TY - JOUR AU - Ayivi-Vinz, Gloria AU - Bakwa Kanyinga, Felly AU - Bergeron, Lysa AU - Décary, Simon AU - Adisso, Lionel Évèhouénou AU - Zomahoun, Vignon Hervé Tchala AU - Daniel, J. Sam AU - Tremblay, Martin AU - Plourde, V. Karine AU - Guay-Bélanger, Sabrina AU - Légaré, France PY - 2022/5/2 TI - Use of the CPD-REACTION Questionnaire to Evaluate Continuing Professional Development Activities for Health Professionals: Systematic Review JO - JMIR Med Educ SP - e36948 VL - 8 IS - 2 KW - CPD-REACTION KW - behavior KW - intention KW - education medical KW - continuing KW - health care professionals KW - questionnaire KW - web-based KW - continuing professional development N2 - Background: Continuing professional development (CPD) is essential for physicians to maintain and enhance their knowledge, competence, skills, and performance. Web-based CPD plays an essential role. However, validated theory?informed measures of their impact are lacking. The CPD-REACTION questionnaire is a validated theory?informed tool that evaluates the impact of CPD activities on clinicians? behavioral intentions. Objective: We aimed to review the use of the CPD-REACTION questionnaire, which measures the impact of CPD activities on health professionals? intentions to change clinical behavior. We examined CPD activity characteristics, ranges of intention, mean scores, score distributions, and psychometric properties. Methods: We conducted a systematic review informed by the Cochrane review methodology. We searched 8 databases from January 1, 2014, to April 20, 2021. Gray literature was identified using Google Scholar and Research Gate. Eligibility criteria included all health care professionals, any study design, and participants? completion of the CPD-REACTION questionnaire either before, after, or before and after a CPD activity. Study selection, data extraction, and study quality evaluation were independently performed by 2 reviewers. We extracted data on characteristics of studies, the CPD activity (eg, targeted clinical behavior and format), and CPD-REACTION use. We used the Mixed Methods Appraisal Tool to evaluate the methodological quality of the studies. Data extracted were analyzed using descriptive statistics and the Student t test (2-tailed) for bivariate analysis. The results are presented as a narrative synthesis reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: Overall, 65 citations were eligible and referred to 52 primary studies. The number of primary studies reporting the use of CPD-REACTION has increased continuously since 2014 from 1 to 16 publications per year (2021). It is available in English, French, Spanish, and Dutch. Most of the studies were conducted in Canada (30/52, 58%). Furthermore, 40 different clinical behaviors were identified. The most common CPD format was e-learning (34/52, 65%). The original version of the CPD-REACTION questionnaire was used in 31 of 52 studies, and an adapted version in 18 of 52 studies. In addition, 31% (16/52) of the studies measured both the pre- and postintervention scores. In 22 studies, CPD providers were university-based. Most studies targeted interprofessional groups of health professionals (31/52, 60%). Conclusions: The use of CPD-REACTION has increased rapidly and across a wide range of clinical behaviors and formats, including a web-based format. Further research should investigate the most effective way to adapt the CPD-REACTION questionnaire to a variety of clinical behaviors and contexts. Trial Registration: PROSPERO CRD42018116492; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116492 UR - https://mededu.jmir.org/2022/2/e36948 UR - http://dx.doi.org/10.2196/36948 UR - http://www.ncbi.nlm.nih.gov/pubmed/35318188 ID - info:doi/10.2196/36948 ER - TY - JOUR AU - Wickramasinghe, Nilmini AU - Thompson, R. Bruce AU - Xiao, Junhua PY - 2022/5/20 TI - The Opportunities and Challenges of Digital Anatomy for Medical Sciences: Narrative Review JO - JMIR Med Educ SP - e34687 VL - 8 IS - 2 KW - digital anatomy KW - digital health KW - virtual reality KW - augmented reality KW - medical education N2 - Background: Anatomy has been the cornerstone of medical education for centuries. However, given the advances in the Internet of Things, this landscape has been augmented in the past decade, shifting toward a greater focus on adopting digital technologies. Digital anatomy is emerging as a new discipline that represents an opportunity to embrace advances in digital health technologies and apply them to the domain of modern medical sciences. Notably, the use of augmented or mixed and virtual reality as well as mobile and platforms and 3D printing in modern anatomy has dramatically increased in the last 5 years. Objective: This review aims to outline the emerging area of digital anatomy and summarize opportunities and challenges for incorporating digital anatomy in medical science education and practices. Methods: Literature searches were performed using the PubMed, Embase, and MEDLINE bibliographic databases for research articles published between January 2005 and June 2021 (inclusive). Out of the 4650 articles, 651 (14%) were advanced to full-text screening and 77 (1.7%) were eligible for inclusion in the narrative review. We performed a Strength, Weakness, Opportunity, and Threat (SWOT) analysis to evaluate the role that digital anatomy plays in both the learning and teaching of medicine and health sciences as well as its practice. Results: Digital anatomy has not only revolutionized undergraduate anatomy education via 3D reconstruction of the human body but is shifting the paradigm of pre- and vocational training for medical professionals via digital simulation, advancing health care. Importantly, it was noted that digital anatomy not only benefits in situ real time clinical practice but also has many advantages for learning and teaching clinicians at multiple levels. Using the SWOT analysis, we described strengths and opportunities that together serve to underscore the benefits of embracing digital anatomy, in particular the areas for collaboration and medical advances. The SWOT analysis also identified a few weaknesses associated with digital anatomy, which are primarily related to the fact that the current reach and range of applications for digital anatomy are very limited owing to its nascent nature. Furthermore, threats are limited to technical aspects such as hardware and software issues. Conclusions: This review highlights the advances in digital health and Health 4.0 in key areas of digital anatomy analytics. The continuous evolution of digital technologies will increase their ability to reinforce anatomy knowledge and advance clinical practice. However, digital anatomy education should not be viewed as a simple technical conversion and needs an explicit pedagogical framework. This review will be a valuable asset for educators and researchers to incorporate digital anatomy into the learning and teaching of medical sciences and their practice. UR - https://mededu.jmir.org/2022/2/e34687 UR - http://dx.doi.org/10.2196/34687 UR - http://www.ncbi.nlm.nih.gov/pubmed/35594064 ID - info:doi/10.2196/34687 ER - TY - JOUR AU - Johnson, Grødem Susanne AU - Potrebny, Thomas AU - Larun, Lillebeth AU - Ciliska, Donna AU - Olsen, Rydland Nina PY - 2022/6/29 TI - Usability Methods and Attributes Reported in Usability Studies of Mobile Apps for Health Care Education: Scoping Review JO - JMIR Med Educ SP - e38259 VL - 8 IS - 2 KW - user-computer interface KW - mobile apps KW - online learning KW - health education KW - students N2 - Background: Mobile devices can provide extendable learning environments in higher education and motivate students to engage in adaptive and collaborative learning. Developers must design mobile apps that are practical, effective, and easy to use, and usability testing is essential for understanding how mobile apps meet users? needs. No previous reviews have investigated the usability of mobile apps developed for health care education. Objective: The aim of this scoping review is to identify usability methods and attributes in usability studies of mobile apps for health care education. Methods: A comprehensive search was carried out in 10 databases, reference lists, and gray literature. Studies were included if they dealt with health care students and usability of mobile apps for learning. Frequencies and percentages were used to present the nominal data, together with tables and graphical illustrations. Examples include a figure of the study selection process, an illustration of the frequency of inquiry usability evaluation and data collection methods, and an overview of the distribution of the identified usability attributes. We followed the Arksey and O?Malley framework for scoping reviews. Results: Our scoping review collated 88 articles involving 98 studies, mainly related to medical and nursing students. The studies were conducted from 22 countries and were published between 2008 and 2021. Field testing was the main usability experiment used, and the usability evaluation methods were either inquiry-based or based on user testing. Inquiry methods were predominantly used: 1-group design (46/98, 47%), control group design (12/98, 12%), randomized controlled trials (12/98, 12%), mixed methods (12/98, 12%), and qualitative methods (11/98, 11%). User testing methods applied were all think aloud (5/98, 5%). A total of 17 usability attributes were identified; of these, satisfaction, usefulness, ease of use, learning performance, and learnability were reported most frequently. The most frequently used data collection method was questionnaires (83/98, 85%), but only 19% (19/98) of studies used a psychometrically tested usability questionnaire. Other data collection methods included focus group interviews, knowledge and task performance testing, and user data collected from apps, interviews, written qualitative reflections, and observations. Most of the included studies used more than one data collection method. Conclusions: Experimental designs were the most commonly used methods for evaluating usability, and most studies used field testing. Questionnaires were frequently used for data collection, although few studies used psychometrically tested questionnaires. The usability attributes identified most often were satisfaction, usefulness, and ease of use. The results indicate that combining different usability evaluation methods, incorporating both subjective and objective usability measures, and specifying which usability attributes to test seem advantageous. The results can support the planning and conduct of future usability studies for the advancement of mobile learning apps in health care education. International Registered Report Identifier (IRRID): RR2-10.2196/19072 UR - https://mededu.jmir.org/2022/2/e38259 UR - http://dx.doi.org/10.2196/38259 UR - http://www.ncbi.nlm.nih.gov/pubmed/35767323 ID - info:doi/10.2196/38259 ER - TY - JOUR AU - Jalali, Alireza AU - Nyman, A. Jacline AU - Hamelin-Mitchell, Elaine PY - 2022/4/5 TI - Fundraising in Education: Road Map to Involving Medical Educators in Fundraising JO - JMIR Med Educ SP - e32597 VL - 8 IS - 2 KW - fundraising KW - philanthropy KW - crowdfunding KW - funding KW - charity KW - higher education KW - university KW - business model KW - revenue streams KW - medical education KW - educators KW - academia KW - academic environments UR - https://mededu.jmir.org/2022/2/e32597 UR - http://dx.doi.org/10.2196/32597 UR - http://www.ncbi.nlm.nih.gov/pubmed/35380542 ID - info:doi/10.2196/32597 ER - TY - JOUR AU - Gibney, Ryan AU - Cantwell, Christina AU - Wray, Alisa AU - Boysen-Osborn, Megan AU - Wiechmann, Warren AU - Saadat, Soheil AU - Smart, Jonathan AU - Toohey, Shannon PY - 2022/4/5 TI - Influence of Factors Relating to Sex and Gender on Rank List Decisions and Perceptions of Residency Training: Survey Study JO - JMIR Med Educ SP - e33592 VL - 8 IS - 2 KW - residency KW - sex KW - gender KW - graduate medical education KW - emergency medicine KW - residents KW - program leadership KW - rank list N2 - Background: Females make up more than half of medical school matriculants but only one-third of emergency medicine (EM) residents. Various factors may contribute to why fewer females choose the field of EM, such as the existing presence of females in the specialty. Objective: This study is a follow-up to previous work, and a survey is used to assess current residents? attitudes and perceptions on various factors, including those relating to sex and gender on creating rank lists as medical students and in perceived effects on residency education. Methods: A web-based survey consisting of Likert scale questions regarding a variety of factors influencing a student?s decision to create a rank list and in perceived effects on residency education was sent to current EM residents in 2020. Results: Residents from 17 programs participated in the survey with an 18.2% (138/758) response rate. The most important factors in creating a rank list were the personality of residents in the program, location, and facility type. For factors specifically related to gender, respondents who answered affirmatively to whether the gender composition of residents affected the selection of a program in making a rank list were more likely to also answer affirmatively to subsequent questions related to the gender of program leadership (P<.001) and gender composition of attending physicians (P<.001). The personality of residents was also the most important factor perceived to affect residency education. For factors influencing rank list and residency education, female respondents placed higher importance on subcategories related to gender (ie, gender composition of the residents, of the program leadership, and of the attending physicians) to a significant degree compared with their male counterparts. Conclusions: Although factors such as location and resident personality show the most importance in influencing residency selection, when stratifying based on respondent sex, females tend to indicate that factors relating to gender have more influence on rank list and residency education compared with males. UR - https://mededu.jmir.org/2022/2/e33592 UR - http://dx.doi.org/10.2196/33592 UR - http://www.ncbi.nlm.nih.gov/pubmed/35380547 ID - info:doi/10.2196/33592 ER - TY - JOUR AU - Bergeron, Lysa AU - Décary, Simon AU - Djade, Djignefa Codjo AU - Daniel, J. Sam AU - Tremblay, Martin AU - Rivest, Louis-Paul AU - Légaré, France PY - 2022/6/2 TI - Factors Associated With Specialists? Intention to Adopt New Behaviors After Taking Web-Based Continuing Professional Development Courses: Cross-sectional Study JO - JMIR Med Educ SP - e34299 VL - 8 IS - 2 KW - continuing professional development KW - CPD-Reaction KW - behavioral intention KW - medical specialists KW - web-based training KW - medical education KW - education KW - physician KW - psychosocial KW - online course N2 - Background: Web-based continuing professional development (CPD) is a convenient and low-cost way for physicians to update their knowledge. However, little is known about the factors that influence their intention to put this new knowledge into practice. Objective: We aimed to identify sociocognitive factors associated with physicians? intention to adopt new behaviors as well as indications of Bloom?s learning levels following their participation in 5 web-based CPD courses. Methods: We performed a cross-sectional study of specialist physicians who had completed 1 of 5 web-based CPD courses offered by the Federation of Medical Specialists of Quebec. The participants then completed CPD-Reaction, a questionnaire based on Godin?s integrated model for health professional behavior change and with evidence of validity that measures behavioral intention (dependent variable) and psychosocial factors influencing intention (n=4). We also assessed variables related to sociodemographics (n=5), course content (n=9), and course format (eg, graphic features and duration) (n=8). Content variables were derived from CanMEDS competencies, Bloom?s learning levels, and Godin?s integrated model. We conducted ANOVA single-factor analysis, calculated the intraclass correlation coefficient (ICC), and performed bivariate and multivariate analyses. Results: A total of 400 physicians participated in the courses (range: 38-135 physicians per course). Average age was 50 (SD 12) years; 56% (n=223) were female, and 44% (n=177) were male. Among the 259 who completed CPD-Reaction, behavioral intention scores ranged from 5.37 (SD 1.17) to 6.60 (SD 0.88) out of 7 and differed significantly from one course to another (P<.001). The ICC indicated that 17% of the total variation in the outcome of interest, the behavioral intention of physicians, could be explained at the level of the CPD course (ICC=0.17). In bivariate analyses, social influences (P<.001), beliefs about capabilities (P<.001), moral norm (P<.001), beliefs about consequences (P<.001), and psychomotor learning (P=.04) were significantly correlated with physicians? intention to adopt new behaviors. Multivariate analysis showed the same factors, except for social influences and psychomotor learning, as significantly correlated with intention. Conclusions: We observed average to high behavioral intention scores after all 5 web-based courses, with some variations by course taken. Factors affecting physicians? intention were beliefs about their capabilities and about the consequences of adopting new clinical behaviors, as well as doubts about whether the new behavior aligned with their moral values. Our results will inform design of future web-based CPD courses to ensure they contribute to clinical behavior change. UR - https://mededu.jmir.org/2022/2/e34299 UR - http://dx.doi.org/10.2196/34299 UR - http://www.ncbi.nlm.nih.gov/pubmed/35476039 ID - info:doi/10.2196/34299 ER - TY - JOUR AU - Aggarwal, Anuj AU - Hess, Olivia AU - Lockman, L. Justin AU - Smith, Lauren AU - Stevens, Mitchell AU - Bruce, Janine AU - Caruso, Thomas PY - 2022/6/30 TI - Anesthesiologists With Advanced Degrees in Education: Qualitative Study of a Changing Paradigm JO - JMIR Med Educ SP - e38050 VL - 8 IS - 2 KW - academic medical centers KW - trends KW - medical education KW - medical KW - faculty KW - anesthesiologists KW - medical professionals KW - learning KW - institute KW - clinician KW - educator KW - experience KW - decision-making KW - training N2 - Background: Anesthesiology education has undergone profound changes over the past century, from a pure clinical apprenticeship to novel comprehensive curricula based on andragogic learning theories. Combined with institutional and regulatory requirements, these new curricula have propagated professionalization of the clinician-educator role. A significant number of clinician-educator anesthesiologists, often with support from department chairs, pursue formal health professions education (HPE) training, yet there are no published data demonstrating the benefits or costs of these degrees to educational leaders. Objective: This study aims to collect the experiences of anesthesiologists who have pursued HPE degrees to understand the advantages and costs of HPE degrees to anesthesiologists. Methods: Investigators performed a qualitative study of anesthesiologists with HPE degrees working at academic medical centers. Interviews were thematically analyzed via an iterative process. They were coded using a team-based approach, and representative themes and exemplary quotations were identified. Results: Seven anesthesiologists were interviewed, representing diverse geographic regions, subspecialties, and medical institutions. Analyses of interview transcripts resulted in the following 6 core themes: outcomes, extrinsic motivators, intrinsic motivators, investment, experience, and recommendations. The interviewees noted the advantages of HPE training for those wishing to pursue leadership or scholarship in medical education; however, they also noted the costs and investment of time in addition to preexisting commitments. The interviewees also highlighted the issues faculty and chairs might consider for the optimal timing of HPE training. Conclusions: There are numerous professional and personal benefits to pursuing HPE degrees for faculty interested in education leadership or scholarship. Making an informed decision to pursue HPE training can be challenging when considering the competing pressures of clinical work and personal obligations. The experiences of the interviewed anesthesiologists offer direction to future anesthesiologists and chairs in their decision-making process of whether and when to pursue HPE training. UR - https://mededu.jmir.org/2022/2/e38050 UR - http://dx.doi.org/10.2196/38050 UR - http://www.ncbi.nlm.nih.gov/pubmed/35771619 ID - info:doi/10.2196/38050 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 - Shah, Savan PY - 2022/5/26 TI - Evaluation of Online Near-Peer Teaching for Penultimate-Year Objective Structured Clinical Examinations in the COVID-19 Era: Longitudinal Study JO - JMIR Med Educ SP - e37872 VL - 8 IS - 2 KW - near-peer teaching KW - peer-assisted learning KW - Objective Structured Clinical Examination KW - OSCE KW - online teaching KW - COVID-19 KW - medical education KW - learning KW - medical school KW - near-peer teacher KW - NPT KW - near-peer learner KW - NPL N2 - Background: The benefits of near-peer learning are well established in several aspects of undergraduate medical education including preparing students for Objective Structured Clinical Examinations (OSCEs). The COVID-19 pandemic has resulted in a paradigm shift to predominantly online teaching. Objective: This study aims to demonstrate the feasibility and benefits of an exclusively online near-peer OSCE teaching program in a time of significant face-to-face and senior-led teaching shortage. Methods: A teaching program was delivered to penultimate-year students by final-year students at Manchester Medical School. Program development involved compiling a list of salient topics and seeking senior faculty approval. Teachers and students were recruited on Facebook. In total, 22 sessions and 42 talks were attended by 72 students and taught by 13 teachers over a 3-month period. Data collection involved anonymous weekly questionnaires and 2 separate anonymous student and teacher postcourse questionnaires including both quantitative and qualitative components. Results: On a scale of 1-10, students rated the quality of the program highly (mean 9.30, SD 1.15) and felt the sessions were highly useful in guiding their revision (mean 8.95, SD 0.94). There was a significant increase in perceived confidence ratings after delivery of the program (P<.001). Teachers felt the program helped them better understand and retain the subject material taught (mean 9.36, SD 0.81) and develop skills to become effective clinical teachers (mean 9.27, SD 0.79). Conclusions: This is the first study demonstrating the efficacy of a near-peer OSCE teaching program delivered exclusively online. This provides an exemplary framework for how similar programs should be encouraged given their efficacy and logistical viability in supplementing the undergraduate curriculum. UR - https://mededu.jmir.org/2022/2/e37872 UR - http://dx.doi.org/10.2196/37872 UR - http://www.ncbi.nlm.nih.gov/pubmed/35617013 ID - info:doi/10.2196/37872 ER - TY - JOUR AU - Yilmaz, Yusuf AU - Jurado Nunez, Alma AU - Ariaeinejad, Ali AU - Lee, Mark AU - Sherbino, Jonathan AU - Chan, M. Teresa PY - 2022/5/27 TI - Harnessing Natural Language Processing to Support Decisions Around Workplace-Based Assessment: Machine Learning Study of Competency-Based Medical Education JO - JMIR Med Educ SP - e30537 VL - 8 IS - 2 KW - natural language processing KW - machine learning algorithms KW - competency-based medical education KW - assessment KW - medical education KW - medical residents KW - machine learning KW - work performance KW - prediction models N2 - Background: Residents receive a numeric performance rating (eg, 1-7 scoring scale) along with a narrative (ie, qualitative) feedback based on their performance in each workplace-based assessment (WBA). Aggregated qualitative data from WBA can be overwhelming to process and fairly adjudicate as part of a global decision about learner competence. Current approaches with qualitative data require a human rater to maintain attention and appropriately weigh various data inputs within the constraints of working memory before rendering a global judgment of performance. Objective: This study explores natural language processing (NLP) and machine learning (ML) applications for identifying trainees at risk using a large WBA narrative comment data set associated with numerical ratings. Methods: NLP was performed retrospectively on a complete data set of narrative comments (ie, text-based feedback to residents based on their performance on a task) derived from WBAs completed by faculty members from multiple hospitals associated with a single, large, residency program at McMaster University, Canada. Narrative comments were vectorized to quantitative ratings using the bag-of-n-grams technique with 3 input types: unigram, bigrams, and trigrams. Supervised ML models using linear regression were trained with the quantitative ratings, performed binary classification, and output a prediction of whether a resident fell into the category of at risk or not at risk. Sensitivity, specificity, and accuracy metrics are reported. Results: The database comprised 7199 unique direct observation assessments, containing both narrative comments and a rating between 3 and 7 in imbalanced distribution (scores 3-5: 726 ratings; and scores 6-7: 4871 ratings). A total of 141 unique raters from 5 different hospitals and 45 unique residents participated over the course of 5 academic years. When comparing the 3 different input types for diagnosing if a trainee would be rated low (ie, 1-5) or high (ie, 6 or 7), our accuracy for trigrams was 87%, bigrams 86%, and unigrams 82%. We also found that all 3 input types had better prediction accuracy when using a bimodal cut (eg, lower or higher) compared with predicting performance along the full 7-point rating scale (50%-52%). Conclusions: The ML models can accurately identify underperforming residents via narrative comments provided for WBAs. The words generated in WBAs can be a worthy data set to augment human decisions for educators tasked with processing large volumes of narrative assessments. UR - https://mededu.jmir.org/2022/2/e30537 UR - http://dx.doi.org/10.2196/30537 UR - http://www.ncbi.nlm.nih.gov/pubmed/35622398 ID - info:doi/10.2196/30537 ER - TY - JOUR AU - Jensen, Katherine AU - Yan, Qi AU - Davies, G. Mark PY - 2022/6/29 TI - Critical Comparison of the Quality and Content of Integrated Vascular Surgery, Thoracic Surgery, and Interventional Radiology Residency Training Program Websites: Qualitative Study JO - JMIR Med Educ SP - e35074 VL - 8 IS - 2 KW - training KW - recruitment KW - website KW - content KW - quality KW - vascular surgery KW - thoracic surgery KW - interventional radiology KW - radiology KW - surgery KW - web-based KW - web resource KW - surgeon KW - comparison KW - residency KW - integrated program N2 - Background: With the move to virtual interviewing, residency websites are an important recruitment resource, introducing applicants to programs across the country and allowing for comparison. Recruitment is highly competitive from a common potential pool between vascular surgery, thoracic surgery, and interventional radiology with the ratio of applicants to positions being highest in interventional radiology, followed by thoracic surgery and lastly vascular surgery, as reported by the National Resident Matching Program. Objective: The aim of this study is to evaluate the accessibility and availability of online content for those integrated residency programs. Methods: A list of accredited vascular surgery, thoracic surgery, and interventional radiology residencies was obtained from the Accreditation Council for Graduate Medical Education (ACGME) database. Program websites were evaluated by trained independent reviewers (n=2) for content items pertaining to program recruitment and education (scored absent or present). Statistical analysis was performed in R software. Results: Of ACGME-accredited programs, 56 of 61 (92%) vascular surgery, 27 of 27 (100%) thoracic surgery, and 74 of 85 (87%) interventional radiology programs had functional websites (P=.12). Vascular surgery websites contained a median of 26 (IQR 20-32) content items, thoracic surgery websites contained a median of 27 (IQR 21-32) content items, and interventional radiology websites contained a median of 23 (IQR 18-27) content items. Two content items considered highly influential to applicant program decisions are procedural experience and faculty mentorship, which were reported at 32% (18/56) and 11% (6/56) for vascular surgery, 19% (5/27) and 11% (3/27) for thoracic surgery, and 50% (37/74) and 15% (11/74) for interventional radiology (P=.008 and P=.75), respectively. Key deficits were work hours, debt management, and curriculum for interventional radiology; resident profiles, sample contracts, and research interests in vascular surgery; and operative experiences and the program director?s contact and message for thoracic surgery. Interventional radiology deficits were work hours, and thoracic surgery deficits were procedural experience. Both interventional radiology and thoracic surgery websites lacked information on evaluation criteria and faculty mentorship. Conclusions: This study has uncovered key differences in the availability of online content for residencies recruiting from the same pool of applicants. Thoracic surgery has the most information, followed by vascular surgery, with interventional radiology reporting the least content. In the era of virtual interviewing from the same potential pool of applicants, programs should review and revise their web presence with the aim to increase the availability of online content to attract valuable candidates. UR - https://mededu.jmir.org/2022/2/e35074 UR - http://dx.doi.org/10.2196/35074 UR - http://www.ncbi.nlm.nih.gov/pubmed/35767342 ID - info:doi/10.2196/35074 ER - TY - JOUR AU - Hamoen, C. Esther AU - De Jong, M. Peter G. AU - Van Blankenstein, M. Floris AU - Reinders, J. Marlies E. PY - 2022/4/7 TI - Design and First Impressions of a Small Private Online Course in Clinical Workplace Learning: Questionnaire and Interview Study JO - JMIR Med Educ SP - e29624 VL - 8 IS - 2 KW - blended learning KW - design-based research KW - web-based learning KW - workplace learning KW - medical education KW - clinical internship N2 - Background: Clinical workplace learning takes place in a dynamic and complex learning environment that is designated as a site for patient care and education. Challenges in clinical training can be overcome by implementing blended learning, as it offers flexible learning programs suitable for student-centered learning, web-based collaboration, and peer learning. Objective: The aim of this study is to evaluate the Small Private Online Course (SPOC) by interns? first impressions and satisfaction measures (N=20) on using the SPOC. This study describes the design process of a SPOC from a theoretical and practical perspective and how it has been integrated into a clinical internship in internal medicine. Methods: The design of the SPOC was based on general theoretical principles that learning should be constructive, contextual, collaborative, and self-regulated, and the self-determination theory to stimulate intrinsic motivation. Interns? impressions and level of satisfaction were evaluated with a web-based questionnaire and group interview. Results: Interns thought the web-based learning environment to be a useful and accessible alternative to improve knowledge and skills. Peer learning and web-based collaboration through peer interaction was perceived as less effective, as student feedback was felt inferior to teacher feedback. The interns would prefer more flexibility within the course, which could improve self-regulated learning and autonomy. Conclusions: The evaluation shows that the SPOC is a useful and accessible addition to the clinical learning environment, providing an alternative opportunity to improve knowledge and skills. Further research is needed to improve web-based collaboration and interaction in our course. UR - https://mededu.jmir.org/2022/2/e29624 UR - http://dx.doi.org/10.2196/29624 UR - http://www.ncbi.nlm.nih.gov/pubmed/35389362 ID - info:doi/10.2196/29624 ER - TY - JOUR AU - Beverly, Elizabeth AU - Rigot, Brooke AU - Love, Carrie AU - Love, Matt PY - 2022/4/29 TI - Perspectives of 360-Degree Cinematic Virtual Reality: Interview Study Among Health Care Professionals JO - JMIR Med Educ SP - e32657 VL - 8 IS - 2 KW - virtual reality KW - qualitative KW - medical education KW - health care KW - digital learning KW - learning platform KW - health care providers N2 - Background: The global market for medical education is projected to increase exponentially over the next 5 years. A mode of delivery expected to drive the growth of this market is virtual reality (VR). VR simulates real-world objects, events, locations, and interactions in 3D multimedia sensory environments. It has been used successfully in medical education for surgical training, learning anatomy, and advancing drug discovery. New VR research has been used to simulate role-playing and clinical encounters; however, most of this research has been conducted with health professions students and not current health care professionals. Thus, more research is needed to explore how health care professionals experience VR with role-playing and clinical encounters. Objective: The aim of this study was to explore health care professionals? experiences with a cinematic VR (cine-VR) training program focused on role-playing and clinical encounters addressing social determinants of health, Appalachian culture, and diabetes. Cine-VR leverages 360-degree video with the narrative storytelling of cinema to create an engaging educational experience. Methods: We conducted in-depth telephone interviews with health care professionals who participated in the cine-VR training. The interviews were audio recorded and transcribed verbatim. A multidisciplinary team coded and analyzed the data using content and thematic analyses with NVivo software. Results: We conducted 24 in-depth interviews with health care professionals (age=45.3, SD 11.3, years; n=16, 67%, women; n=22, 92%, White; and n=4, 17%, physicians) to explore their experiences with the cine-VR training. Qualitative analysis revealed five themes: immersed in the virtual world: seeing a 360-degree sphere allowed participants to immerse themselves in the virtual world; facilitated knowledge acquisition: all the participants accurately recalled the culture of Appalachia and listed the social determinants of health presented in the training; empathized with multiple perspectives: the cine-VR provided a glimpse into the real life of the main character, and participants described thinking about, feeling, and empathizing with the character?s frustrations and disappointments; perceived ease of use of cine-VR: 96% (23/24) of the participants described the cine-VR as easy to use, and they liked the 360-degree movement, image resolution, and sound quality but noted limitations with the buttons on the headsets and risk for motion sickness; and perceived utility of cine-VR as a teaching tool: participants described cine-VR as an effective teaching tool because it activated visual and affective learning for them. Conclusions: Participants emphasized the realism of the cine-VR training program. They attributed the utility of the cine-VR to visual learning in conjunction with the emotional connection to the VR characters. Furthermore, participants reported that the cine-VR increased their empathy for people. More research is needed to confirm an association between the level of immersion and empathy in cine-VR training for health care professionals. UR - https://mededu.jmir.org/2022/2/e32657 UR - http://dx.doi.org/10.2196/32657 UR - http://www.ncbi.nlm.nih.gov/pubmed/35486427 ID - info:doi/10.2196/32657 ER - TY - JOUR AU - Gosselin Boucher, Vincent AU - Bacon, Simon AU - Voisard, Brigitte AU - Dragomir, I. Anda AU - Gemme, Claudia AU - Larue, Florent AU - Labbé, Sara AU - Szczepanik, Geneviève AU - Corace, Kimberly AU - Campbell, Tavis AU - Vallis, Michael AU - Garber, Gary AU - Rouleau, Codie AU - Diodati, G. Jean AU - Rabi, Doreen AU - Sultan, Serge AU - Lavoie, Kim AU - PY - 2022/6/24 TI - Assessing Physician?s Motivational Communication Skills: 5-Step Mixed Methods Development Study of the Motivational Communication Competency Assessment Test JO - JMIR Med Educ SP - e31489 VL - 8 IS - 2 KW - assessment KW - motivational communication KW - tool development KW - physicians KW - health promotion N2 - Background: Training physicians to provide effective behavior change counseling using approaches such as motivational communication (MC) is an important aspect of noncommunicable chronic disease prevention and management. However, existing evaluation tools for MC skills are complex, invasive, time consuming, and impractical for use within the medical context. Objective: The objective of this study is to develop and validate a short web-based tool for evaluating health care provider (HCP) skills in MC?the Motivational Communication Competency Assessment Test (MC-CAT). Methods: Between 2016 and 2021, starting with a set of 11 previously identified core MC competencies and using a 5-step, mixed methods, integrated knowledge translation approach, the MC-CAT was created by developing a series of 4 base cases and a scoring scheme, validating the base cases and scoring scheme with international experts, creating 3 alternative versions of the 4 base cases (to create a bank of 16 cases, 4 of each type of base case) and translating the cases into French, integrating the cases into the web-based MC-CAT platform, and conducting initial internal validity assessments with university health students. Results: The MC-CAT assesses MC competency in 20 minutes by presenting HCPs with 4 out of a possible 16 cases (randomly selected and ordered) addressing various behavioral targets (eg, smoking, physical activity, diet, and medication adherence). Individual and global competency scores were calculated automatically for the 11 competency items across the 4 cases, providing automatic scores out of 100. From the factorial analysis of variance for the difference in competency and ranking scores, no significant differences were identified between the different case versions across individual and global competency (P=.26 to P=.97) and ranking scores (P=.24 to P=.89). The initial tests of internal consistency for rank order among the 24 student participants were in the acceptable range (?=.78). Conclusions: The results suggest that MC-CAT is an internally valid tool to facilitate the evaluation of MC competencies among HCPs and is ready to undergo comprehensive psychometric property analyses with a national sample of health care providers. Once psychometric property assessments have been completed, this tool is expected to facilitate the assessment of MC skills among HCPs, skills that will better support patients in adopting healthier lifestyles, which will significantly reduce the personal, social, and economic burdens of noncommunicable chronic diseases. UR - https://mededu.jmir.org/2022/2/e31489 UR - http://dx.doi.org/10.2196/31489 UR - http://www.ncbi.nlm.nih.gov/pubmed/35749167 ID - info:doi/10.2196/31489 ER - TY - JOUR AU - Lin, Yuchen AU - Lemos, Martin AU - Neuschaefer-Rube, Christiane PY - 2022/4/27 TI - Digital Health and Learning in Speech-Language Pathology, Phoniatrics, and Otolaryngology: Survey Study for Designing a Digital Learning Toolbox App JO - JMIR Med Educ SP - e34042 VL - 8 IS - 2 KW - digital learning KW - mLearning KW - mHealth KW - speech-language pathology KW - phoniatrics KW - otolaryngology KW - communication disorders KW - mobile phone N2 - Background: The digital age has introduced opportunities and challenges for clinical education and practice caused by infinite incoming information and novel technologies for health. In the interdisciplinary field of communication sciences and disorders (CSD), engagement with digital topics has emerged slower than in other health fields, and effective strategies for accessing, managing, and focusing on digital resources are greatly needed. Objective: We aimed to conceptualize and investigate preferences of stakeholders regarding a digital learning toolbox, an app containing a library of current resources for CSD. This cross-sectional survey study conducted in German-speaking countries investigated professional and student perceptions and preferences regarding such an app?s features, functions, content, and associated concerns. Methods: An open web-based survey was disseminated to professionals and students in the field of CSD, including speech-language pathologists (SLPs; German: Logopäd*innen), speech-language pathology students, phoniatricians, otolaryngologists, and medical students. Insights into preferences and perceptions across professions, generations, and years of experience regarding a proposed app were investigated. Results: Of the 164 participants, an overwhelming majority (n=162, 98.8%) indicated readiness to use such an app, and most participants (n=159, 96.9%) perceived the proposed app to be helpful. Participants positively rated app functions that would increase utility (eg, tutorial, quality rating function, filters based on content or topic, and digital format); however, they had varied opinions regarding an app community feature. Regarding app settings, most participants rated the option to share digital resources through social media links (144/164, 87.8%), receive and manage push notifications (130/164, 79.3%), and report technical issues (160/164, 97.6%) positively. However, significant variance was noted across professions (H3=8.006; P=.046) and generations (H3=9.309; P=.03) regarding a username-password function, with SLPs indicating greater perceived usefulness in comparison to speech-language pathology students (P=.045), as was demonstrated by Generation X versus Generation Z (P=.04). Participants perceived a range of clinical topics to be important; however, significant variance was observed across professions, between physicians and SLPs regarding the topic of diagnostics (H3=9.098; P=.03) and therapy (H3=21.236; P<.001). Concerns included technical challenges, data protection, quality of the included resources, and sustainability of the proposed app. Conclusions: This investigation demonstrated that professionals and students show initial readiness to engage in the co-design and use of an interdisciplinary digital learning toolbox app. Specifically, this app could support effective access, sharing, evaluation, and knowledge management in a digital age of rapid change. Formalized digital skills education in the field of CSD is just a part of the solution. It will be crucial to explore flexible, adaptive strategies collaboratively for managing digital resources and tools to optimize targeted selection and use of relevant, high-quality evidence in a world of bewildering data. UR - https://mededu.jmir.org/2022/2/e34042 UR - http://dx.doi.org/10.2196/34042 UR - http://www.ncbi.nlm.nih.gov/pubmed/35475980 ID - info:doi/10.2196/34042 ER - TY - JOUR AU - White, A. Andrew AU - King, M. Ann AU - D?Addario, E. Angelo AU - Brigham, Berg Karen AU - Dintzis, Suzanne AU - Fay, E. Emily AU - Gallagher, H. Thomas AU - Mazor, M. Kathleen PY - 2022/4/29 TI - Video-Based Communication Assessment of Physician Error Disclosure Skills by Crowdsourced Laypeople and Patient Advocates Who Experienced Medical Harm: Reliability Assessment With Generalizability Theory JO - JMIR Med Educ SP - e30988 VL - 8 IS - 2 KW - medical error disclosure KW - simulation studies KW - communication assessment KW - graduate medical education KW - crowdsourcing KW - patient-centered care KW - generalizability theory KW - medical education KW - medical error KW - communication N2 - Background: Residents may benefit from simulated practice with personalized feedback to prepare for high-stakes disclosure conversations with patients after harmful errors and to meet American Council on Graduate Medical Education mandates. Ideally, feedback would come from patients who have experienced communication after medical harm, but medical researchers and leaders have found it difficult to reach this community, which has made this approach impractical at scale. The Video-Based Communication Assessment app is designed to engage crowdsourced laypeople to rate physician communication skills but has not been evaluated for use with medical harm scenarios. Objective: We aimed to compare the reliability of 2 assessment groups (crowdsourced laypeople and patient advocates) in rating physician error disclosure communication skills using the Video-Based Communication Assessment app. Methods: Internal medicine residents used the Video-Based Communication Assessment app; the case, which consisted of 3 sequential vignettes, depicted a delayed diagnosis of breast cancer. Panels of patient advocates who have experienced harmful medical error, either personally or through a family member, and crowdsourced laypeople used a 5-point scale to rate the residents? error disclosure communication skills (6 items) based on audiorecorded responses. Ratings were aggregated across items and vignettes to create a numerical communication score for each physician. We used analysis of variance, to compare stringency, and Pearson correlation between patient advocates and laypeople, to identify whether rank order would be preserved between groups. We used generalizability theory to examine the difference in assessment reliability between patient advocates and laypeople. Results: Internal medicine residents (n=20) used the Video-Based Communication Assessment app. All patient advocates (n=8) and 42 of 59 crowdsourced laypeople who had been recruited provided complete, high-quality ratings. Patient advocates rated communication more stringently than crowdsourced laypeople (patient advocates: mean 3.19, SD 0.55; laypeople: mean 3.55, SD 0.40; P<.001), but patient advocates? and crowdsourced laypeople?s ratings of physicians were highly correlated (r=0.82, P<.001). Reliability for 8 raters and 6 vignettes was acceptable (patient advocates: G coefficient 0.82; crowdsourced laypeople: G coefficient 0.65). Decision studies estimated that 12 crowdsourced layperson raters and 9 vignettes would yield an acceptable G coefficient of 0.75. Conclusions: Crowdsourced laypeople may represent a sustainable source of reliable assessments of physician error disclosure skills. For a simulated case involving delayed diagnosis of breast cancer, laypeople correctly identified high and low performers. However, at least 12 raters and 9 vignettes are required to ensure adequate reliability and future studies are warranted. Crowdsourced laypeople rate less stringently than raters who have experienced harm. Future research should examine the value of the Video-Based Communication Assessment app for formative assessment, summative assessment, and just-in-time coaching of error disclosure communication skills. UR - https://mededu.jmir.org/2022/2/e30988 UR - http://dx.doi.org/10.2196/30988 UR - http://www.ncbi.nlm.nih.gov/pubmed/35486423 ID - info:doi/10.2196/30988 ER - TY - JOUR AU - Ajab, Shereen AU - Pearson, Emma AU - Dumont, Steven AU - Mitchell, Alicia AU - Kastelik, Jack AU - Balaji, Packianathaswamy AU - Hepburn, David PY - 2022/5/9 TI - An Alternative to Traditional Bedside Teaching During COVID-19: High-Fidelity Simulation-Based Study JO - JMIR Med Educ SP - e33565 VL - 8 IS - 2 KW - simulation KW - high fidelity KW - low fidelity KW - COVID-19 KW - bedside teaching KW - undergraduate medical education KW - fidelity KW - medical education KW - medical student KW - review KW - innovation KW - risk KW - design KW - implementation N2 - Background: Bedside teaching is integral to medical education and has been highlighted to improve clinical and communication skills, as well as clinical reasoning. Despite the significant advantages of bedside teaching, its usage within medical education has been declining, and COVID-19 has added additional challenges. The pandemic has resulted in a significant reduction in opportunities to deliver bedside teaching due to risk of viral exposure, patients declining student interactions, and ward closures. Educators have therefore been required to be innovative in their teaching methods, leading to the use of online learning, social media platforms, and simulation. Simulation-based education allows for learning in a low-risk environment and affords the opportunity for deliberated repeated practice with case standardization. The results demonstrate that simulation-based training can increase students? confidence, increase the rates of correct clinical diagnoses, and improve retention of skills and knowledge when compared with traditional teaching methods. Objective: To mitigate the impact of COVID-19 upon bedside teaching for third year students at Hull York Medical School amid closure of the cardiorespiratory wards, a high-fidelity simulation-based model of traditional bedside teaching was designed and implemented. The objectives of the teaching session were to enable students to perform history taking and a focused cardiorespiratory clinical examination in a COVID-19?safe environment using SimMan 3G. Methods: Four clinical teaching fellows with experience of simulation-based medical education scripted histories for 2 common cardiorespiratory cases, which were asthma and aortic stenosis. The simulation sessions were designed for students to take a focused cardiorespiratory history and clinical examination using SimMan 3G. All cases involved dynamic vital signs, and the simulator allowed for auscultation of an ejection systolic murmur and wheezing in accordance with the cases chosen. Key aspects of the pathologies, including epidemiology, differential diagnoses, investigations, and management, were summarized using an interactive PowerPoint presentation, followed by a debriefing session. Results: In total, 12 third year medical students undertook the sessions, and overall feedback was highly positive. Of the 10 students who completed the feedback questionnaires, 90% (n=9) felt more confident in their clinical examination skills following the teaching; 100% (n=10) of the students responded that they would recommend the session to a colleague; and implementation of regular simulation was frequently requested on feedback. These results are in keeping with the current literature. Conclusions: Bedside teaching continues to face ongoing challenges from the COVID-19 pandemic as well as declining patient recruitment and fluctuations in clinical findings. The support for simulation-based medical education is derived from high-quality studies; however, studies describing the use of this technology for bedside teaching in the undergraduate curriculum are limited. The authors describe a highly effective teaching session amid the pandemic, which allowed for maintenance of staff and student safety alongside continued education during a challenging time for educators globally. UR - https://mededu.jmir.org/2022/2/e33565 UR - http://dx.doi.org/10.2196/33565 UR - http://www.ncbi.nlm.nih.gov/pubmed/35404828 ID - info:doi/10.2196/33565 ER - TY - JOUR AU - James, K. Hannah AU - Fawdington, A. Ross PY - 2022/6/29 TI - Freestyle Deliberate Practice Cadaveric Hand Surgery Simulation Training for Orthopedic Residents: Cohort Study JO - JMIR Med Educ SP - e34791 VL - 8 IS - 2 KW - simulation KW - high fidelity simulation KW - orthopedic residency KW - surgical training KW - postgraduate education KW - medical education KW - medical student KW - surgeon KW - hand KW - hand surgery KW - surgery KW - orthopedic KW - cadaver KW - cadaveric simulation KW - cadaveric KW - training KW - cadaveric training KW - DP KW - deliberate practice N2 - Background: Cadaveric simulation training may be part of the solution to reduced quantity and quality of operative surgical training in the modern climate. Cadaveric simulation allows the early part of the surgical learning curve to be moved away from patients into the laboratory, and there is a growing body of evidence that it may be an effective adjunct to traditional methods for training surgical residents. It is typically resource constrained as cadaveric material and facilities are expensive. Therefore, there is a need to be sure that any given cadaveric training intervention is maximally impactful. Deliberate practice (DP) theory as applied to cadaveric simulation training might enhance the educational impact. Objective: The objectives of this study were (1) to assess the impact of a freestyle DP cadaveric hand surgery simulation training intervention on self-reported operative confidence for 3 different procedures and (2) to assess the subjective transfer validity, perceived educational value, and simulation fidelity of the training. Methods: This study used validated questionnaires to assess the training impact on a cohort of orthopedic residents. The freestyle course structure allowed the residents to prospectively define personalized learning objectives, which were then addressed through DP. The study was conducted at Keele Anatomy and Surgical Training Centre, a medical school with an integrated cadaveric training laboratory in England, United Kingdom. A total of 22 orthopedic surgery residents of postgraduate year (PGY) 5-10 from 3 regional surgical training programs participated in this study. Results: The most junior (PGY 5-6) residents had the greatest self-reported confidence gains after training for the 3 procedures (distal radius open reduction internal fixation, flexor tendon repair, ulnar shortening osteotomy), and these gains diminished with resident seniority. The confidence gains were proportional to the perceived procedural complexity, with the most complex procedure having the lowest pretraining confidence score across all experience levels, and the greatest confidence increase in posttraining. Midstage (PGY 7-8) residents reported receiving the highest level of educational benefit from the training but perceived the simulation to be less realistic, compared to either the junior or senior residents. The most senior residents (PGY 9-10) reported the greatest satisfaction with the self-directed, freestyle nature of the training. All groups reported that they were extremely likely to transfer their technical skill gains to their workplace, that they would change their current practice based on these skills, and that their patients would benefit as a result of their having undertaken the training. Conclusions: Freestyle, resident-directed cadaveric simulation provides optimum DP conditions whereby residents can target their individualized learning needs. By receiving intensive, directed feedback from faculty, they can make rapid skill gains in a short amount of time. Subjective transfer validity potential from the training was very high, and objective, quantitative evidence of this is required from future work. UR - https://mededu.jmir.org/2022/2/e34791 UR - http://dx.doi.org/10.2196/34791 UR - http://www.ncbi.nlm.nih.gov/pubmed/35767315 ID - info:doi/10.2196/34791 ER - TY - JOUR AU - Guillaume, Dominique AU - Troncoso, Erica AU - Duroseau, Brenice AU - Bluestone, Julia AU - Fullerton, Judith PY - 2022/6/7 TI - Mobile-Social Learning for Continuing Professional Development in Low- and Middle-Income Countries: Integrative Review JO - JMIR Med Educ SP - e32614 VL - 8 IS - 2 KW - digital learning KW - continuing medical education KW - mHealth KW - peer learning KW - mentorship KW - health systems KW - global health KW - mobile phone N2 - Background: Access to continuing professional development (CPD) for health care workers in low- and middle-income countries (LMICs) is severely limited. Digital technology serves as a promising platform for supporting CPD for health care workers by providing educational content virtually and enabling virtual peer-to-peer and mentor interaction for enhanced learning. Digital strategies for CPD that foster virtual interaction can increase workforce retention and bolster the health workforce in LMICs. Objective: The objective of this integrative review was to evaluate the evidence on which digital platforms were used to provide CPD to health care workers and clinical students in LMICs, which was complemented with virtual peer-to-peer or mentor interaction. We phrased this intersection of virtual learning and virtual interaction as mobile-social learning. Methods: A comprehensive database and gray literature search was conducted to identify qualitative, quantitative, and mixed methods studies, along with empirical evidence, that used digital technology to provide CPD and virtual interaction with peers or mentors. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Eligible articles were written in English, conducted in an LMIC, and used a mobile device to provide CPD and facilitate virtual peer-to-peer or mentor interaction. Titles, abstracts, and full texts were screened, followed by an assessment of the quality of evidence and an appraisal of the articles. A content analysis was then used to deductively code the data into emerging themes. Results: A total of 750 articles were identified, and 31 (4.1%) were included in the review. SMS text messaging and mobile instant messaging were the most common methods used to provide continuing education and virtual interaction between peers and mentors (25/31, 81%). Across the included articles, participants had high acceptability for using digital platforms for learning and interaction. Virtual peer interaction and mentorship were found to contribute to positive learning outcomes in most studies (27/31, 87%) through increased knowledge sharing, knowledge gains, improved clinical skills, and improved service delivery. Peer-to-peer and mentor interaction were found to improve social support and reduce feelings of isolation (9/31, 29%). There were several challenges in the implementation and use of digital technology for mobile-social learning, including limited access to resources (eg, internet coverage and stable electricity), flexibility in scheduling to participate in CPD, and sociobehavioral challenges among students. Conclusions: The summary suggests that mobile-social learning is a useful modality for curriculum dissemination and skill training and that the interface of mobile and social learning serves as a catalyst for improved learning outcomes coupled with increased social capital. UR - https://mededu.jmir.org/2022/2/e32614 UR - http://dx.doi.org/10.2196/32614 UR - http://www.ncbi.nlm.nih.gov/pubmed/35671080 ID - info:doi/10.2196/32614 ER - TY - JOUR AU - Grunhut, Joel AU - Marques, Oge AU - Wyatt, M. Adam T. PY - 2022/6/7 TI - Needs, Challenges, and Applications of Artificial Intelligence in Medical Education Curriculum JO - JMIR Med Educ SP - e35587 VL - 8 IS - 2 KW - artificial intelligence KW - AI KW - medical education KW - medical student UR - https://mededu.jmir.org/2022/2/e35587 UR - http://dx.doi.org/10.2196/35587 UR - http://www.ncbi.nlm.nih.gov/pubmed/35671077 ID - info:doi/10.2196/35587 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 - 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 -