR Nursing SP - e46819 VL - 6 KW - nursing informatics KW - digital health KW - COVID-19 pandemic KW - workforce KW - sociotechnical approach N2 - Background: The COVID-19 pandemic has accelerated the use of digital health innovations, which has greatly impacted nursing practice. However, little is known about the use of digital health services by nurses and how this has changed during the pandemic. Objective: This study explored the sociotechnical challenges that nurses encountered in using digital health services implemented during the pandemic and, accordingly, what digital health capabilities they expect from the emerging workforce. Methods: Five groups of nurses, including chief nursing information officers, nurses, clinical educators, nurse representatives at digital health vendor companies, and nurse representatives in government bodies across Australia were interviewed. They were asked about their experience of digital health during the pandemic, their sociotechnical challenges, and their expectations of the digital health capabilities of emerging nurses to overcome these challenges. Interviews were deductively analyzed based on 8 sociotechnical themes, including technical challenges, nurse-technology interaction, clinical content management, training and human resources, communication and workflow, internal policies and guidelines, external factors, and effectiveness assessment of digital health for postpandemic use. Results: Sixteen participants were interviewed. Human factors and clinical workflow challenges were highly mentioned. Nurses? lack of knowledge and involvement in digital health implementation and evaluation led to inefficient use of these technologies during the pandemic. They expected the emerging workforce to be digitally literate and actively engaged in digital health interventions beyond documentation, such as data analytics and decision-making. Conclusions: Nurses should be involved in digital health interventions to efficiently use these technologies and provide safe and quality care. Collaborative efforts among policy makers, vendors, and clinical and academic industries can leverage digital health capabilities in the nursing workforce. UR - https://nursing.jmir.org/2023/1/e46819 UR - http://dx.doi.org/10.2196/46819 UR - http://www.ncbi.nlm.nih.gov/pubmed/37585256 ID - info:doi/10.2196/46819 ER - TY - JOUR AU - Spadaro, Benedetta AU - Martin-Key, A. Nayra AU - Funnell, Erin AU - Bená?ek, Ji?í AU - Bahn, Sabine PY - 2023/8/7 TI - Opportunities for the Implementation of a Digital Mental Health Assessment Tool in the United Kingdom: Exploratory Survey Study JO - JMIR Form Res SP - e43271 VL - 7 KW - assessment KW - digital mental health KW - development KW - implementation KW - mental health KW - provision KW - support KW - mobile phone N2 - Background: Every year, one-fourth of the people in the United Kingdom experience diagnosable mental health concerns, yet only a proportion receive a timely diagnosis and treatment. With novel developments in digital technologies, the potential to increase access to mental health assessments and triage is promising. Objective: This study aimed to investigate the current state of mental health provision in the United Kingdom and understand the utility of, and interest in, digital mental health technologies. Methods: A web-based survey was generated using Qualtrics XM. Participants were recruited via social media. Data were explored using descriptive statistics. Results: The majority of the respondents (555/618, 89.8%) had discussed their mental health with a general practitioner. More than three-fourths (503/618, 81.4%) of the respondents had been diagnosed with a mental health disorder, with the most common diagnoses being depression and generalized anxiety disorder. Diagnostic waiting times from first contact with a health care professional varied by diagnosis. Neurodevelopmental disorders (30/56, 54%), bipolar disorder (25/52, 48%), and personality disorders (48/101, 47.5%) had the longest waiting times, with almost half (103/209, 49.3%) of these diagnoses taking >6 months. Participants stated that waiting times resulted in symptoms worsening (262/353, 74.2%), lower quality of life (166/353, 47%), and the necessity to seek emergency care (109/353, 30.9%). Of the 618 participants, 386 (62.5%) stated that they felt that their mental health symptoms were not always taken seriously by their health care provider and 297 (48.1%) were not given any psychoeducational information. The majority of the respondents (416/595, 77.5%) did not have the chance to discuss mental health support and treatment options. Critically, 16.1% (96/595) did not find any treatment or support provided at all helpful, with 63% (48/76) having discontinued treatment with no effective alternatives. Furthermore, 88.3% (545/617) of the respondents) had sought help on the web regarding mental health symptoms, and 44.4% (272/612) had used a web application or smartphone app for their mental health. Psychoeducation (364/596, 61.1%), referral to a health care professional (332/596, 55.7%), and symptom monitoring (314/596, 52.7%) were the most desired app features. Only 6.8% (40/590) of the participants said that they would not be interested in using a mental health assessment app. Respondents were the most interested to receive an overall severity score of their mental health symptoms (441/546, 80.8%) and an indication of whether they should seek mental health support (454/546, 83.2%). Conclusions: Key gaps in current UK mental health care provision are highlighted. Assessment and treatment waiting times together with a lack of information regarding symptoms and treatment options translated into poor care experiences. The participants? responses provide proof-of-concept support for the development of a digital mental health assessment app and valuable recommendations regarding desirable app features. UR - https://formative.jmir.org/2023/1/e43271 UR - http://dx.doi.org/10.2196/43271 UR - http://www.ncbi.nlm.nih.gov/pubmed/37549003 ID - info:doi/10.2196/43271 ER - TY - JOUR AU - Hsiang, Y. Esther AU - Ganeshan, Smitha AU - Patel, Saharsh AU - Yurkovic, Alexandra AU - Parekh, Ami PY - 2023/7/14 TI - Training Physicians in the Digital Health Era: How to Leverage the Residency Elective JO - JMIR Med Educ SP - e46752 VL - 9 KW - digital health KW - care delivery innovation KW - physician-leader KW - medical training KW - residency education KW - eHealth KW - residency KW - medical education KW - software KW - elective KW - intern KW - telehealth KW - telemedicine UR - https://mededu.jmir.org/2023/1/e46752 UR - http://dx.doi.org/10.2196/46752 UR - http://www.ncbi.nlm.nih.gov/pubmed/37450323 ID - info:doi/10.2196/46752 ER - TY - JOUR AU - Darnell, C. Julia AU - Lou, Mimi AU - Goldstone, W. Lisa PY - 2023/7/10 TI - 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 JO - JMIR Med Educ SP - e43313 VL - 9 KW - digital health KW - telehealth KW - digital therapeutics KW - mobile health applications KW - wearable health technologies KW - pharmacy education KW - medical education KW - patient cases KW - technology KW - education KW - digital KW - survey KW - intervention N2 - 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. UR - https://mededu.jmir.org/2023/1/e43313 UR - http://dx.doi.org/10.2196/43313 UR - http://www.ncbi.nlm.nih.gov/pubmed/37428523 ID - info:doi/10.2196/43313 ER - TY - JOUR AU - Malerbi, Korn Fernando AU - Nakayama, Filipe Luis AU - Gayle Dychiao, Robyn AU - Zago Ribeiro, Lucas AU - Villanueva, Cleva AU - Celi, Anthony Leo AU - Regatieri, Vinicius Caio PY - 2023/6/22 TI - Digital Education for the Deployment of Artificial Intelligence in Health Care JO - J Med Internet Res SP - e43333 VL - 25 KW - artificial intelligence KW - digital health KW - health education KW - machine learning KW - digital education KW - digital KW - education KW - transformation KW - neural KW - network KW - evaluation KW - dataset KW - data KW - set KW - clinical UR - https://www.jmir.org/2023/1/e43333 UR - http://dx.doi.org/10.2196/43333 UR - http://www.ncbi.nlm.nih.gov/pubmed/37347537 ID - info:doi/10.2196/43333 ER - TY - JOUR AU - Naranjo-Saucedo, Belen Ana AU - Escobar-Rodriguez, Antonio German AU - Tabernero, Carmen AU - Cuadrado, Esther AU - Parra-Calderon, Luis Carlos AU - Arenas, Alicia PY - 2023/5/31 TI - Mobile Health Requirements for the Occupational Health Assessment of Health Care Professionals: Delphi Study JO - JMIR Form Res SP - e40327 VL - 7 KW - occupational health assessment KW - psychosocial risks KW - health care professionals KW - mobile health KW - mHealth KW - Delphi method N2 - Background: In recent years, owing to the COVID-19 pandemic, awareness of the high level of stress among health care professionals has increased, and research in this area has intensified. Hospital staff members have historically been known to work in an environment involving high emotional demands, time pressure, and workload. Furthermore, the pandemic has increased the strain experienced by health care professionals owing to the high number of people they need to manage and, on many occasions, the limited available resources with which they must carry out their functions. These psychosocial risks are not always well dealt with by the organization or the professionals themselves. Therefore, it is necessary to have tools to assess these psychosocial risks and to optimize the management of this demand from health care professionals. Digital health, and more specifically, mobile health (mHealth), is presented as a health care modality that can contribute greatly to respond to these unmet needs. Objective: We aimed to analyze whether mHealth tools can provide value for the study and management of psychosocial risks in health care professionals, and assess the requirements of these tools. Methods: A Delphi study was carried out to determine the opinions of experts on the relevance of using mHealth tools to evaluate physiological indicators and psychosocial factors in order to assess occupational health, and specifically, stress and burnout, in health care professionals. The study included 58 experts with knowledge and experience in occupational risk prevention, psychosocial work, and health-related technology, as well as health professionals from private and public sectors. Results: Our data suggested that there is still controversy about the roles that organizations play in occupational risk prevention in general and psychosocial risks in particular. An adequate assessment of the stress levels and psychosocial factors can help improve employees? well-being. Moreover, making occupational health evaluations available to the team would positively affect employees by increasing their feelings of being taken into account by the organization. This assessment can be improved with mHealth tools that identify and quickly highlight the difficulties or problems that occur among staff and work teams. However, to achieve good adherence and participation in occupational health and safety evaluations, experts consider that it is essential to ensure the privacy of professionals and to develop feelings of being supported by their supervisors. Conclusions: For years, mHealth has been used mainly to propose intervention programs to improve occupational health. Our research highlights the usefulness of these tools for evaluating psychosocial risks in a preliminary and essential phase of approaches to improve the health and well-being of professionals in health care settings. The most urgent requirements these tools must meet are those aimed at protecting the confidentiality and privacy of measurements. UR - https://formative.jmir.org/2023/1/e40327 UR - http://dx.doi.org/10.2196/40327 UR - http://www.ncbi.nlm.nih.gov/pubmed/37256659 ID - info:doi/10.2196/40327 ER - TY - JOUR AU - Alami, Jawad AU - Hammonds, Clare AU - Hensien, Erin AU - Khraibani, Jenan AU - Borowitz, Stephen AU - Hellems, Martha AU - Riggs, Sara PY - 2023/5/10 TI - Examining Pediatric Resident Electronic Health Records Use During Prerounding: Mixed Methods Observational Study JO - JMIR Med Educ SP - e38079 VL - 9 KW - EHR KW - pediatric KW - usability KW - prerounding KW - training KW - electronic health record KW - eHealth N2 - Background: Electronic health records (EHRs) play a substantial role in modern health care, especially during prerounding, when residents gather patient information to inform daily care decisions of the care team. The effective use of the EHR system is crucial for efficient and frustration-free prerounding. Ideally, the system should be designed to support efficient user interactions by presenting data effectively and providing easy navigation between different pages. Additionally, training on the system should aim to make user interactions more efficient by familiarizing the users with best practices that minimize interaction time while using the full potential of the system?s capabilities. However, formal training on EHR systems often falls short of providing residents with all the necessary EHR-related skills, leading to the adoption of inefficient practices and the underuse of the system?s full range of capabilities. Objective: This study aims to examine the efficiency of EHR use during prerounding among pediatric residents, assess the effect of experience level on EHR use, and identify areas for improvement in EHR design and training. Methods: A mixed methods approach was used, involving a self-reported survey and video analysis of prerounding practices of the entire population of pediatric residents from a large teaching hospital in the South Atlantic Region. The residents were stratified by experience level by postgraduate year. Data were collected on the number of pages accessed, duration of prerounding, task completion rates, and effective use of data sources. Observational and qualitative data complemented the quantitative analysis. Our study followed the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) reporting guidelines, ensuring completeness and transparency of reporting. Results: Of the 30 pediatric residents, 20 were included in the analyses; of these, 16 (80%) missed at least 1 step during prerounding. Although more experienced residents on average omitted fewer steps, 4 (57%) of the 7 most experienced residents still omitted at least 1 step. On average, residents took 6.5 minutes to round each patient and accessed 21 pages within the EHR during prerounding; no statistically significant differences were observed between experience levels for prerounding times (P=.48) or number of pages accessed (P=.92). The use of aggregated data pages within the EHR system neither seem to improve prerounding times nor decrease the number of pages accessed. Conclusions: The findings suggest that EHR design should be improved to better support user needs, and hospitals should adopt more effective training programs to familiarize residents with the system?s capabilities. We recommend implementing prerounding checklists and providing ongoing EHR training programs for health care practitioners. Despite the generalizability of limitations of our study in terms of sample size and specialization, it offers valuable insights for future research to investigate the impact of EHR use on patient outcomes and satisfaction, as well as identify factors that contribute to efficient and effective EHR usage. UR - https://mededu.jmir.org/2023/1/e38079 UR - http://dx.doi.org/10.2196/38079 UR - http://www.ncbi.nlm.nih.gov/pubmed/37163346 ID - info:doi/10.2196/38079 ER - TY - JOUR AU - Bajra, Rika AU - Frazier, Winfred AU - Graves, Lisa AU - Jacobson, Katherine AU - Rodriguez, Andres AU - Theobald, Mary AU - Lin, Steven PY - 2023/5/8 TI - Feasibility and Acceptability of a US National Telemedicine Curriculum for Medical Students and Residents: Multi-institutional Cross-sectional Study JO - JMIR Med Educ SP - e43190 VL - 9 KW - curriculum KW - distance education KW - graduate medical education KW - telemedicine KW - undergraduate medical education N2 - Background: Telemedicine use increased as a response to health care delivery changes necessitated by the COVID-19 pandemic. However, lack of standardized curricular content creates gaps and inconsistencies in effectively integrating telemedicine training at both the undergraduate medical education and graduate medical education levels. Objective: This study evaluated the feasibility and acceptability of a web-based national telemedicine curriculum developed by the Society of Teachers of Family Medicine for medical students and family medicine (FM) residents. Based on the Association of American Medical Colleges telehealth competencies, the asynchronous curriculum featured 5 self-paced modules; covered topics include evidence-based telehealth uses, best practices in communication and remote physical examinations, technology requirements and documentation, access and equity in telehealth delivery, and the promise and potential perils of emerging technologies. Methods: A total of 17 medical schools and 17 FM residency programs implemented the curriculum between September 1 and December 31, 2021. Participating sites represented 25 states in all 4 US census regions with balanced urban, suburban, and rural settings. A total of 1203 learners, including 844 (70%) medical students and 359 (30%) FM residents, participated. Outcomes were measured through self-reported 5-point Likert scale responses. Results: A total of 92% (1101/1203) of learners completed the entire curriculum. Across the modules, 78% (SD 3%) of participants agreed or strongly agreed that they gained new knowledge, skills, or attitudes that will help them in their training or career; 87% (SD 4%) reported that the information presented was at the right level for them; 80% (SD 2%) reported that the structure of the modules was effective; and 78% (SD 3%) agreed or strongly agreed that they were satisfied. Overall experience using the national telemedicine curriculum did not differ significantly between medical students and FM residents on binary analysis. No consistent statistically significant relationships were found between participants? responses and their institution?s geographic region, setting, or previous experience with a telemedicine curriculum. Conclusions: Both undergraduate medical education and graduate medical education learners, represented by diverse geographic regions and institutions, indicated that the curriculum was broadly acceptable and effective. UR - https://mededu.jmir.org/2023/1/e43190 UR - http://dx.doi.org/10.2196/43190 UR - http://www.ncbi.nlm.nih.gov/pubmed/37155241 ID - info:doi/10.2196/43190 ER - TY - JOUR AU - Preiksaitis, Carl AU - Dayton, R. John AU - Kabeer, Rana AU - Bunney, Gabrielle AU - Boukhman, Milana PY - 2023/2/24 TI - Teaching Principles of Medical Innovation and Entrepreneurship Through Hackathons: Case Study and Qualitative Analysis JO - JMIR Med Educ SP - e43916 VL - 9 KW - hackathon KW - innovation KW - entrepreneurship KW - medical education KW - gamification KW - curriculum KW - biodesign KW - emergency medicine KW - health care innovation KW - medical innovation KW - training KW - design KW - implementation KW - development KW - physician KW - educational N2 - Background: Innovation and entrepreneurship training are increasingly recognized as being important in medical education. However, the lack of faculty comfort with the instruction of these concepts as well as limited scholarly recognition for this work has limited the implementation of curricula focused on these skills. Furthermore, this lack of familiarity limits the inclusion of practicing physicians in health care innovation, where their experience is valuable. Hackathons are intense innovation competitions that use gamification principles to increase comfort with creative thinking, problem-solving, and interpersonal collaboration, but they require further exploration in medical innovation. Objective: To address this, we aimed to design, implement, and evaluate a health care hackathon with 2 main goals: to improve emergency physician familiarity with the principles of health care innovation and entrepreneurship and to develop innovative solutions to 3 discrete problems facing emergency medicine physicians and patients. Methods: We used previously described practices for conducting hackathons to develop and implement our hackathon (HackED!). We partnered with the American College of Emergency Physicians, the Stanford School of Biodesign, and the Institute of Design at Stanford (d.school) to lend institutional support and expertise in health care innovation to our event. We determined a location, time frame, and logistics for the competition and settled on 3 use cases for teams to work on. We planned to explore the learning experience of participants within a pragmatic paradigm and complete an abductive thematic analysis using data from a variety of sources. Results: HackED! took place from October 1-3, 2022. In all, 3 teams developed novel solutions to each of the use cases. Our investigation into the educational experience of participants suggested that the event was valuable and uncovered themes suggesting that the learning experience could be understood within a framework from entrepreneurship education not previously described in relation to hackathons. Conclusions: Health care hackathons appear to be a viable method of increasing physician experience with innovation and entrepreneurship principles and addressing complex problems in health care. Hackathons should be considered as part of educational programs that focus on these concepts. UR - https://mededu.jmir.org/2023/1/e43916 UR - http://dx.doi.org/10.2196/43916 UR - http://www.ncbi.nlm.nih.gov/pubmed/36826988 ID - info:doi/10.2196/43916 ER - TY - JOUR AU - Liu, Shalom David AU - Sawyer, Jake AU - Luna, Alexander AU - Aoun, Jihad AU - Wang, Janet AU - Boachie, Lord AU - Halabi, Safwan AU - Joe, Bina PY - 2022/10/21 TI - Perceptions of US Medical Students on Artificial Intelligence in Medicine: Mixed Methods Survey Study JO - JMIR Med Educ SP - e38325 VL - 8 IS - 4 KW - artificial intelligence KW - eHealth KW - digital health KW - integration KW - medical education KW - medical curriculum KW - education KW - medical student KW - medical school KW - elective course N2 - Background: Given the rapidity with which artificial intelligence is gaining momentum in clinical medicine, current physician leaders have called for more incorporation of artificial intelligence topics into undergraduate medical education. This is to prepare future physicians to better work together with artificial intelligence technology. However, the first step in curriculum development is to survey the needs of end users. There has not been a study to determine which media and which topics are most preferred by US medical students to learn about the topic of artificial intelligence in medicine. Objective: We aimed to survey US medical students on the need to incorporate artificial intelligence in undergraduate medical education and their preferred means to do so to assist with future education initiatives. Methods: A mixed methods survey comprising both specific questions and a write-in response section was sent through Qualtrics to US medical students in May 2021. Likert scale questions were used to first assess various perceptions of artificial intelligence in medicine. Specific questions were posed regarding learning format and topics in artificial intelligence. Results: We surveyed 390 US medical students with an average age of 26 (SD 3) years from 17 different medical programs (the estimated response rate was 3.5%). A majority (355/388, 91.5%) of respondents agreed that training in artificial intelligence concepts during medical school would be useful for their future. While 79.4% (308/388) were excited to use artificial intelligence technologies, 91.2% (353/387) either reported that their medical schools did not offer resources or were unsure if they did so. Short lectures (264/378, 69.8%), formal electives (180/378, 47.6%), and Q and A panels (167/378, 44.2%) were identified as preferred formats, while fundamental concepts of artificial intelligence (247/379, 65.2%), when to use artificial intelligence in medicine (227/379, 59.9%), and pros and cons of using artificial intelligence (224/379, 59.1%) were the most preferred topics for enhancing their training. Conclusions: The results of this study indicate that current US medical students recognize the importance of artificial intelligence in medicine and acknowledge that current formal education and resources to study artificial intelligence?related topics are limited in most US medical schools. Respondents also indicated that a hybrid formal/flexible format would be most appropriate for incorporating artificial intelligence as a topic in US medical schools. Based on these data, we conclude that there is a definitive knowledge gap in artificial intelligence education within current medical education in the US. Further, the results suggest there is a disparity in opinions on the specific format and topics to be introduced. UR - https://mededu.jmir.org/2022/4/e38325 UR - http://dx.doi.org/10.2196/38325 UR - http://www.ncbi.nlm.nih.gov/pubmed/36269641 ID - info:doi/10.2196/38325 ER - TY - JOUR AU - Smith, Katharine AU - Torous, John AU - Cipriani, Andrea PY - 2022/10/14 TI - Teaching Telepsychiatry Skills: Building on the Lessons of the COVID-19 Pandemic to Enhance Mental Health Care in the Future JO - JMIR Ment Health SP - e37939 VL - 9 IS - 10 KW - mHealth KW - mental health KW - smartphones KW - telehealth KW - telepsychiatry KW - COVID-19 UR - https://mental.jmir.org/2022/10/e37939 UR - http://dx.doi.org/10.2196/37939 UR - http://www.ncbi.nlm.nih.gov/pubmed/35358948 ID - info:doi/10.2196/37939 ER - TY - JOUR AU - Chartash, David AU - Rosenman, Marc AU - Wang, Karen AU - Chen, Elizabeth PY - 2022/9/13 TI - Informatics in Undergraduate Medical Education: Analysis of Competency Frameworks and Practices Across North America JO - JMIR Med Educ SP - e39794 VL - 8 IS - 3 KW - undergraduate medical education KW - medical informatics KW - curriculum KW - medical education KW - education KW - North America KW - framework KW - clinical KW - informatics KW - Canada KW - United States KW - US KW - teaching KW - management KW - cognitive N2 - Background: With the advent of competency-based medical education, as well as Canadian efforts to include clinical informatics within undergraduate medical education, competency frameworks in the United States have not emphasized the skills associated with clinical informatics pertinent to the broader practice of medicine. Objective: By examining the competency frameworks with which undergraduate medical education in clinical informatics has been developed in Canada and the United States, we hypothesized that there is a gap: the lack of a unified competency set and frame for clinical informatics education across North America. Methods: We performed directional competency mapping between Canadian and American graduate clinical informatics competencies and general graduate medical education competencies. Directional competency mapping was performed between Canadian roles and American common program requirements using keyword matching at the subcompetency and enabling competency levels. In addition, for general graduate medical education competencies, the Physician Competency Reference Set developed for the Liaison Committee on Medical Education was used as a direct means of computing the ontological overlap between competency frameworks. Results: Upon mapping Canadian roles to American competencies via both undergraduate and graduate medical education competency frameworks, the difference in focus between the 2 countries can be thematically described as a difference between the concepts of clinical and management reasoning. Conclusions: We suggest that the development or deployment of informatics competencies in undergraduate medical education should focus on 3 items: the teaching of diagnostic reasoning, such that the information tasks that comprise both clinical and management reasoning can be discussed; precision medical education, where informatics can provide for more fine-grained evaluation; and assessment methods to support traditional pedagogical efforts (both at the bedside and beyond). Assessment using cases or structured assessments (eg, Objective Structured Clinical Examinations) would help students draw parallels between clinical informatics and fundamental clinical subjects and would better emphasize the cognitive techniques taught through informatics. UR - https://mededu.jmir.org/2022/3/e39794 UR - http://dx.doi.org/10.2196/39794 UR - http://www.ncbi.nlm.nih.gov/pubmed/36099007 ID - info:doi/10.2196/39794 ER - TY - JOUR AU - Yin, Leena AU - Ng, Fiona AU - Rutherford-Rojas, Mateo AU - Williams, Mia AU - Cornes, Susannah AU - Fernandez, Alicia AU - Garcia, E. Maria AU - Khoong, C. Elaine PY - 2022/8/11 TI - Assessing Medical Student Readiness to Navigate Language Barriers in Telehealth: Cross-sectional Survey Study JO - JMIR Med Educ SP - e36096 VL - 8 IS - 3 KW - interpreters KW - language barriers KW - medical students KW - medical education KW - limited English proficiency KW - telehealth KW - telemedicine KW - online education KW - clinician KW - health care professional N2 - Background: The COVID-19 pandemic has greatly increased telehealth usage in the United States. Patients with limited English proficiency (LEP) face barriers to health care, which may be mitigated when providers work with professional interpreters. However, telehealth may exacerbate disparities if clinicians are not trained to work with interpreters in that setting. Although medical students are now involved in telehealth on an unprecedented scale, no educational innovations have been published that focus on digital care across language barriers. Objective: The aim of this study is to investigate advanced medical students? confidence in caring for patients with LEP during telehealth encounters. Methods: We administered a written survey to medical students on clinical clerkships at one US institution in August and September 2020. We assessed students? overall confidence in working with interpreters; confidence in performing 8 clinical tasks during in-person versus telehealth encounters; and frequency of performing 5 different clinical tasks with patients with LEP compared to English-speaking patients during in-person versus telehealth encounters. Wilcoxon signed-rank tests and chi-square tests were used to compare confidence and task performance frequency, respectively, for patients with LEP versus English-speaking patients during telehealth encounters. Students were also asked to identify barriers to care for patients with LEP. The free-response questions were qualitatively analyzed using open coding to identify key themes. Results: Of 300 medical students surveyed, 121 responded. Furthermore, 72 students answered >50% of questions and were included in the analyses. Compared to caring for patients with LEP during in-person encounters, respondents were less confident in working with interpreters (P<.001), developing trust (P<.001), identifying agenda (P=.005), eliciting preferences for diabetes management (P=.01), and empowering patients in lifestyle modifications (P=.04) during telehealth encounters. During both in-person and telehealth encounters, approximately half of students (40%-78%) reported engaging less frequently in every clinical task with patients with LEP and this was as low as 22% (13/59) for some tasks. Students identified these key barriers to care for patients with LEP: time pressure, interpretation quality and access, technical difficulties, cultural differences, and difficulty with rapport building. Conclusions: Advanced medical students were significantly less confident caring for patients with LEP via telehealth than in person. Broader implementation of training around navigating language barriers is necessary for telehealth care, which has rapidly expanded in the United States. Our study identified potential key areas for curricular focus, including creating patient-centered agendas and management plans within the constraints of virtual settings. These developments must take place simultaneously with systems-level improvements in interpreter infrastructure to ensure high-quality care for linguistically diverse patients. UR - https://mededu.jmir.org/2022/3/e36096 UR - http://dx.doi.org/10.2196/36096 UR - http://www.ncbi.nlm.nih.gov/pubmed/35969421 ID - info:doi/10.2196/36096 ER - TY - JOUR AU - Vuku?i? Rukavina, Tea AU - Machala Popla?en, Lovela AU - Majer, Marjeta AU - Reli?, Danko AU - Viski?, Jo?ko AU - Mareli?, Marko PY - 2022/8/9 TI - Defining Potentially Unprofessional Behavior on Social Media for Health Care Professionals: Mixed Methods Study JO - JMIR Med Educ SP - e35585 VL - 8 IS - 3 KW - professionalism KW - e-professionalism KW - internet KW - social media KW - social networking KW - medicine KW - dental medicine KW - health care professionals KW - students KW - faculty N2 - Background: Social media presence among health care professionals is ubiquitous and largely beneficial for their personal and professional lives. New standards are forming in the context of e-professionalism, which are loosening the predefined older and offline terms. With these benefits also come dangers, with exposure to evaluation on all levels from peers, superiors, and the public, as witnessed in the #medbikini movement. Objective: The objectives of this study were to develop an improved coding scheme (SMePROF coding scheme) for the assessment of unprofessional behavior on Facebook of medical or dental students and faculty, compare reliability between coding schemes used in previous research and SMePROF coding scheme, compare gender-based differences for the assessment of the professional content on Facebook, validate the SMePROF coding scheme, and assess the level of and to characterize web-based professionalism on publicly available Facebook profiles of medical or dental students and faculty. Methods: A search was performed via a new Facebook account using a systematic probabilistic sample of students and faculty in the University of Zagreb School of Medicine and School of Dental Medicine. Each profile was subsequently assessed with regard to professionalism based on previously published criteria and compared using the SMePROF coding scheme developed for this study. Results: Intercoder reliability increased when the SMePROF coding scheme was used for the comparison of gender-based coding results. Results showed an increase in the gender-based agreement of the final codes for the category professionalism, from 85% in the first phase to 96.2% in the second phase. Final results of the second phase showed that there was almost no difference between female and male coders for coding potentially unprofessional content for students (7/240, 2.9% vs 5/203, 2.5%) or for coding unprofessional content for students (11/240, 4.6% vs 11/203, 5.4%). Comparison of definitive results between the first and second phases indicated an understanding of web-based professionalism, with unprofessional content being very low, both for students (9/222, 4.1% vs 12/206, 5.8%) and faculty (1/25, 4% vs 0/23, 0%). For assessment of the potentially unprofessional content, we observed a 4-fold decrease, using the SMePROF rubric, for students (26/222, 11.7% to 6/206, 2.9%) and a 5-fold decrease for faculty (6/25, 24% to 1/23, 4%). Conclusions: SMePROF coding scheme for assessing professionalism of health-care professionals on Facebook is a validated and more objective instrument. This research emphasizes the role that context plays in the perception of unprofessional and potentially unprofessional content and provides insight into the existence of different sets of rules for web-based and offline interaction that marks behavior as unprofessional. The level of e-professionalism on Facebook profiles of medical or dental students and faculty available for public viewing has shown a high level of understanding of e-professionalism. UR - https://mededu.jmir.org/2022/3/e35585 UR - http://dx.doi.org/10.2196/35585 UR - http://www.ncbi.nlm.nih.gov/pubmed/35758 ID - info:doi/10.2196/35585 ER - TY - JOUR AU - Tso, Sze Lai PY - 2022/7/29 TI - Use of Social Media for Implementing Diagnoses, Consultation, Training, and Case Reporting Among Medical Professionals to Improve Patient Care: Case Study of WeChat Groups Across Health Care Settings JO - JMIR Med Educ SP - e26419 VL - 8 IS - 3 KW - mHealth KW - WeChat KW - implementation research KW - low-resource settings KW - innovative medical technologies KW - digital health KW - medical education KW - social media KW - mobile health technologies KW - bottom-up approach N2 - Background: Health professionals in low- and middle-resource settings have limited access to up-to-date resources for diagnosing and treating illnesses, training medical staff, reviewing newly disseminated guidelines and publications, and preparing data for international disease reporting. A concomitant difficulty in high-resource settings is the need for continuing education and skills up-training in innovative procedures on unfamiliar social media platforms. These challenges can delay both patient care and epidemiological surveillance efforts. To overcome these challenges, health professionals have adapted WeChat Groups to implement timely, low-cost, and high-quality patient care. Objective: The primary study aim was to describe the processes taken by medical professionals across their diverse physical and virtual networks in adapting a bottom-up approach to collectively overcome resource shortages. The secondary study aim was to delineate the pathways, procedures, and resource/information sharing implemented by medical professionals using an international publicly available popular social media app (WeChat) to enhance performance of facility-based procedures and protocols for improved patient care. Methods: In-depth interviews, observations, and digital ethnography of WeChat Groups communications were collected from medical professionals in interconnected networks of health care facilities. Participants? WeChat Groups usage and observations of their professional functions in interconnected networks were collected from November 2018 to 2019. Qualitative analysis and thematic coding were used to develop constructs and themes in NVivo. Constructs incorporated descriptions for the implementation and uses of WeChat Groups for professional connections, health care procedures, and patient care. Themes supporting the constructs focused on the pathways and venues used by medical professionals to build trust, to establish and solidify online networks, and to identify requests and resource sharing within WeChat Groups. Results: There were 58 participants (males 36 and females 22) distributed across 24 health care settings spanning geographical networks in south China. Analysis yielded 4 constructs and 11 themes delineating the bottom-up usage of WeChat Groups among clinicians, technicians, nurses, pharmacists, and public health administrators. Participants used WeChat Groups for collectively training hospital staff in complex new procedures, processing timely diagnoses of biological specimens, staying abreast of latest trends and clinical procedures and symptoms, and contributing to case reporting for emergent illnesses and international surveillance reporting. An unexpected strength of implementing clinical, training, and research support on a popular app with international coverage is the added ability to overcome administrative and geographic barriers in resource distribution. This advantage increased a network?s access to WeChat Groups members both working within China and abroad, greatly expanding the scope of shared resources. Conclusions: The organic, bottom-up approach of repurposing extant social media apps is low cost and efficient for timely implementation to improve patient care. WeChat?s international user base enables medical staff to access widespread professional networks across geographic, administrative, and economic barriers, with potential to reduce health disparities in low-resource settings. UR - https://mededu.jmir.org/2022/3/e26419 UR - http://dx.doi.org/10.2196/26419 UR - http://www.ncbi.nlm.nih.gov/pubmed/35904858 ID - info:doi/10.2196/26419 ER - TY - JOUR AU - Krause-Jüttler, Grit AU - Weitz, Jürgen AU - Bork, Ulrich PY - 2022/5/4 TI - Interdisciplinary Collaborations in Digital Health Research: Mixed Methods Case Study JO - JMIR Hum Factors SP - e36579 VL - 9 IS - 2 KW - team science KW - interdisciplinary KW - research collaboration KW - digital health KW - team processes N2 - Background: Digital innovations in medicine are disruptive technologies that can change the way diagnostic procedures and treatments are delivered. Such innovations are typically designed in teams with different disciplinary backgrounds. This paper concentrates on 2 interdisciplinary research teams with 20 members from the medicine and engineering sciences working jointly on digital health solutions. Objective: The aim of this paper was to identify factors on the individual, team, and organizational levels that influence the implementation of interdisciplinary research projects elaborating on digital applications for medicine and, based on the results, to draw conclusions for the proactive design of the interdisciplinary research process to make these projects successful. Methods: To achieve this aim, 2 interdisciplinary research teams were observed, and a small case study (response rate: 15/20, 75%) was conducted using a web-based questionnaire containing both closed and open self-report questions. The Spearman rank correlation coefficient was calculated to analyze the quantitative data. The answers to the open-ended questions were subjected to qualitative content analysis. Results: With regard to the interdisciplinary research projects investigated, the influencing factors of the three levels presented (individual, team, and organization) have proven to be relevant for interdisciplinary research cooperation. Conclusions: With regard to recommendations for the future design of interdisciplinary cooperation, management aspects are addressed, that is, the installation of a coordinator, systematic definition of goals, required resources, and necessary efforts on the part of the involved interdisciplinary research partners. As only small groups were investigated, further research in this field is necessary to derive more general recommendations for interdisciplinary research teams. Trial Registration: German Clinical Trials Register, DRKS00023909, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023909?; German Clinical Trials Register, DRKS00025077, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00025077 UR - https://humanfactors.jmir.org/2022/2/e36579 UR - http://dx.doi.org/10.2196/36579 UR - http://www.ncbi.nlm.nih.gov/pubmed/35507400 ID - info:doi/10.2196/36579 ER - TY - JOUR AU - Lauffenburger, C. Julie AU - DiFrancesco, F. Matthew AU - Barlev, A. Renee AU - Robertson, Ted AU - Kim, Erin AU - Coll, D. Maxwell AU - Haff, Nancy AU - Fontanet, P. Constance AU - Hanken, Kaitlin AU - Oran, Rebecca AU - Avorn, Jerry AU - Choudhry, K. Niteesh PY - 2022/4/27 TI - Overcoming Decisional Gaps in High-Risk Prescribing by Junior Physicians Using Simulation-Based Training: Protocol for a Randomized Controlled Trial JO - JMIR Res Protoc SP - e31464 VL - 11 IS - 4 KW - pragmatic trial KW - behavioral science KW - prescribing KW - benzodiazepines KW - antipsychotics KW - impact evaluation N2 - Background: Gaps between rational thought and actual decisions are increasingly recognized as a reason why people make suboptimal choices in states of heightened emotion, such as stress. These observations may help explain why high-risk medications continue to be prescribed to acutely ill hospitalized older adults despite widely accepted recommendations against these practices. Role playing and other efforts, such as simulation training, have demonstrated benefits to help people avoid decisional gaps but have not been tested to reduce overprescribing of high-risk medications. Objective: This study aims to evaluate the impact of a simulation-based training program designed to address decisional gaps on prescribing of high-risk medications compared with control. Methods: In this 2-arm pragmatic trial, we are randomizing at least 36 first-year medical resident physicians (ie, interns) who provide care on inpatient general medicine services at a large academic medical center to either intervention (simulation-based training) or control (online educational training). The intervention comprises a 40-minute immersive individual simulation training consisting of a reality-based patient care scenario in a simulated environment at the beginning of their inpatient service rotation. The simulation focuses on 3 types of high-risk medications, including benzodiazepines, antipsychotics, and sedative hypnotics (Z-drugs), in older adults, and is specifically designed to help the physicians identify their reactions and prescribing decisions in stressful situations that are common in the inpatient setting. The simulation scenario is followed by a semistructured debriefing with an expert facilitator. The trial?s primary outcome is the number of medication doses for any of the high-risk medications prescribed by the interns to patients aged 65 years or older who were not taking one of the medications upon admission. Secondary outcomes include prescribing by all providers on the care team, being discharged on 1 of the medications, and prescribing of related medications (eg, melatonin, trazodone), or the medications of interest for the control intervention. These outcomes will be measured using electronic health record data. Results: Recruitment of interns began on March 29, 2021. Recruitment for the trial ended in Q42021, with follow-up completed by Q12022. Conclusions: This trial will evaluate the impact of a simulation-based training program designed using behavioral science principles on prescribing of high-risk medications by junior physicians. If the intervention is shown to be effective, this approach could potentially be reproducible by others and for a broader set of behaviors. Trial Registration: ClinicalTrials.gov NCT04668248; https://clinicaltrials.gov/ct2/show/NCT04668248 International Registered Report Identifier (IRRID): PRR1-10.2196/31464 UR - https://www.researchprotocols.org/2022/4/e31464 UR - http://dx.doi.org/10.2196/31464 UR - http://www.ncbi.nlm.nih.gov/pubmed/35475982 ID - info:doi/10.2196/31464 ER - TY - JOUR AU - Tilahun, Binyam AU - Endehabtu, F. Berhanu AU - Gashu, D. Kassahun AU - Mekonnen, A. Zeleke AU - Animut, Netsanet AU - Belay, Hiwot AU - Denboba, Wubshet AU - Alemu, Hibret AU - Mohammed, Mesoud AU - Abate, Biruk PY - 2022/4/12 TI - Current and Future Needs for Human Resources for Ethiopia?s National Health Information System: Survey and Forecasting Study JO - JMIR Med Educ SP - e28965 VL - 8 IS - 2 KW - forecasting KW - human resources KW - health information system KW - workforce KW - Ethiopia KW - health informatics KW - healthcare professionals N2 - Background: Strengthening the national health information system is one of Ethiopia?s priority transformation agendas. A well-trained and competent workforce is the essential ingredient to a strong health information system. However, this workforce has neither been quantified nor characterized well, and there is no roadmap of required human resources to enhance the national health information system. Objective: We aimed to determine the current state of the health information system workforce and to forecast the human resources needed for the health information system by 2030. Methods: We conducted a survey to estimate the current number of individuals employed in the health information system unit and the turnover rate. Document review and key-informant interviews were used to collect current human resources and available health information system position data from 110 institutions, including the Ministry of Health, federal agencies, regional health bureaus, zonal health departments, district health offices, and health facilities. The Delphi technique was used to forecast human resources required for the health information system in the next ten years: 3 rounds of workshops with experts from the Ministry of Health, universities, agencies, and regional health bureaus were held. In the first expert meeting, we set criteria, which was followed by expert suggestions and feedback. Results: As of April 2020, there were 10,344 health information system professionals working in the governmental health system. Nearly 95% (20/21) of district health offices and 86.7% (26/30) of health centers reported that the current number of health information system positions was inadequate. In the period from June 2015 to June 2019, health information technicians had high turnover (48/244, 19.7%) at all levels of the health system. In the next ten years, we estimate that 50,656 health information system professionals will be needed to effectively implement the Ethiopia's national health information system. Conclusions: Current health information system?related staffing levels were found to be inadequate. To meet the estimated need of 50,656 multidisciplinary health information system professionals by 2030, the Ministry of Health and regional health bureaus, in collaboration with partners and academic institutions, need to work on retaining existing and training additional health information system professionals. UR - https://mededu.jmir.org/2022/2/e28965 UR - http://dx.doi.org/10.2196/28965 UR - http://www.ncbi.nlm.nih.gov/pubmed/35412469 ID - info:doi/10.2196/28965 ER - TY - JOUR AU - Boillat, Thomas AU - Nawaz, A. Faisal AU - Rivas, Homero PY - 2022/4/12 TI - Readiness to Embrace Artificial Intelligence Among Medical Doctors and Students: Questionnaire-Based Study JO - JMIR Med Educ SP - e34973 VL - 8 IS - 2 KW - artificial intelligence in medicine KW - health care KW - questionnaire KW - medical doctors KW - medical students N2 - Background: Similar to understanding how blood pressure is measured by a sphygmomanometer, physicians will soon have to understand how an artificial intelligence?based application has come to the conclusion that a patient has hypertension, diabetes, or cancer. Although there are an increasing number of use cases where artificial intelligence is or can be applied to improve medical outcomes, the extent to which medical doctors and students are ready to work and leverage this paradigm is unclear. Objective: This research aims to capture medical students? and doctors? level of familiarity toward artificial intelligence in medicine as well as their challenges, barriers, and potential risks linked to the democratization of this new paradigm. Methods: A web-based questionnaire comprising five dimensions?demographics, concepts and definitions, training and education, implementation, and risks?was systematically designed from a literature search. It was completed by 207 participants in total, of which 105 (50.7%) medical doctors and 102 (49.3%) medical students trained in all continents, with most of them in Europe, the Middle East, Asia, and North America. Results: The results revealed no significant difference in the familiarity of artificial intelligence between medical doctors and students (P=.91), except that medical students perceived artificial intelligence in medicine to lead to higher risks for patients and the field of medicine in general (P<.001). We also identified a rather low level of familiarity with artificial intelligence (medical students=2.11/5; medical doctors=2.06/5) as well as a low attendance to education or training. Only 2.9% (3/105) of medical doctors attended a course on artificial intelligence within the previous year, compared with 9.8% (10/102) of medical students. The complexity of the field of medicine was considered one of the biggest challenges (medical doctors=3.5/5; medical students=3.8/5), whereas the reduction of physicians? skills was the most important risk (medical doctors=3.3; medical students=3.6; P=.03). Conclusions: The question is not whether artificial intelligence will be used in medicine, but when it will become a standard practice for optimizing health care. The low level of familiarity with artificial intelligence identified in this study calls for the implementation of specific education and training in medical schools and hospitals to ensure that medical professionals can leverage this new paradigm and improve health outcomes. UR - https://mededu.jmir.org/2022/2/e34973 UR - http://dx.doi.org/10.2196/34973 UR - http://www.ncbi.nlm.nih.gov/pubmed/35412463 ID - info:doi/10.2196/34973 ER - TY - JOUR AU - Gray, Kathleen AU - Slavotinek, John AU - Dimaguila, Luis Gerardo AU - Choo, Dawn PY - 2022/4/4 TI - Artificial Intelligence Education for the Health Workforce: Expert Survey of Approaches and Needs JO - JMIR Med Educ SP - e35223 VL - 8 IS - 2 KW - artificial intelligence KW - curriculum KW - ethics KW - human-computer interaction KW - interprofessional education KW - machine learning KW - natural language processing KW - professional development KW - robotics N2 - Background: The preparation of the current and future health workforce for the possibility of using artificial intelligence (AI) in health care is a growing concern as AI applications emerge in various care settings and specializations. At present, there is no obvious consensus among educators about what needs to be learned or how this learning may be supported or assessed. Objective: Our study aims to explore health care education experts? ideas and plans for preparing the health workforce to work with AI and identify critical gaps in curriculum and educational resources across a national health care system. Methods: A survey canvassed expert views on AI education for the health workforce in terms of educational strategies, subject matter priorities, meaningful learning activities, desired attitudes, and skills. A total of 39 senior people from different health workforce subgroups across Australia provided ratings and free-text responses in late 2020. Results: The responses highlighted the importance of education on ethical implications, suitability of large data sets for use in AI clinical applications, principles of machine learning, and specific diagnosis and treatment applications of AI as well as alterations to cognitive load during clinical work and the interaction between humans and machines in clinical settings. Respondents also outlined barriers to implementation, such as lack of governance structures and processes, resource constraints, and cultural adjustment. Conclusions: Further work around the world of the kind reported in this survey can assist educators and education authorities who are responsible for preparing the health workforce to minimize the risks and realize the benefits of implementing AI in health care. UR - https://mededu.jmir.org/2022/2/e35223 UR - http://dx.doi.org/10.2196/35223 UR - http://www.ncbi.nlm.nih.gov/pubmed/35249885 ID - info:doi/10.2196/35223 ER - TY - JOUR AU - Wang, Jiaqi Judy AU - Singh, K. Rishabh AU - Miselis, Hough Heather AU - Stapleton, Nicole Stephanie PY - 2022/3/31 TI - Technology Literacy in Undergraduate Medical Education: Review and Survey of the US Medical School Innovation and Technology Programs JO - JMIR Med Educ SP - e32183 VL - 8 IS - 1 KW - curricular development KW - medical innovation KW - medical technology KW - student engagement N2 - Background: Modern innovations, like machine learning, genomics, and digital health, are being integrated into medical practice at a rapid pace. Physicians in training receive little exposure to the implications, drawbacks, and methodologies of upcoming technologies prior to their deployment. As a result, there is an increasing need for the incorporation of innovation and technology (I&T) training, starting in medical school. Objective: We aimed to identify and describe curricular and extracurricular opportunities for innovation in medical technology in US undergraduate medical education to highlight challenges and develop insights for future directions of program development. Methods: A review of publicly available I&T program information on the official websites of US allopathic medical schools was conducted in June 2020. Programs were categorized by structure and implementation. The geographic distribution of these categories across US regions was analyzed. A survey was administered to school-affiliated student organizations with a focus on I&T and publicly available contact information. The data collected included the founding year, thematic focus, target audience, activities offered, and participant turnout rate. Results: A total of 103 I&T opportunities at 69 distinct Liaison Committee on Medical Education?accredited medical schools were identified and characterized into the following six categories: (1) integrative 4-year curricula, (2) facilitated doctor of medicine/master of science dual degree programs in a related field, (3) interdisciplinary collaborations, (4) areas of concentration, (5) preclinical electives, and (6) student-run clubs. The presence of interdisciplinary collaboration is significantly associated with the presence of student-led initiatives (P=.001). ?Starting and running a business in healthcare? and ?medical devices? were the most popular thematic focuses of student-led I&T groups, representing 87% (13/15) and 80% (12/15) of respondents, respectively. ?Career pathways exploration for students? was the only type of activity that was significantly associated with a high event turnout rate of >26 students per event (P=.03). Conclusions: Existing school-led and student-driven opportunities in medical I&T indicate growing national interest and reflect challenges in implementation. The greater visibility of opportunities, collaboration among schools, and development of a centralized network can be considered to better prepare students for the changing landscape of medical practice. UR - https://mededu.jmir.org/2022/1/e32183 UR - http://dx.doi.org/10.2196/32183 UR - http://www.ncbi.nlm.nih.gov/pubmed/35357319 ID - info:doi/10.2196/32183 ER - TY - JOUR AU - Ramchandran, S. Rajeev AU - Yousefi-Nooraie, Reza AU - Dadgostar, Porooshat AU - Yilmaz, Sule AU - Basant, Jesica AU - Dozier, M. Ann PY - 2022/3/30 TI - Implementation of Teleophthalmology to Improve Diabetic Retinopathy Surveillance: Qualitative Interview Study of Clinical Staff Informed by Implementation Science Frameworks JO - JMIR Diabetes SP - e32162 VL - 7 IS - 1 KW - Consolidated Framework for Implementation Research KW - teleophthalmology KW - diabetic retinopathy KW - implementation KW - qualitative study KW - Practical, Robust Implementation and Sustainability Model N2 - Background: The store-and-forward camera-based evaluation of the eye, or teleophthalmology, is an effective way to identify diabetic retinopathy, the leading cause of blindness in the United States, but uptake has been slow. Understanding the barriers to and facilitators of implementing teleophthalmology programs from those actively adopting, running, and sustaining such programs is important for widespread adoption. Objective: This study aims to understand the factors that are important in introducing teleophthalmology to improve access to diagnostic eye care for patients with diabetes in primary care clinics by using implementation science. Methods: This qualitative study in 3 urban, low-income, largely racial and ethnic minority?serving safety-net primary care clinics in Rochester, New York, interviewed nurses and physicians on implementing a teleophthalmology program by using questions informed by the Practical, Robust Implementation and Sustainability Model and the Consolidated Framework for Implementation Research. Results: Primary care nurses operationalizing the program in their clinics saw increased work burden and a lack of self-efficacy as barriers. Continuous training on the teleophthalmology process for nurses, physicians, and administrative staff through in-service and peer training by champions and superusers were identified by interviewees as needs. Facilitators included the perceived convenience for the patient and a perceived educational advantage to the program, as it gave an opportunity for providers to discuss the importance of eye care with patients. Concerns in making and tracking referrals to ophthalmology because of challenges related to care coordination were highlighted. The financial aspects of the program (eg, patient coverage and care provider reimbursement) were unclear to many staff members, influencing adoption and sustainability. Conclusions: Streamlining processes and workflows, training and assigning adequate staff, effectively coordinating care between primary care and eye care to improve follow-ups, and ensuring financial viability can all help streamline the adoption of teleophthalmology. UR - https://diabetes.jmir.org/2022/1/e32162 UR - http://dx.doi.org/10.2196/32162 UR - http://www.ncbi.nlm.nih.gov/pubmed/35353038 ID - info:doi/10.2196/32162 ER - TY - JOUR AU - Knop, Michael AU - Weber, Sebastian AU - Mueller, Marius AU - Niehaves, Bjoern PY - 2022/3/24 TI - Human Factors and Technological Characteristics Influencing the Interaction of Medical Professionals With Artificial Intelligence?Enabled Clinical Decision Support Systems: Literature Review JO - JMIR Hum Factors SP - e28639 VL - 9 IS - 1 KW - artificial intelligence KW - clinical decision support systems KW - CDSS KW - decision-making KW - diagnostic decision support KW - human?computer interaction KW - human?AI collaboration KW - machine learning KW - patient outcomes KW - deep learning KW - trust KW - literature review N2 - Background: The digitization and automation of diagnostics and treatments promise to alter the quality of health care and improve patient outcomes, whereas the undersupply of medical personnel, high workload on medical professionals, and medical case complexity increase. Clinical decision support systems (CDSSs) have been proven to help medical professionals in their everyday work through their ability to process vast amounts of patient information. However, comprehensive adoption is partially disrupted by specific technological and personal characteristics. With the rise of artificial intelligence (AI), CDSSs have become an adaptive technology with human-like capabilities and are able to learn and change their characteristics over time. However, research has not reflected on the characteristics and factors essential for effective collaboration between human actors and AI-enabled CDSSs. Objective: Our study aims to summarize the factors influencing effective collaboration between medical professionals and AI-enabled CDSSs. These factors are essential for medical professionals, management, and technology designers to reflect on the adoption, implementation, and development of an AI-enabled CDSS. Methods: We conducted a literature review including 3 different meta-databases, screening over 1000 articles and including 101 articles for full-text assessment. Of the 101 articles, 7 (6.9%) met our inclusion criteria and were analyzed for our synthesis. Results: We identified the technological characteristics and human factors that appear to have an essential effect on the collaboration of medical professionals and AI-enabled CDSSs in accordance with our research objective, namely, training data quality, performance, explainability, adaptability, medical expertise, technological expertise, personality, cognitive biases, and trust. Comparing our results with those from research on non-AI CDSSs, some characteristics and factors retain their importance, whereas others gain or lose relevance owing to the uniqueness of human-AI interactions. However, only a few (1/7, 14%) studies have mentioned the theoretical foundations and patient outcomes related to AI-enabled CDSSs. Conclusions: Our study provides a comprehensive overview of the relevant characteristics and factors that influence the interaction and collaboration between medical professionals and AI-enabled CDSSs. Rather limited theoretical foundations currently hinder the possibility of creating adequate concepts and models to explain and predict the interrelations between these characteristics and factors. For an appropriate evaluation of the human-AI collaboration, patient outcomes and the role of patients in the decision-making process should be considered. UR - https://humanfactors.jmir.org/2022/1/e28639 UR - http://dx.doi.org/10.2196/28639 UR - http://www.ncbi.nlm.nih.gov/pubmed/35323118 ID - info:doi/10.2196/28639 ER - TY - JOUR AU - Zhang, Zhan AU - Joy, Karen AU - Harris, Richard AU - Ozkaynak, Mustafa AU - Adelgais, Kathleen AU - Munjal, Kevin PY - 2022/2/28 TI - Applications and User Perceptions of Smart Glasses in Emergency Medical Services: Semistructured Interview Study JO - JMIR Hum Factors SP - e30883 VL - 9 IS - 1 KW - smart glasses KW - hands-free technologies KW - emergency medical services KW - user studies KW - mobile phone N2 - Background: Smart glasses have been gaining momentum as a novel technology because of their advantages in enabling hands-free operation and see-what-I-see remote consultation. Researchers have primarily evaluated this technology in hospital settings; however, limited research has investigated its application in prehospital operations. Objective: The aim of this study is to understand the potential of smart glasses to support the work practices of prehospital providers, such as emergency medical services (EMS) personnel. Methods: We conducted semistructured interviews with 13 EMS providers recruited from 4 hospital-based EMS agencies in an urban area in the east coast region of the United States. The interview questions covered EMS workflow, challenges encountered, technology needs, and users? perceptions of smart glasses in supporting daily EMS work. During the interviews, we demonstrated a system prototype to elicit more accurate and comprehensive insights regarding smart glasses. Interviews were transcribed verbatim and analyzed using the open coding technique. Results: We identified four potential application areas for smart glasses in EMS: enhancing teleconsultation between distributed prehospital and hospital providers, semiautomating patient data collection and documentation in real time, supporting decision-making and situation awareness, and augmenting quality assurance and training. Compared with the built-in touch pad, voice commands and hand gestures were indicated as the most preferred and suitable interaction mechanisms. EMS providers expressed positive attitudes toward using smart glasses during prehospital encounters. However, several potential barriers and user concerns need to be considered and addressed before implementing and deploying smart glasses in EMS practice. They are related to hardware limitations, human factors, reliability, workflow, interoperability, and privacy. Conclusions: Smart glasses can be a suitable technological means for supporting EMS work. We conclude this paper by discussing several design considerations for realizing the full potential of this hands-free technology. UR - https://humanfactors.jmir.org/2022/1/e30883 UR - http://dx.doi.org/10.2196/30883 UR - http://www.ncbi.nlm.nih.gov/pubmed/35225816 ID - info:doi/10.2196/30883 ER - TY - JOUR AU - Lee, Robert AU - Hitt, James AU - Hobika, G. Geoffrey AU - Nader, D. Nader PY - 2022/2/28 TI - The Case for the Anesthesiologist-Informaticist JO - JMIR Perioper Med SP - e32738 VL - 5 IS - 1 KW - anesthesia KW - anesthesiology KW - AIMS KW - anesthesia information management systems KW - clinical informatics KW - anesthesia informatics KW - perioperative informatics KW - health information KW - perioperative medicine KW - health technology UR - https://periop.jmir.org/2022/1/e32738 UR - http://dx.doi.org/10.2196/32738 UR - http://www.ncbi.nlm.nih.gov/pubmed/35225822 ID - info:doi/10.2196/32738 ER - TY - JOUR AU - Yeung, Kan Andy Wai AU - Parvanov, D. Emil AU - Hribersek, Mojca AU - Eibensteiner, Fabian AU - Klager, Elisabeth AU - Kletecka-Pulker, Maria AU - Rössler, Bernhard AU - Schebesta, Karl AU - Willschke, Harald AU - Atanasov, G. Atanas AU - Schaden, Eva PY - 2022/2/9 TI - Digital Teaching in Medical Education: Scientific Literature Landscape Review JO - JMIR Med Educ SP - e32747 VL - 8 IS - 1 KW - medical education KW - digital teaching KW - virtual reality KW - augmented reality KW - anatomy KW - basic life support KW - satisfaction KW - bibliometric KW - medicine KW - life support KW - online learning KW - literature KW - trend KW - citation N2 - Background: Digital teaching in medical education has grown in popularity in the recent years. However, to the best of our knowledge, no bibliometric report to date has been published that analyzes this important literature set to reveal prevailing topics and trends and their impacts reflected in citation counts. Objective: We used a bibliometric approach to unveil and evaluate the scientific literature on digital teaching research in medical education, demonstrating recurring research topics, productive authors, research organizations, countries, and journals. We further aimed to discuss some of the topics and findings reported by specific highly cited works. Methods: The Web of Science electronic database was searched to identify relevant papers on digital teaching research in medical education. Basic bibliographic data were obtained by the ?Analyze? and ?Create Citation Report? functions of the database. Complete bibliographic data were exported to VOSviewer for further analyses. Visualization maps were generated to display the recurring author keywords and terms mentioned in the titles and abstracts of the publications. Results: The analysis was based on data from 3978 papers that were identified. The literature received worldwide contributions with the most productive countries being the United States and United Kingdom. Reviews were significantly more cited, but the citations between open access vs non?open access papers did not significantly differ. Some themes were cited more often, reflected by terms such as virtual reality, innovation, trial, effectiveness, and anatomy. Different aspects in medical education were experimented for digital teaching, such as gross anatomy education, histology, complementary medicine, medicinal chemistry, and basic life support. Some studies have shown that digital teaching could increase learning satisfaction, knowledge gain, and even cost-effectiveness. More studies were conducted on trainees than on undergraduate students. Conclusions: Digital teaching in medical education is expected to flourish in the future, especially during this era of COVID-19 pandemic. UR - https://mededu.jmir.org/2022/1/e32747 UR - http://dx.doi.org/10.2196/32747 UR - http://www.ncbi.nlm.nih.gov/pubmed/35138260 ID - info:doi/10.2196/32747 ER - TY - JOUR AU - Shaikh, Ahmed AU - Bhatia, Abhishek AU - Yadav, Ghanshyam AU - Hora, Shashwat AU - Won, Chung AU - Shankar, Mark AU - Heerboth, Aaron AU - Vemulapalli, Prakash AU - Navalkar, Paresh AU - Oswal, Kunal AU - Heaton, Clay AU - Saunik, Sujata AU - Khanna, Tarun AU - Balsari, Satchit PY - 2022/1/10 TI - Applying Human-Centered Design Principles to Digital Syndromic Surveillance at a Mass Gathering in India: Viewpoint JO - J Med Internet Res SP - e27952 VL - 24 IS - 1 KW - mHealth KW - design KW - human centered design KW - intervention KW - syndromic surveillance KW - digital health UR - https://www.jmir.org/2022/1/e27952 UR - http://dx.doi.org/10.2196/27952 UR - http://www.ncbi.nlm.nih.gov/pubmed/35006088 ID - info:doi/10.2196/27952 ER - TY - JOUR AU - Forgie, E. Ella M. AU - Lai, Hollis AU - Cao, Bo AU - Stroulia, Eleni AU - Greenshaw, J. Andrew AU - Goez, Helly PY - 2021/12/24 TI - Social Media and the Transformation of the Physician-Patient Relationship: Viewpoint JO - J Med Internet Res SP - e25230 VL - 23 IS - 12 KW - social media KW - social determinants of health KW - precision medicine KW - patient care UR - https://www.jmir.org/2021/12/e25230 UR - http://dx.doi.org/10.2196/25230 UR - http://www.ncbi.nlm.nih.gov/pubmed/34951596 ID - info:doi/10.2196/25230 ER - TY - JOUR AU - Bouamra, Benjamin AU - Chakroun, Karim AU - Medeiros De Bustos, Elisabeth AU - Dobson, Jennifer AU - Rouge, Jeanne-Antide AU - Moulin, Thierry PY - 2021/12/22 TI - Simulation-Based Teaching of Telemedicine for Future Users of Teleconsultation and Tele-Expertise: Feasibility Study JO - JMIR Med Educ SP - e30440 VL - 7 IS - 4 KW - telemedicine KW - teleconsultation KW - simulation training KW - health care KW - training KW - education KW - digital training KW - medical education N2 - Background: Health care professionals worldwide are increasingly using telemedicine in their daily clinical practice. However, there is still a lack of dedicated education and training even though it is needed to improve the quality of the diverse range of telemedicine activities. Simulation-based training may be a useful tool in telemedicine education and training delivery. Objective: This study aims to assess the feasibility and acceptability of simulation-based telemedicine training. Methods: We assessed five telemedicine training sessions conducted in a simulation laboratory. The training was focused on video teleconsultations between a patient and a health care professional. The assessment included the participants? satisfaction and attitudes toward the training. Results: We included 29 participants in total. Participant satisfaction was high (mean score 4.9 of 5), and those that took part stated the high applicability of the simulation-based training to their telemedicine practices (mean score 4.6 of 5). They also stated that they intended to use telemedicine in the future (mean score 4.5 of 5). Conclusions: Simulation-based training of telemedicine dedicated to video teleconsultation was feasible and showed high satisfaction from participants. However, it remains difficult to scale for a high number of health care professionals. UR - https://mededu.jmir.org/2021/4/e30440 UR - http://dx.doi.org/10.2196/30440 UR - http://www.ncbi.nlm.nih.gov/pubmed/34941553 ID - info:doi/10.2196/30440 ER - TY - JOUR AU - Charow, Rebecca AU - Jeyakumar, Tharshini AU - Younus, Sarah AU - Dolatabadi, Elham AU - Salhia, Mohammad AU - Al-Mouaswas, Dalia AU - Anderson, Melanie AU - Balakumar, Sarmini AU - Clare, Megan AU - Dhalla, Azra AU - Gillan, Caitlin AU - Haghzare, Shabnam AU - Jackson, Ethan AU - Lalani, Nadim AU - Mattson, Jane AU - Peteanu, Wanda AU - Tripp, Tim AU - Waldorf, Jacqueline AU - Williams, Spencer AU - Tavares, Walter AU - Wiljer, David PY - 2021/12/13 TI - Artificial Intelligence Education Programs for Health Care Professionals: Scoping Review JO - JMIR Med Educ SP - e31043 VL - 7 IS - 4 KW - machine learning KW - deep learning KW - health care providers KW - education KW - learning KW - patient care N2 - Background: As the adoption of artificial intelligence (AI) in health care increases, it will become increasingly crucial to involve health care professionals (HCPs) in developing, validating, and implementing AI-enabled technologies. However, because of a lack of AI literacy, most HCPs are not adequately prepared for this revolution. This is a significant barrier to adopting and implementing AI that will affect patients. In addition, the limited existing AI education programs face barriers to development and implementation at various levels of medical education. Objective: With a view to informing future AI education programs for HCPs, this scoping review aims to provide an overview of the types of current or past AI education programs that pertains to the programs? curricular content, modes of delivery, critical implementation factors for education delivery, and outcomes used to assess the programs? effectiveness. Methods: After the creation of a search strategy and keyword searches, a 2-stage screening process was conducted by 2 independent reviewers to determine study eligibility. When consensus was not reached, the conflict was resolved by consulting a third reviewer. This process consisted of a title and abstract scan and a full-text review. The articles were included if they discussed an actual training program or educational intervention, or a potential training program or educational intervention and the desired content to be covered, focused on AI, and were designed or intended for HCPs (at any stage of their career). Results: Of the 10,094 unique citations scanned, 41 (0.41%) studies relevant to our eligibility criteria were identified. Among the 41 included studies, 10 (24%) described 13 unique programs and 31 (76%) discussed recommended curricular content. The curricular content of the unique programs ranged from AI use, AI interpretation, and cultivating skills to explain results derived from AI algorithms. The curricular topics were categorized into three main domains: cognitive, psychomotor, and affective. Conclusions: This review provides an overview of the current landscape of AI in medical education and highlights the skills and competencies required by HCPs to effectively use AI in enhancing the quality of care and optimizing patient outcomes. Future education efforts should focus on the development of regulatory strategies, a multidisciplinary approach to curriculum redesign, a competency-based curriculum, and patient-clinician interaction. UR - https://mededu.jmir.org/2021/4/e31043 UR - http://dx.doi.org/10.2196/31043 UR - http://www.ncbi.nlm.nih.gov/pubmed/34898458 ID - info:doi/10.2196/31043 ER - TY - JOUR AU - Nadav, Janna AU - Kaihlanen, Anu-Marja AU - Kujala, Sari AU - Laukka, Elina AU - Hilama, Pirjo AU - Koivisto, Juha AU - Keskimäki, Ilmo AU - Heponiemi, Tarja PY - 2021/12/1 TI - How to Implement Digital Services in a Way That They Integrate Into Routine Work: Qualitative Interview Study Among Health and Social Care Professionals JO - J Med Internet Res SP - e31668 VL - 23 IS - 12 KW - digital services KW - implementation KW - health and social care professionals KW - integration KW - normalization process theory KW - interview KW - social work KW - health care KW - focus groups N2 - Background: Although the COVID-19 pandemic has significantly boosted the implementation of digital services worldwide, it has become increasingly important to understand how these solutions are integrated into professionals? routine work. Professionals who are using the services are key influencers in the success of implementations. To ensure successful implementations, it is important to understand the multiprofessional perspective, especially because implementations are likely to increase even more. Objective: The aim of this study is to examine health and social care professionals? experiences of digital service implementations and to identify factors that support successful implementations and should be considered in the future to ensure that the services are integrated into professionals? routine work. Methods: A qualitative approach was used, in which 8 focus group interviews were conducted with 30 health and social care professionals from 4 different health centers in Finland. Data were analyzed using qualitative content analysis. The resulting categories were organized under the components of normalization process theory. Results: Our results suggested 14 practices that should be considered when implementing new digital services into routine work. To get professionals to understand and make sense of the new service, (1) the communication related to the implementation should be comprehensive and continuous and (2) the implementation process should be consistent. (3) A justification for the service being implemented should also be given. The best way to engage the professionals with the service is (4) to give them opportunities to influence and (5) to make sure that they have a positive attitude toward the service. To enact the new service into professionals? routine work, it is important that (6) the organization take a supportive approach by providing support from several easy and efficient sources. The professionals should also have (7) enough time to become familiar with the service, and they should have (8) enough know-how about the service. The training should be (9) targeted individually according to skills and work tasks, and (10) it should be diverse. The impact of the implementation on the professionals? work should be evaluated. The service (11) should be easy to use, and (12) usage monitoring should happen. An opportunity (13) to give feedback on the service should also be offered. Moreover, (14) the service should support professionals? work tasks. Conclusions: We introduce 14 practices for organizations and service providers on how to ensure sustainable implementation of new digital services and the smooth integration into routine work. It is important to pay more attention to comprehensive and continuing communication. Organizations should conduct a competence assessment before training in order to ensure proper alignment. Follow-ups to the implementation process should be performed to guarantee sustainability of the service. Our findings from a forerunner country of digitalization can be useful for countries that are beginning their service digitalization or further developing their digital services. UR - https://www.jmir.org/2021/12/e31668 UR - http://dx.doi.org/10.2196/31668 UR - http://www.ncbi.nlm.nih.gov/pubmed/34855610 ID - info:doi/10.2196/31668 ER - TY - JOUR AU - Jorge, Serafim Ana Elisa AU - Bennell, Louise Kim AU - Kimp, Jared Alexander AU - Campbell, Kate Penny AU - Hinman, Shane Rana PY - 2021/12/1 TI - An e-Learning Program for Physiotherapists to Manage Knee Osteoarthritis Via Telehealth During the COVID-19 Pandemic: Real-World Evaluation Study Using Registration and Survey Data JO - JMIR Med Educ SP - e30378 VL - 7 IS - 4 KW - osteoarthritis KW - knee KW - physiotherapy KW - exercise KW - e-learning KW - telehealth KW - pain KW - education KW - implementation KW - evaluation KW - professional development KW - rehabilitation N2 - Background: The COVID-19 pandemic necessitated clinicians to transition to telehealth, often with little preparation or training. The Physiotherapy Exercise and Physical Activity for Knee Osteoarthritis (PEAK) e-learning modules were developed to upskill physiotherapists in management of knee osteoarthritis (OA) via telehealth and in-person. In the research setting, the e-learning modules are perceived by physiotherapists as effective when they are part of a comprehensive training program for a clinical trial. However, the effectiveness of the modules on their own in a real-world setting is unknown. Objective: This study aims to evaluate the reach, effectiveness, adoption, and implementation of PEAK e-learning modules. Methods: This longitudinal study was informed by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Participants were clinicians, researchers, educators, and health care students who registered for access to the modules between April 1 and November 30, 2020. Reach was evaluated by outcomes (countries, referral sources, and attrition) extracted from registration data and embedded within precourse surveys in the Learning Management System (LMS). Effectiveness was evaluated by outcomes (confidence with videoconferencing; likelihood of using education, strengthening exercise, and physical activity in a treatment plan for knee OA; usefulness of modules) measured using a 10-point numeric rating scale (NRS; score range from 1=not confident or likely or useful at all to 10=extremely confident or likely or useful) in pre- and postcourse (on completion) surveys in the LMS. Adoption and implementation were evaluated by demographic and professional characteristics and outcomes related to the use of learning and usefulness of program elements (measured via a 4-point Likert scale, from not at all useful to extremely useful) in a survey administered 4 months after module completion. Results: Broad reach was achieved, with 6720 people from 97 countries registering for access. Among registrants, there were high levels of attrition, with 36.65% (2463/6720) commencing the program and precourse survey and 19.61% (1318/6720) completing all modules and the postcourse survey. The program was effective. Learners who completed the modules demonstrated increased confidence with videoconferencing (mean change 3.1, 95% CI 3.0-3.3 NRS units) and increased likelihood of using education, strengthening and physical activity in a knee OA treatment plan, compared to precourse. Adoption and implementation of learning (n=149 respondents) occurred at 4 months. More than half of the respondents used their learning to structure in-person consultations with patients (80/142, 56.3%) and patient information booklets in their clinical practice (75/142, 52.8%). Conclusions: Findings provide evidence of the reach and effectiveness of an asynchronous self-directed e-learning program in a real-world setting among physiotherapists. The e-learning modules offer clinicians an accessible educational course to learn about best-practice knee OA management, including telehealth delivery via videoconferencing. Attrition across the e-learning program highlights the challenges of keeping learners engaged in self-directed web-based learning. UR - https://mededu.jmir.org/2021/4/e30378 UR - http://dx.doi.org/10.2196/30378 UR - http://www.ncbi.nlm.nih.gov/pubmed/34587585 ID - info:doi/10.2196/30378 ER - TY - JOUR AU - Vuku?i? Rukavina, Tea AU - Viski?, Jo?ko AU - Machala Popla?en, Lovela AU - Reli?, Danko AU - Mareli?, Marko AU - Jokic, Drazen AU - Sedak, Kristijan PY - 2021/11/17 TI - Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review JO - J Med Internet Res SP - e25770 VL - 23 IS - 11 KW - e-professionalism KW - social media KW - internet KW - health care professionals KW - physicians KW - nurses KW - students KW - medicine KW - dental medicine KW - nursing N2 - Background: As we are witnessing the evolution of social media (SM) use worldwide among the general population, the popularity of SM has also been embraced by health care professionals (HCPs). In the context of SM evolution and exponential growth of users, this scoping review summarizes recent findings of the e-professionalism of HCPs. Objective: The purpose of this scoping review is to characterize the recent original peer-reviewed research studies published between November 1, 2014, to December 31, 2020, on e-professionalism of HCPs; to assess the quality of the methodologies and approaches used; to explore the impact of SM on e-professionalism of HCPs; to recognize the benefits and dangers of SM; and to provide insights to guide future research in this area. Methods: A search of the literature published from November 1, 2014, to December 31, 2020, was performed in January 2021 using 3 databases (PubMed, CINAHL, and Scopus). The searches were conducted using the following defined search terms: ?professionalism? AND ?social media? OR ?social networks? OR ?Internet? OR ?Facebook? OR ?Twitter? OR ?Instagram? OR ?TikTok.? The search strategy was limited to studies published in English. This scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Results: Of the 1632 retrieved papers, a total of 88 studies were finally included in this review. Overall, the quality of the studies was satisfactory. Participants in the reviewed studies were from diverse health care professions. Medical health professionals were involved in about three-quarters of the studies. Three key benefits of SM on e-professionalism of HCPs were identified: (1) professional networking and collaboration, (2) professional education and training, and (3) patient education and health promotion. For the selected studies, there were five recognized dangers of SM on e-professionalism of HCPs: (1) loosening accountability, (2) compromising confidentiality, (3) blurred professional boundaries, (4) depiction of unprofessional behavior, and (5) legal issues and disciplinary consequences. This scoping review also recognizes recommendations for changes in educational curricula regarding e-professionalism as opportunities for improvement and barriers that influence HCPs use of SM in the context of e-professionalism. Conclusions: Findings in the reviewed studies indicate the existence of both benefits and dangers of SM on e-professionalism of HCPs. Even though there are some barriers recognized, this review has highlighted existing recommendations for including e-professionalism in the educational curricula of HCPs. Based on all evidence provided, this review provided new insights and guides for future research on this area. There is a clear need for robust research to investigate new emerging SM platforms, the efficiency of guidelines and educational interventions, and the specifics of each profession regarding their SM potential and use. UR - https://www.jmir.org/2021/11/e25770 UR - http://dx.doi.org/10.2196/25770 UR - http://www.ncbi.nlm.nih.gov/pubmed/34662284 ID - info:doi/10.2196/25770 ER - TY - JOUR AU - Burmann, Anja AU - Tischler, Max AU - Faßbach, Mira AU - Schneitler, Sophie AU - Meister, Sven PY - 2021/11/11 TI - The Role of Physicians in Digitalizing Health Care Provision: Web-Based Survey Study JO - JMIR Med Inform SP - e31527 VL - 9 IS - 11 KW - digitalization KW - digital transformation KW - health care KW - human factor KW - physicians KW - digital natives KW - web-based survey KW - digital health N2 - Background: Digitalization affects all areas of society, including the health care sector. However, the digitalization of health care provision is progressing slowly compared to other sectors. In the professional and political literature, physicians are partially portrayed as digitalization sceptics. Thus, the role of physicians in this process requires further investigation. The theory of ?digital natives? suggests a lower hurdle for younger generations to engage with digital technologies. Objective: The objective of this study was to investigate the role of physicians in the process of digitalizing health care provision in Germany and to assess the age factor. Methods: We conducted a large-scale study to assess the role of this professional group in the progress of the digital transformation of the German health care sector. Therefore, in an anonymous online survey, we inquired about the current digital penetration of the personal working environment, expectations, attitude toward, and concerns regarding digitalization. Based on these data, we studied associations with the nominal variable age and variations across 2 age groups. Results: The 1274 participants included in the study generally showed a high affinity towards digitalization with a mean of 3.88 on a 5-point Likert scale; 723 respondents (56.75%) stated they personally use mobile apps in their everyday working life, with a weak tendency to be associated with the respondents? age (?=0.26). Participants saw the most noticeable existing benefits through digitalization in data quality and readability (882/1274, 69.23%) and the least in patient engagement (213/1274, 16.72%). Medical practitioners preponderantly expect further improvements through increased digitalization across almost all queried areas but the most in access to medical knowledge (1136/1274, 89.17%), treatment of orphan diseases (1016/1274, 79.75%), and medical research (1023/1274, 80.30%). Conclusions: Respondents defined their role in the digitalization of health care provision as ambivalent: ?scrutinizing? on the one hand but ?active? and ?open? on the other. A gap between willingness to participate and digital sovereignty was indicated. Thus, education on digitalization as a means to support health care provision should not only be included in the course of study but also in the continuing process of further and advanced training. UR - https://medinform.jmir.org/2021/11/e31527 UR - http://dx.doi.org/10.2196/31527 UR - http://www.ncbi.nlm.nih.gov/pubmed/34545813 ID - info:doi/10.2196/31527 ER - TY - JOUR AU - Jeyakumar, Tharshini AU - Ambata-Villanueva, Sharon AU - McClure, Sarah AU - Henderson, Carolyn AU - Wiljer, David PY - 2021/10/22 TI - Best Practices for the Implementation and Sustainment of Virtual Health Information System Training: Qualitative Study JO - JMIR Med Educ SP - e30613 VL - 7 IS - 4 KW - training KW - health care providers KW - educational technology KW - patient care KW - COVID-19 KW - development KW - practice KW - best practice KW - pedagogy KW - teaching KW - implementation KW - medical education KW - online education KW - care delivery KW - perception KW - effectiveness N2 - Background: The COVID-19 pandemic has necessitated the adoption and implementation of digital technologies to help transform the educational ecosystem and the delivery of care. Objective: We sought to understand instructors? and learners? perceptions of the challenges and opportunities faced in implementing health information system virtual training amid the COVID-19 pandemic. Methods: Semistructured interviews were conducted with education specialists and health care staff who provided or had taken part in a virtual instructor-led training at a large Canadian academic health sciences center. Guided by the Technology Acceptance Model and the Community of Inquiry framework, we analyzed interview transcript themes deductively and inductively. Results: Of the 18 individuals participating in the study, 9 were education specialists, 5 were learners, 3 were program coordinators, and 1 was a senior manager at the Centre for Learning, Innovation, and Simulation. We found 3 predominant themes: adopting a learner-centered approach for a meaningful learning experience, embracing the advances in educational technologies to maximize the transfer of learning, and enhancing the virtual user experience. Conclusions: This study adds to the literature on designing and implementing virtual training in health care organizations by highlighting the importance of recognizing learners? needs and maximizing the transfer of learning. Findings from this study can be used to help inform the design and development of training strategies to support learners across an organization during the current climate and to ensure changes are sustainable. UR - https://mededu.jmir.org/2021/4/e30613 UR - http://dx.doi.org/10.2196/30613 UR - http://www.ncbi.nlm.nih.gov/pubmed/34449402 ID - info:doi/10.2196/30613 ER - TY - JOUR AU - Nakanishi, Miharu AU - Yamasaki, Syudo AU - Endo, Kaori AU - Niimura, Junko AU - Ziylan, Canan AU - Bakker, M. Ton J. E. AU - Granvik, Eva AU - Nägga, Katarina AU - Nishida, Atsushi PY - 2021/10/12 TI - e-Learning and Web-Based Tools for Psychosocial Interventions Addressing Neuropsychiatric Symptoms of Dementia During the COVID-19 Pandemic in Tokyo, Japan: Quasi-Experimental Study JO - JMIR Med Educ SP - e30652 VL - 7 IS - 4 KW - dementia KW - home care services KW - implementation science KW - nursing homes KW - web-based tool N2 - Background: Concern has been raised that the COVID-19 pandemic and consequent social distancing measures may increase neuropsychiatric symptoms in people with dementia. Thus, we developed and delivered an e-learning training course to professional caregivers on using a web-based tool for psychosocial interventions for people with dementia. Objective: The aim of our study was to evaluate the feasibility and efficacy of an e-learning course in combination with a web-based tool in addressing neuropsychiatric symptoms of dementia. Methods: A quasi-experimental design was used in Tokyo, Japan. The e-learning course was delivered three times to professional caregivers between July and December 2020. Caregivers who completed the course assessed the level of neuropsychiatric symptoms in people with dementia using the total score from the Neuropsychiatric Inventory (NPI) via a web-based tool. The primary outcome measures were the number of caregivers who implemented follow-up NPI evaluations by March 2021 and the change in NPI scores from baseline to their most recent follow-up evaluations. As a control group, information was also obtained from professional caregivers who completed a face-to-face training course using the same web-based tool between July 2019 and March 2020. Results: A total of 268 caregivers completed the e-learning course in 2020. Of the 268 caregivers, 56 (20.9%) underwent follow-up evaluations with 63 persons with dementia. The average NPI score was significantly reduced from baseline (mean 20.4, SD 16.2) to the most recent follow-up evaluations (mean 14.3, SD 13.4). The effect size was assumed to be medium (Cohen drm [repeated measures]=0.40). The control group consisted of 252 caregivers who completed a face-to-face training course. Of the 252 caregivers, 114 (45.2%) underwent follow-up evaluations. Compared to the control group, caregivers who completed the e-learning course were significantly less likely to implement follow-up evaluations (?21=52.0, P<.001). The change in NPI scores did not differ according to the type of training course (baseline-adjusted difference=?0.61, P=.69). Conclusions: The replacement of face-to-face training with e-learning may have provided professionals with an opportunity to participate in the dementia behavior analysis and support enhancement (DEMBASE) program who may not have participated in the program otherwise. Although the program showed equal efficacy in terms of the two training courses, the feasibility was suboptimal with lower implementation levels for those receiving e-learning training. Thus, further strategies should be developed to improve feasibility by providing motivational triggers for implementation and technical support for care professionals. Using online communities in the program should also be investigated. UR - https://mededu.jmir.org/2021/4/e30652 UR - http://dx.doi.org/10.2196/30652 UR - http://www.ncbi.nlm.nih.gov/pubmed/34543224 ID - info:doi/10.2196/30652 ER - TY - JOUR AU - Yang, Lin AU - Zheng, Si AU - Xu, Xiaowei AU - Sun, Yueping AU - Wang, Xuwen AU - Li, Jiao PY - 2021/10/1 TI - Medical Data Mining Course Development in Postgraduate Medical Education: Web-Based Survey and Case Study JO - JMIR Med Educ SP - e24027 VL - 7 IS - 4 KW - medical data mining KW - course development KW - online teaching KW - postgraduate medical education N2 - Background: Medical postgraduates? demand for data capabilities is growing, as biomedical research becomes more data driven, integrative, and computational. In the context of the application of big data in health and medicine, the integration of data mining skills into postgraduate medical education becomes important. Objective: This study aimed to demonstrate the design and implementation of a medical data mining course for medical postgraduates with diverse backgrounds in a medical school. Methods: We developed a medical data mining course called ?Practical Techniques of Medical Data Mining? for postgraduate medical education and taught the course online at Peking Union Medical College (PUMC). To identify the background knowledge, programming skills, and expectations of targeted learners, we conducted a web-based questionnaire survey. After determining the instructional methods to be used in the course, three technical platforms?Rain Classroom, Tencent Meeting, and WeChat?were chosen for online teaching. A medical data mining platform called Medical Data Mining - R Programming Hub (MedHub) was developed for self-learning, which could support the development and comprehensive testing of data mining algorithms. Finally, we carried out a postcourse survey and a case study to demonstrate that our online course could accommodate a diverse group of medical students with a wide range of academic backgrounds and programming experience. Results: In total, 200 postgraduates from 30 disciplines participated in the precourse survey. Based on the analysis of students? characteristics and expectations, we designed an optimized course structured into nine logical teaching units (one 4-hour unit per week for 9 weeks). The course covered basic knowledge of R programming, machine learning models, clinical data mining, and omics data mining, among other topics, as well as diversified health care analysis scenarios. Finally, this 9-week course was successfully implemented in an online format from May to July in the spring semester of 2020 at PUMC. A total of 6 faculty members and 317 students participated in the course. Postcourse survey data showed that our course was considered to be very practical (83/83, 100% indicated ?very positive? or ?positive?), and MedHub received the best feedback, both in function (80/83, 96% chose ?satisfied?) and teaching effect (80/83, 96% chose ?satisfied?). The case study showed that our course was able to fill the gap between student expectations and learning outcomes. Conclusions: We developed content for a data mining course, with online instructional methods to accommodate the diversified characteristics of students. Our optimized course could improve the data mining skills of medical students with a wide range of academic backgrounds and programming experience. UR - https://mededu.jmir.org/2021/4/e24027 UR - http://dx.doi.org/10.2196/24027 UR - http://www.ncbi.nlm.nih.gov/pubmed/34596575 ID - info:doi/10.2196/24027 ER - TY - JOUR AU - Mohan, Vishnu AU - Garrison, Cort AU - Gold, A. Jeffrey PY - 2021/9/20 TI - Using a New Model of Electronic Health Record Training to Reduce Physician Burnout: A Plan for Action JO - JMIR Med Inform SP - e29374 VL - 9 IS - 9 KW - electronic health records KW - clinician burnout KW - EHR training KW - clinician wellness KW - after-hours EHR use KW - EHR KW - patient data KW - burnout KW - simulation KW - efficiency KW - optimization KW - well-being UR - https://medinform.jmir.org/2021/9/e29374 UR - http://dx.doi.org/10.2196/29374 UR - http://www.ncbi.nlm.nih.gov/pubmed/34325400 ID - info:doi/10.2196/29374 ER - TY - JOUR AU - Alsahali, Saud PY - 2021/9/3 TI - Awareness, Views, Perceptions, and Beliefs of Pharmacy Interns Regarding Digital Health in Saudi Arabia: Cross-sectional Study JO - JMIR Med Educ SP - e31149 VL - 7 IS - 3 KW - digital health KW - eHealth KW - mHealth KW - telehealth KW - telemedicine KW - attitude KW - awareness KW - pharmacy interns N2 - 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. UR - https://mededu.jmir.org/2021/3/e31149 UR - http://dx.doi.org/10.2196/31149 UR - http://www.ncbi.nlm.nih.gov/pubmed/34338649 ID - info:doi/10.2196/31149 ER - TY - JOUR AU - Tudor Car, Lorainne AU - Kyaw, Myint Bhone AU - Nannan Panday, S. Rishi AU - van der Kleij, Rianne AU - Chavannes, Niels AU - Majeed, Azeem AU - Car, Josip PY - 2021/7/21 TI - Digital Health Training Programs for Medical Students: Scoping Review JO - JMIR Med Educ SP - e28275 VL - 7 IS - 3 KW - digital health KW - education KW - eHealth KW - medical students KW - scoping review KW - electronic health records KW - computer literacy N2 - Background: Medical schools worldwide are accelerating the introduction of digital health courses into their curricula. The COVID-19 pandemic has contributed to this swift and widespread transition to digital health and education. However, the need for digital health competencies goes beyond the COVID-19 pandemic because they are becoming essential for the delivery of effective, efficient, and safe care. Objective: This review aims to collate and analyze studies evaluating digital health education for medical students to inform the development of future courses and identify areas where curricula may need to be strengthened. Methods: We carried out a scoping review by following the guidance of the Joanna Briggs Institute, and the results were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. We searched 6 major bibliographic databases and gray literature sources for articles published between January 2000 and November 2019. Two authors independently screened the retrieved citations and extracted the data from the included studies. Discrepancies were resolved by consensus discussions between the authors. The findings were analyzed using thematic analysis and presented narratively. Results: A total of 34 studies focusing on different digital courses were included in this review. Most of the studies (22/34, 65%) were published between 2010 and 2019 and originated in the United States (20/34, 59%). The reported digital health courses were mostly elective (20/34, 59%), were integrated into the existing curriculum (24/34, 71%), and focused mainly on medical informatics (17/34, 50%). Most of the courses targeted medical students from the first to third year (17/34, 50%), and the duration of the courses ranged from 1 hour to 3 academic years. Most of the studies (22/34, 65%) reported the use of blended education. A few of the studies (6/34, 18%) delivered courses entirely digitally by using online modules, offline learning, massive open online courses, and virtual patient simulations. The reported courses used various assessment approaches such as paper-based assessments, in-person observations, and online assessments. Most of the studies (30/34, 88%) evaluated courses mostly by using an uncontrolled before-and-after design and generally reported improvements in students? learning outcomes. Conclusions: Digital health courses reported in literature are mostly elective, focus on a single area of digital health, and lack robust evaluation. They have diverse delivery, development, and assessment approaches. There is an urgent need for high-quality studies that evaluate digital health education. UR - https://mededu.jmir.org/2021/3/e28275 UR - http://dx.doi.org/10.2196/28275 UR - http://www.ncbi.nlm.nih.gov/pubmed/34287206 ID - info:doi/10.2196/28275 ER - TY - JOUR AU - Grzeska, Alexander AU - Ali, Shan AU - Szmuda, Tomasz AU - S?oniewski, Pawe? PY - 2021/5/28 TI - Objective Outcomes Evaluation of Innovative Digital Health Curricula. Comment on ?Undergraduate Medical Competencies in Digital Health and Curricular Module Development: Mixed Methods Study? JO - J Med Internet Res SP - e26034 VL - 23 IS - 5 KW - digital health KW - eHealth KW - mHealth KW - digital health education KW - elective module KW - eHealth education KW - curriculum KW - medical school KW - digital health mindset KW - qualitative research KW - interview KW - survey UR - https://www.jmir.org/2021/5/e26034 UR - http://dx.doi.org/10.2196/26034 UR - http://www.ncbi.nlm.nih.gov/pubmed/34047706 ID - info:doi/10.2196/26034 ER - TY - JOUR AU - De Gagne, C. Jennie AU - Cho, Eunji AU - Yamane, S. Sandra AU - Jin, Haesu AU - Nam, D. Jeehae AU - Jung, Dukyoo PY - 2021/5/13 TI - Analysis of Cyberincivility in Posts by Health Professions Students: Descriptive Twitter Data Mining Study JO - JMIR Med Educ SP - e28805 VL - 7 IS - 2 KW - cyberincivility KW - digital professionalism KW - health professions students KW - social media KW - social networking sites KW - Twitter N2 - Background: Health professions students use social media to communicate with other students and health professionals, discuss career plans or coursework, and share the results of research projects or new information. These platforms allow students to share thoughts and perceptions that are not disclosed in formal education settings. Twitter provides an excellent window through which health professions educators can observe students? sociocultural and learning needs. However, despite its merits, cyberincivility on Twitter among health professions students has been reported. Cyber means using electronic technologies, and incivility is a general term for bad manners. As such, cyberincivility refers to any act of disrespectful, insensitive, or disruptive behavior in an electronic environment. Objective: This study aims to describe the characteristics and instances of cyberincivility posted on Twitter by self-identified health professions students. A further objective of the study is to analyze the prevalence of tweets perceived as inappropriate or potentially objectionable while describing patterns and differences in the instances of cyberincivility posted by those users. Methods: We used a cross-sectional descriptive Twitter data mining method to collect quantitative and qualitative data from August 2019 to February 2020. The sample was taken from users who self-identified as health professions students (eg, medicine, nursing, dental, pharmacy, physician assistant, and physical therapy) in their user description. Data management and analysis were performed with a combination of SAS 9.4 for descriptive and inferential statistics, including logistic regression, and NVivo 12 for descriptive patterns of textual data. Results: We analyzed 20 of the most recent tweets for each account (N=12,820). A total of 639 user accounts were analyzed for quantitative analysis, including 280 (43.8%) medicine students and 329 (51.5%) nursing students in 22 countries: the United States (287/639, 44.9%), the United Kingdom (197/639, 30.8%), unknown countries (104/639, 16.3%), and 19 other countries (51/639, 8.0%). Of the 639 accounts, 193 (30.2%) were coded as having instances of cyberincivility. Of these, 61.7% (119/193), 32.6% (63/193), and 5.7% (11/193) belonged to students in nursing, medicine, and other disciplines, respectively. Among 502 instances of cyberincivility identified from 641 qualitative analysis samples, the largest categories were profanity and product promotion. Several aggressive or biased comments toward other users, politicians, or certain groups of people were also found. Conclusions: Cyberincivility is a multifaceted phenomenon that must be considered in its complexity if health professions students are to embrace a culture of mutual respect and collaboration. Students? perceptions and reports of their Twitter experiences offer insights into behavior on the web and the evolving role of cyberspace, and potentially problematic posts provide opportunities for teaching digital professionalism. Our study indicates that there is a continued need to provide students with guidance and training regarding the importance of maintaining a professional persona on the web. UR - https://mededu.jmir.org/2021/2/e28805 UR - http://dx.doi.org/10.2196/28805 UR - http://www.ncbi.nlm.nih.gov/pubmed/33983129 ID - info:doi/10.2196/28805 ER - TY - JOUR AU - Wamsley, Maria AU - Cornejo, Laeesha AU - Kryzhanovskaya, Irina AU - Lin, W. Brian AU - Sullivan, Joseph AU - Yoder, Jordan AU - Ziv, Tali PY - 2021/4/21 TI - Best Practices for Integrating Medical Students Into Telehealth Visits JO - JMIR Med Educ SP - e27877 VL - 7 IS - 2 KW - telehealth KW - undergraduate medical education KW - workplace learning KW - ambulatory care KW - telehealth competencies KW - medical education KW - student education KW - digital learning KW - online learning KW - ambulatory KW - digital health UR - https://mededu.jmir.org/2021/2/e27877 UR - http://dx.doi.org/10.2196/27877 UR - http://www.ncbi.nlm.nih.gov/pubmed/33881407 ID - info:doi/10.2196/27877 ER - TY - JOUR AU - Blease, Charlotte AU - Torous, John AU - Kharko, Anna AU - DesRoches, M. Catherine AU - Harcourt, Kendall AU - O'Neill, Stephen AU - Salmi, Liz AU - Wachenheim, Deborah AU - Hägglund, Maria PY - 2021/4/16 TI - Preparing Patients and Clinicians for Open Notes in Mental Health: Qualitative Inquiry of International Experts JO - JMIR Ment Health SP - e27397 VL - 8 IS - 4 KW - open notes KW - electronic health records KW - attitudes KW - survey KW - mental health KW - psychiatry KW - psychotherapy KW - qualitative research KW - mobile phone N2 - Background: In a growing number of countries worldwide, clinicians are sharing mental health notes, including psychiatry and psychotherapy notes, with patients. Objective: The aim of this study is to solicit the views of experts on provider policies and patient and clinician training or guidance in relation to open notes in mental health care. Methods: In August 2020, we conducted a web-based survey of international experts on the practice of sharing mental health notes. Experts were identified as informaticians, clinicians, chief medical information officers, patients, and patient advocates who have extensive research knowledge about or experience of providing access to or having access to mental health notes. This study undertook a qualitative descriptive analysis of experts? written responses and opinions (comments) to open-ended questions on training clinicians, patient guidance, and suggested policy regulations. Results: A total of 70 of 92 (76%) experts from 6 countries responded. We identified four major themes related to opening mental health notes to patients: the need for clarity about provider policies on exemptions, providing patients with basic information about open notes, clinician training in writing mental health notes, and managing patient-clinician disagreement about mental health notes. Conclusions: This study provides timely information on policy and training recommendations derived from a wide range of international experts on how to prepare clinicians and patients for open notes in mental health. The results of this study point to the need for further refinement of exemption policies in relation to sharing mental health notes, guidance for patients, and curricular changes for students and clinicians as well as improvements aimed at enhancing patient and clinician-friendly portal design. UR - https://mental.jmir.org/2021/4/e27397 UR - http://dx.doi.org/10.2196/27397 UR - http://www.ncbi.nlm.nih.gov/pubmed/33861202 ID - info:doi/10.2196/27397 ER - TY - JOUR AU - Miller, E. Matthew AU - Scholl, Gretchen AU - Corby, Sky AU - Mohan, Vishnu AU - Gold, A. Jeffrey PY - 2021/3/9 TI - The Impact of Electronic Health Record?Based Simulation During Intern Boot Camp: Interventional Study JO - JMIR Med Educ SP - e25828 VL - 7 IS - 1 KW - electronic health records KW - medical education KW - simulation KW - usability KW - training N2 - Background: Accurate data retrieval is an essential part of patient care in the intensive care unit (ICU). The electronic health record (EHR) is the primary method for data storage and data review. We previously reported that residents participating in EHR-based simulations have varied and nonstandard approaches to finding data in the ICU, with subsequent errors in recognizing patient safety issues. We hypothesized that a novel EHR simulation-based training exercise would decrease EHR use variability among intervention interns, irrespective of prior EHR experience. Objective: This study aims to understand the impact of a novel, short, high-fidelity, simulation-based EHR learning activity on the intern data gathering workflow and satisfaction. Methods: A total of 72 internal medicine interns across the 2018 and 2019 academic years underwent a dedicated EHR training session as part of a week-long boot camp early in their training. We collected data on previous EHR and ICU experience for all subjects. Training consisted of 1 hour of guided review of a high-fidelity, simulated ICU patient chart focusing on best navigation practices for data retrieval. Specifically, the activity focused on using high- and low-yield data visualization screens determined by expert consensus. The intervention group interns then had 20 minutes to review a new simulated patient chart before the group review. EHR screen navigation was captured using screen recording software and compared with data from existing ICU residents performing the same task on the same medical charts (N=62). Learners were surveyed immediately and 6 months after the activity to assess satisfaction and preferred EHR screen use. Results: Participants found the activity useful and enjoyable immediately and after 6 months. Intervention interns used more individual screens than reference residents (18 vs 20; P=.008), but the total number of screens used was the same (35 vs 38; P=.30). Significantly more intervention interns used the 10 most common screens (73% vs 45%; P=.001). Intervention interns used high-yield screens more often and low-yield screens less often than the reference residents, which are persistent on self-report 6 months later. Conclusions: A short, high-fidelity, simulation-based learning activity focused on provider-specific data gathering was found to be enjoyable and to modify navigation patterns persistently. This suggests that workflow-specific simulation-based EHR training throughout training is of educational benefit to residents. UR - https://mededu.jmir.org/2021/1/e25828 UR - http://dx.doi.org/10.2196/25828 UR - http://www.ncbi.nlm.nih.gov/pubmed/33687339 ID - info:doi/10.2196/25828 ER - TY - JOUR AU - Jeyakumar, Tharshini AU - McClure, Sarah AU - Lowe, Mandy AU - Hodges, Brian AU - Fur, Katharine AU - Javier-Brozo, Mariquita AU - Tassone, Maria AU - Anderson, Melanie AU - Tripp, Tim AU - Wiljer, David PY - 2021/2/24 TI - An Education Framework for Effective Implementation of a Health Information System: Scoping Review JO - J Med Internet Res SP - e24691 VL - 23 IS - 2 KW - health information system KW - health care providers KW - education KW - learning KW - patient care N2 - Background: To optimize their use of a new Health Information System (HIS), supporting health care providers require effective HIS education. Failure to provide this education can significantly hinder an organization?s HIS implementation and sustainability efforts. Objective: The aim of this review is to understand the most effective educational strategies and approaches to enable health care providers to optimally use an HIS. Methods: Ovid MEDLINE, Ovid Embase, EBSCO Cumulative Index to Nursing and Allied Health Literature, and EBSCO Education Resources Information Center were searched to identify relevant papers. Relevant studies were systematically reviewed and analyzed using a qualitative thematic analysis approach. Results: Of the 3539 studies screened, 17 were included for data extraction. The literature on the most effective approaches to enable health care providers to optimally use an HIS emphasized the importance of investing in engaging and understanding learners in the clinical context, maximizing the transfer of learning to care, and designing continuous and agile evaluation to meet the emerging demands of the clinical environment. Conclusions: This review supports the advancement of a new HIS learning framework that organizational leaders and educators can use to guide HIS education design and development. Future research should examine how this framework can be translated into practice. UR - https://www.jmir.org/2021/2/e24691 UR - http://dx.doi.org/10.2196/24691 UR - http://www.ncbi.nlm.nih.gov/pubmed/33625370 ID - info:doi/10.2196/24691 ER - TY - JOUR AU - Thapa, Subash AU - Nielsen, Bo Jesper AU - Aldahmash, M. Abdullah AU - Qadri, R. Fatima AU - Leppin, Anja PY - 2021/2/19 TI - Willingness to Use Digital Health Tools in Patient Care Among Health Care Professionals and Students at a University Hospital in Saudi Arabia: Quantitative Cross-sectional Survey JO - JMIR Med Educ SP - e18590 VL - 7 IS - 1 KW - attitude KW - digital health KW - electronic medical record KW - health care professionals KW - health care students KW - Saudi Arabia KW - self-efficacy KW - telemedicine KW - willingness to use N2 - Background: The adoption rate of digital health in the health care sector is low in many countries. A facilitating factor for successful implementation and adoption of digital health is acceptance by current and future health care professionals. Objective: This study was conducted to identify factors associated with willingness to use digital health tools in patient care among health care professionals and students. Methods: This was a quantitative cross-sectional survey study conducted among health care professionals and students at a university hospital in Riyadh, Saudi Arabia. A nonprobability convenience sampling procedure was used to recruit participants. Data were collected using a self-completed e-questionnaire that was distributed by email. Chi-square tests, t tests, and logistic regression were used to analyze the data. Results: We found that 181 out of 218 health care professionals (83.0%; 75.6% [59/78] physicians; 87.1% [122/140] nurses) and 115 out of 154 students (74.7%; 80.0% [76/95] medical students and 66.1% [39/59] nursing students) were willing to use digital tools in patient care. Willingness to use digital tools was significantly associated with attitude (Adjusted Odds Ratios [AOR] 1.96; 95% CI 1.14-3.36) and self-efficacy (AOR 1.64; 95% CI 1.17-2.30) among health care professionals, and with current year of study (AOR 2.08; 95% CI 1.18-3.68) and self-efficacy (AOR 1.77; 95% CI 1.17-2.69) among students. No significant difference in willingness to use digital tools was found between physicians and nurses (P=.113), and between medical and nursing students (P=.079). Conclusions: The findings of this study should encourage policy makers and hospital managers to implement relevant eHealth interventions within routine health care systems in Saudi Arabia. For successful implementation, digital health education programs should be implemented simultaneously, so that current and future health care professionals are able to develop required positive attitudes as well as practical skills and competencies. UR - http://mededu.jmir.org/2021/1/e18590/ UR - http://dx.doi.org/10.2196/18590 UR - http://www.ncbi.nlm.nih.gov/pubmed/33605896 ID - info:doi/10.2196/18590 ER - TY - JOUR AU - Nazeha, Nuraini AU - Pavagadhi, Deepali AU - Kyaw, Myint Bhone AU - Car, Josip AU - Jimenez, Geronimo AU - Tudor Car, Lorainne PY - 2020/11/5 TI - A Digitally Competent Health Workforce: Scoping Review of Educational Frameworks JO - J Med Internet Res SP - e22706 VL - 22 IS - 11 KW - digital health KW - eHealth KW - health professions education KW - digital competency KW - competency KW - framework KW - review KW - medical education N2 - Background: Digital health technologies can be key to improving health outcomes, provided health care workers are adequately trained to use these technologies. There have been efforts to identify digital competencies for different health care worker groups; however, an overview of these efforts has yet to be consolidated and analyzed. Objective: The review aims to identify and study existing digital health competency frameworks for health care workers and provide recommendations for future digital health training initiatives and framework development. Methods: A literature search was performed to collate digital health competency frameworks published from 2000. A total of 6 databases including gray literature sources such as OpenGrey, ResearchGate, Google Scholar, Google, and websites of relevant associations were searched in November 2019. Screening and data extraction were performed in parallel by the reviewers. The included evidence is narratively described in terms of characteristics, evolution, and structural composition of frameworks. A thematic analysis was also performed to identify common themes across the included frameworks. Results: In total, 30 frameworks were included in this review, a majority of which aimed at nurses, originated from high-income countries, were published since 2016, and were developed via literature reviews, followed by expert consultations. The thematic analysis uncovered 28 digital health competency domains across the included frameworks. The most prevalent domains pertained to basic information technology literacy, health information management, digital communication, ethical, legal, or regulatory requirements, and data privacy and security. The Health Information Technology Competencies framework was found to be the most comprehensive framework, as it presented 21 out of the 28 identified domains, had the highest number of competencies, and targeted a wide variety of health care workers. Conclusions: Digital health training initiatives should focus on competencies relevant to a particular health care worker group, role, level of seniority, and setting. The findings from this review can inform and guide digital health training initiatives. The most prevalent competency domains identified represent essential interprofessional competencies to be incorporated into health care workers? training. Digital health frameworks should be regularly updated with novel digital health technologies, be applicable to low- and middle-income countries, and include overlooked health care worker groups such as allied health professionals. UR - https://www.jmir.org/2020/11/e22706 UR - http://dx.doi.org/10.2196/22706 UR - http://www.ncbi.nlm.nih.gov/pubmed/33151152 ID - info:doi/10.2196/22706 ER - TY - JOUR AU - Poncette, Akira-Sebastian AU - Glauert, Leon Daniel AU - Mosch, Lina AU - Braune, Katarina AU - Balzer, Felix AU - Back, Alexander David PY - 2020/10/29 TI - Undergraduate Medical Competencies in Digital Health and Curricular Module Development: Mixed Methods Study JO - J Med Internet Res SP - e22161 VL - 22 IS - 10 KW - digital health KW - eHealth KW - mHealth KW - digital health education KW - elective module KW - eHealth education KW - curriculum KW - medical school KW - digital health mindset KW - qualitative research KW - interview KW - survey N2 - Background: Owing to an increase in digital technologies in health care, recently leveraged by the COVID-19 pandemic, physicians are required to use these technologies appropriately and to be familiar with their implications on patient care, the health system, and society. Therefore, medical students should be confronted with digital health during their medical education. However, corresponding teaching formats and concepts are still largely lacking in the medical curricula. Objective: This study aims to introduce digital health as a curricular module at a German medical school and to identify undergraduate medical competencies in digital health and their suitable teaching methods. Methods: We developed a 3-week curricular module on digital health for third-year medical students at a large German medical school, taking place for the first time in January 2020. Semistructured interviews with 5 digital health experts were recorded, transcribed, and analyzed using an abductive approach. We obtained feedback from the participating students and lecturers of the module through a 17-item survey questionnaire. Results: The module received overall positive feedback from both students and lecturers who expressed the need for further digital health education and stated that the field is very important for clinical care and is underrepresented in the current medical curriculum. We extracted a detailed overview of digital health competencies, skills, and knowledge to teach the students from the expert interviews. They also contained suggestions for teaching methods and statements supporting the urgency of the implementation of digital health education in the mandatory curriculum. Conclusions: An elective class seems to be a suitable format for the timely introduction of digital health education. However, a longitudinal implementation in the mandatory curriculum should be the goal. Beyond training future physicians in digital skills and teaching them digital health?s ethical, legal, and social implications, the experience-based development of a critical digital health mindset with openness to innovation and the ability to assess ever-changing health technologies through a broad transdisciplinary approach to translate research into clinical routine seem more important. Therefore, the teaching of digital health should be as practice-based as possible and involve the educational cooperation of different institutions and academic disciplines. UR - http://www.jmir.org/2020/10/e22161/ UR - http://dx.doi.org/10.2196/22161 UR - http://www.ncbi.nlm.nih.gov/pubmed/33118935 ID - info:doi/10.2196/22161 ER - TY - JOUR AU - Vossen, Kjeld AU - Rethans, Jan-Joost AU - van Kuijk, J. Sander M. AU - van der Vleuten, P. Cees AU - Kubben, L. Pieter PY - 2020/10/1 TI - Understanding Medical Students? Attitudes Toward Learning eHealth: Questionnaire Study JO - JMIR Med Educ SP - e17030 VL - 6 IS - 2 KW - eHealth KW - student opinion KW - mHealth KW - medical education KW - students KW - medicine KW - curriculum KW - digital skills N2 - Background: Several publications on research into eHealth demonstrate promising results. Prior researchers indicated that the current generation of doctors is not trained to take advantage of eHealth in clinical practice. Therefore, training and education for everyone using eHealth are key factors to its successful implementation. We set out to review whether medical students feel prepared to take advantage of eHealth innovations in medicine. Objective: Our objective was to evaluate whether medical students desire a dedicated eHealth curriculum during their medical studies. Methods: A questionnaire assessing current education, the need for education about eHealth topics, and the didactical forms for teaching these topics was developed. Questionnaire items were scored on a scale from 1 (fully disagree with a topic) to 10 (fully agree with a topic). This questionnaire was distributed among 1468 medical students of Maastricht University in the Netherlands. R version 3.5.0 (The R Foundation) was used for all statistical procedures. Results: A total of 303 students out of 1468, representing a response rate of 20.64%, replied to our questionnaire. The aggregate statement ?I feel prepared to take advantage of the technological developments within the medical field? was scored at a mean value of 4.8 out of 10. Mean scores regarding the need for education about eHealth topics ranged from 6.4 to 7.3. Medical students did not favor creating their own health apps or mobile apps; the mean score was 4.9 for this topic. The most popular didactical option, with a mean score 7.2, was to remotely follow a real-life patient under the supervision of a doctor. Conclusions: To the best of our knowledge, this is the largest evaluation of students? opinions on eHealth training in a medical undergraduate curriculum. We found that medical students have positives attitudes toward incorporating eHealth into the medical curriculum. UR - http://mededu.jmir.org/2020/2/e17030/ UR - http://dx.doi.org/10.2196/17030 UR - http://www.ncbi.nlm.nih.gov/pubmed/33001034 ID - info:doi/10.2196/17030 ER - TY - JOUR AU - Echelard, Jean-François AU - Méthot, François AU - Nguyen, Hue-Anh AU - Pomey, Marie-Pascale PY - 2020/9/11 TI - Medical Student Training in eHealth: Scoping Review JO - JMIR Med Educ SP - e20027 VL - 6 IS - 2 KW - medical education KW - eHealth KW - digital health KW - mHealth KW - health apps KW - telehealth KW - artificial intelligence KW - electronic health records KW - programming KW - internet of things N2 - Background: eHealth is the use of information and communication technologies to enable and improve health and health care services. It is crucial that medical students receive adequate training in eHealth as they will work in clinical environments that are increasingly being enabled by technology. This trend is especially accelerated by the COVID-19 pandemic as it complicates traditional face-to-face medical consultations and highlights the need for innovative approaches in health care. Objective: This review aims to evaluate the extent and nature of the existing literature on medical student training in eHealth. In detail, it aims to examine what this education consists of, the barriers, enhancing factors, and propositions for improving the medical curriculum. This review focuses primarily on some key technologies such as mobile health (mHealth), the internet of things (IoT), telehealth, and artificial intelligence (AI). Methods: Searches were performed on 4 databases, and articles were selected based on the eligibility criteria. Studies had to be related to the training of medical students in eHealth. The eligibility criteria were studies published since 2014, from a peer-reviewed journal, and written in either English or French. A grid was used to extract and chart data. Results: The search resulted in 25 articles. The most studied aspect was mHealth. eHealth as a broad concept, the IoT, AI, and programming were least covered. A total of 52% (13/25) of all studies contained an intervention, mostly regarding mHealth, electronic health records, web-based medical resources, and programming. The findings included various barriers, enhancing factors, and propositions for improving the medical curriculum. Conclusions: Trends have emerged regarding the suboptimal present state of eHealth training and barriers, enhancing factors, and propositions for optimal training. We recommend that additional studies be conducted on the following themes: barriers, enhancing factors, propositions for optimal training, competencies that medical students should acquire, learning outcomes from eHealth training, and patient care outcomes from this training. Additional studies should be conducted on eHealth and each of its aspects, especially on the IoT, AI, programming, and eHealth as a broad concept. Training in eHealth is critical to medical practice in clinical environments that are increasingly being enabled by technology. The need for innovative approaches in health care during the COVID-19 pandemic further highlights the relevance of this training. UR - https://mededu.jmir.org/2020/2/e20027 UR - http://dx.doi.org/10.2196/20027 UR - http://www.ncbi.nlm.nih.gov/pubmed/32915154 ID - info:doi/10.2196/20027 ER -