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Technology, innovation, and openness in medical education in the information age.

Latest Submissions Open for Peer Review

JMIR has been a leader in applying openness, participation, collaboration and other "2.0" ideas to scholarly publishing, and since December 2009 offers open peer review articles, allowing JMIR users to sign themselves up as peer reviewers for specific articles currently considered by the Journal (in addition to author- and editor-selected reviewers). Note that this is a not a complete list of submissions as authors can opt-out. The list below shows recently submitted articles where submitting authors have not opted-out of open peer-review and where the editor has not made a decision yet. (Note that this feature is for reviewing specific articles - if you just want to sign up as reviewer (and wait for the editor to contact you if articles match your interests), please sign up as reviewer using your profile).
To assign yourself to an article as reviewer, you must have a user account on this site (if you don't have one, register for a free account here) and be logged in (please verify that your email address in your profile is correct). Add yourself as a peer reviewer to any article by clicking the '+Peer-review Me!+' link under each article. Full instructions on how to complete your review will be sent to you via email shortly after. Do not sign up as peer-reviewer if you have any conflicts of interest (note that we will treat any attempts by authors to sign up as reviewer under a false identity as scientific misconduct and reserve the right to promptly reject the article and inform the host institution).
The standard turnaround time for reviews is currently 2 weeks, and the general aim is to give constructive feedback to the authors and/or to prevent publication of uninteresting or fatally flawed articles. Reviewers will be acknowledged by name if the article is published, but remain anonymous if the article is declined.
The abstracts on this page are unpublished studies - please do not cite them (yet). If you wish to cite them/wish to see them published, write your opinion in the form of a peer-review!

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JMIR Submissions under Open Peer Review

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Titles/Abstracts of Articles Currently Open for Review

Titles/Abstracts of Articles Currently Open for Review:

  • Trends in the Japanese National Medical Licensing Examination: A Cross-sectional Study

    Date Submitted: May 28, 2025
    Open Peer Review Period: May 29, 2025 - Jul 24, 2025

    Background: The Japanese National Medical Licensing Examination (NMLE) is mandatory for all medical graduates to become licensed physicians in Japan. Given the cultural emphasis on summative assessment, the NMLE has had a significant impact on Japanese medical education. Although the NMLE Content Guidelines have been revised approximately every five years over the last two decades, there is an absence of objective literature analyzing how the actual exam itself has evolved. Objective: To provide a holistic view of the trends of the actual exam over time, this study used a combined rule-based and data-driven approach. We primarily focused on classifying the questions according to the perspectives outlined in the NMLE Content Guidelines, while complementing this approach with a natural language processing technique called topic modeling to identify latent topics. Methods: Publicly available NMLE data from 2001 to 2024 were collected. Six exam iterations (2,880 questions) were manually classified from three perspectives (Level, Content, and Taxonomy) based on pre-established rules derived from the guidelines. Temporal trends within each classification were evaluated using the Cochran-Armitage test. Additionally, topic modeling was conducted for all 24 exam iterations (11,540 questions) using the BERTopic framework. The temporal trends of each topic were traced using linear regression models of topic frequencies to identify topics growing in prominence. Results: In Level classification, the proportion of questions addressing common or emergent diseases increased from 60% to 76% (p < 0.001). In Content classification, the proportion of questions assessing knowledge of pathophysiology decreased from 52% to 33% (p < 0.001), whereas the proportion assessing practical knowledge of primary emergency care increased from 20% to 29% (p < 0.001). In Taxonomy classification, the proportion of questions that could be answered solely through simple recall of knowledge decreased from 51% to 30% (p < 0.001), while the proportion assessing advanced analytical skills, such as interpreting and evaluating the meaning of each answer choice according to the given context, increased from 4% to 19% (p < 0.001). Topic modeling identified 25 distinct topics, and 10 topics exhibited an increasing trend. Non-organ-specific topics with notable increases included “Comprehensive Clinical Questions,” “Accountability in Medical Practice and Patients’ Rights,” “Care, Daily Living Support, and Community Healthcare,” and “Infection Control and Safety Management in Basic Clinical Procedures.” Conclusions: This study identified significant shifts in the Japanese NMLE over the past two decades, suggesting that Japanese undergraduate medical education is evolving to place greater importance on practical problem-solving abilities than on rote memorization. This study also identified latent topics that showed an increase, possibly reflecting underlying social conditions. Clinical Trial: NA

  • Background: Performing a radial artery puncture is often stressful for medical students due to the risk of causing significant pain. Objective: This study evaluated whether a structured training programme—combining theoretical instruction, simulation-based practice, and debriefing—could influence students’ procedural confidence, decision-making, and patient experience during their first clinical arterial puncture. Methods: Third-year medical students who had never performed an arterial puncture were assigned to one of two groups: a structured training group (G1) or a control group receiving informal or no specific training (G2). After performing their first arterial puncture under supervision, students completed a questionnaire assessing apprehension, satisfaction, and confidence. The decision to use local anaesthesia, puncture success, and patient-rated pain and apprehension were also recorded. Results: Self-reported apprehension and confidence were similar between groups. However, G1 students were significantly less likely to use local anaesthesia compared to G2 students (35% vs. 76%; p = 0.0033), suggesting greater procedural confidence. First-attempt success rates were comparable (G1: 23%; G2: 48%; p = 0.18). Patient pain ratings were lower when anaesthesia was used, but the difference was not statistically significant. Conclusions: Structured training influenced students’ behaviour during their first arterial puncture, reducing reliance on anaesthesia despite similar levels of self-reported apprehension. These findings support the behavioural impact of structured procedural education and call for future research using validated assessment tools and long-term follow-up. Clinical Trial: This study was conducted in hospitals affiliated with the Faculté de Santé Sorbonne Université, one of the medical schools in the Paris area. It was approved by the institutional review board of the Institut National de la Santé et de la Recherche Médicale (CEEI, reference IRB00003888).

  • Background: The rise of generative artificial intelligence (gAI) has created both opportunities and challenges in higher education. Although the potential benefits of learning support are widely recognized, little is known about how incoming medical students in Japan perceive and intend to use such technology. Objective: This study investigated the status of gAI usage, learning behaviors, and perceptions of first-year medical students in Japan. Methods: An anonymous online survey was conducted among 118 first-year medical students at Chiba University in April 2025. The questionnaire assessed prior gAI use, willingness to learn, perceptions of gAI, and the intention to use it academically. Likert scales, correlation analyses, and content analyses of free-text responses were used. Results: Of the respondents, 84.7% had prior experience with the gAI, primarily in language learning and information gathering. However, only 49.2% had learning experiences, mostly through informal sources, such as web browsing and peer interaction. Students showed a high willingness to learn about gAI (mean score: 4.3/5.0), which correlated with positive perceptions. Despite this interest, attitudes toward using gAI for academic assignments were neutral (mean 3.0/5.0). Content analysis of the open-ended responses revealed three types of attitudes: positive, cautious, and negative. Conclusions: Although most students used the gAI, their limited exposure to formal learning suggests that self-directed experience alone may not foster confidence or informed use. Neutral attitudes and mixed qualitative responses highlighted the need for structured gAI literacy education that balances the benefits of ethical and critical considerations in medical education.

  • Impact of peer supervision by pharmacy students on admission medication reconciliation: a pre-post study.

    Date Submitted: May 16, 2025
    Open Peer Review Period: May 20, 2025 - Jul 15, 2025

    Background: Although the medication reconciliation is known to reduce the frequency of medication errors, its practical implementation can be challenging in several respects. In our institution, pharmacy students perform admission medication reconciliations under the supervision of a pharmacist or pharmacy resident. Objective: The objective of the present study was to establish the feasibility of peer supervision (i.e. the supervision by a pharmacy student of a medication reconciliation performed by another pharmacy student) in terms of the quality and efficiency of admission medication reconciliations. Methods: A prospective, single-center, observational study was conducted in two clinical departments at Lille University Medical Center (Lille, France). Initially, organizational procedures were defined and a checklist for reconciliation supervision was developed. A baseline (reference) time period without peer supervision was compared with an implementation period with peer supervision. Results: A total of 317 medication reconciliations were conducted: 102 without supervision and 215 with supervision by a pharmacy student. Peer supervision reduced the pharmacist time required for this task by half: the mean time fell from 23 to 11 minutes. Furthermore, peer supervision was associated with a decrease in the number of errors made by students (from 1.5 to 0.9 per reconciliation) and detected by pharmacists during the reconciliation validation. Conclusions: Student peer validation appears to be an innovative, strategic method for optimizing medication reconciliations, freeing up pharmacist time, and leveraging the skills of pharmacy students.

  • Background: Clinical reasoning is a key skill of the medical profession. In many virtual patient environments, the students enter the diagnoses, and all students receive the same feedback with an explanation why a certain diagnosis is considered correct. Results of meta-analyses highlight the benefits of feedbacking information to students based on their individual answers. Such adaptive feedback is time and resource demanding. Objective: We propose computer-supported adaptive feedback as an interactive, resource-optimised and scalable alternative. Methods: In the current study we compare static expert feedback agains computer supported adaptive feedback in two learning modes, individual and collaborative learning modes. Overall 105 students completed a pre and post test, consisting of 10 multiple choice items and 12 key feature items. In the meantime they diagnosed 8 virtual patients with either adaptive feedback or static feedback, either in the collaborative or individual learning mode. Results: Results indicate that students who received computer supported adaptive feedback outperformed students who received static feedback in the posttest independent from the learning mode. Students who worked in the collaborative learning mode had a higher diagnostic accuracy in the learning phase, but not in the posttest, independent from the feedback given. Conclusions: Considering the novelty of the system in itself and the presentation of the adaptive feedback to the students the results are promising. With future development and implementation of artificial intelligence in the generation of answers the learning of medical students. Until then an NLP-based system, such as the one presented in this study, seems to be a viable solution to provide a large number of students with elaborated adaptive feedback. Clinical Trial: 17-250

  • Background: Global health-care education that cultivates international orientation is important for providing medical care in consideration of diverse backgrounds and collaboration with foreign medical professionals. Virtual international exchange programs could be a new type of global education in the present post-pandemic era. Objective: This study aimed to examine the effectiveness of a virtual international exchange program in fostering global quality including academic and professional learning as well as international orientation from student perspectives across five countries. This research is expected to contribute to education for the development of global human resources in health professions. Methods: This intervention research used a convergent parallel mixed-method design. In the this research, five days interactive virtual program was provided to occupational therapy students from Bangladesh, Indonesia, Japan, Philippine and Thailand. The research participants were asked about their program expectations and international orientation before the program, and program evaluations and international orientation after the program. Numerical data of questionnaire on program expectations/evaluations were analyzed using descriptive statistics. Qualitative data of questionnaire on international orientation were subjected to Steps for Coding and Theorization (SCAT). Results: 12 students answered questionnaires both before and after the program.　Overall, the students’ expectations of the program were met in terms of expertise, scientific learning skills, and group interactions. They were motivated by vague interests before the program, but after the program, reported having a more concrete image and specific form of what they learned from an international perspective. The participants enjoyed communication with others from diverse backgrounds even though recognizing the difficulty of understanding different values. They also expressed satisfaction with their understanding of occupational therapy professionals and diverse societies, including medical systems from other countries. Conclusions: These findings indicate that the program provided the participants with valuable opportunities for cultivating global qualities such as problem-finding/-solving and interactions with groups with diverse backgrounds. Clinical Trial: UMIN-Clinical Trials registry system (ID: R000061896)

  • Background: The anesthesia and critical care residency program in Morocco is a four-year, time-based training program whose effectiveness is evaluated in our study through the performance of residents and the factors affecting it, based on the core competencies established by the Moroccan Board of Anesthesiology and Critical Care (MBACC). Objective: To describe anesthesia and critical care residents’ performance and its affecting factors. Methods: We conducted a single-center prospective survey in January 2024, using a self-assessment questionnaire of technical skills related to residents' practice. For each skill, we addressed questions quantifying a given item's difficulty or success rate. An overall performance composite score was calculated based on the scores obtained for each skill assessed. A multivariate analysis was performed to determine the factors affecting this performance. Results: We included 66 residents. Their end-of-course overall performance met MBACC requirements at the end of the curriculum (72.3 [68.5-75.7] for a maximum score of 100), with a progression marked by a plateau between the second and third year. Multivariate analysis identified a prior experience to residency, shift leadership, and the number of patients anesthetized per day as factors improving the overall performance, while critical care-induced stress, shift-induced stress, and the number of shifts per week reduced performance. Conclusions: The progression of residents' overall performance is eligible for optimization through an introduction to critical care, notably via simulation, to reduce the stress during practice and acquire sufficient experience to occupy a chief position during shifts while limiting the number of weekly shifts. The formulation of recommendations requires a higher level of proof, which implies an external confirmatory study on a multi-center scale.

  • Background: Patient safety remains a global priority, with preventable adverse events—often caused by communication failures among healthcare professionals—posing serious risks. Interprofessional education (IPE) is a promising strategy to improve collaboration and communication, thereby enhancing care quality and patient outcomes. While IPE has been widely studied in student populations, limited evidence exists regarding its implementation and effectiveness for licensed rehabilitation professionals such as physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs). Objective: This scoping review aimed to comprehensively map the implementation, content, and effects of interprofessional education (IPE) targeting groups including licensed physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs). Methods: This scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review guidelines. Searches were performed using PubMed, Web of Science, CINAHL, MEDLINE, and ERIC databases, targeting studies published up to March 2024. The study population consisted of licensed PTs, OTs, and SLPs. Regarding concept, we targeted studies in which IPE was provided to groups with at least one licensed PT, OT, or SLP. Regarding context, we included studies reporting the effects of IPE in clinical settings. Controlled vocabulary (e.g., MeSH) for terms such as IPE, PT, OT, and SLP was used to develop the search strategy. Eight reviewers extracted data and identified eligible studies. Results: Of the 3,389 records identified, eight were included. Mapping revealed that IPE implementation primarily involved lectures, discussions, and team-based practices. The content covered theories and concepts, treatment, and workplace problem-solving. Regarding effects, the results demonstrated that IPE improved role understanding, collaboration skills, knowledge, and confidence in the long term. However, simulation training did not improve interprofessional attitudes or network expansion. Conclusions: IPE targeting licensed PTs, OTs, and SLPs was structured in a way that combined multiple implementation methods to enable comprehensive learning, with the content adjusted to meet participant needs. Future studies should consider systematic reviews and meta-analyses to identify recommended combinations of IPE implementation and content. Clinical Trial: Not applicable.

  • Background: Gender-based violence (GBV) is a public health issue affecting one in three women globally. Its impact on women's health is challenging, including physical, mental, and social consequences. Healthcare professionals have a unique opportunity in identifying and supporting GBV victims, but a well-known lack of adequate training. Objective: This study aims to develop educational resources using virtual reality scenarios to be used with problem-based and experiential learning approaches for health sciences students to enhance their skills in addressing GBV. Methods: A co-creation process was used to develop the educational resources with a qualitative approach. A focus group of six experienced professionals was carried out, in order to identify key learning needs and common GBV cases. Finally, four scenarios were created following four different main topics: pregnancy-related violence, drug addiction, psychological abuse in elderly women, and vicarious violence. These scenarios were recorded in 360º video format and accompanied by learning guides. Results: The focus group analysis led to the identification of 18 learning needs across nine categories. The four VR scenarios were designed to cover critical GBV situations, fostering transversal skills as empathic communication, ethical decision-making, and interdisciplinary collaboration. Two didactic methodologies were proposed: a problem-based learning sequence and a single-session experiential learning approach, both orientated towards promoting active involvement and critical thinking. Conclusions: The co-creation method and focus group understanding ensured the resources' applicability and reliability. The VR scenarios fulfil the gap between theory and practice, providing an innovative approach to GBV education for health sciences students.

  • Background: Students pursuing health professional education, are preparing for professions where they will interact with people in vulnerable life situations. Therefore, it is crucial that these students develop knowledge and skills in interaction, communication, and guidance during their education. In the context of health professions, this can be described as developing therapeutic competencies. Utilizing virtual learning environments, 360-degree video, and VR technology, the resource allows students to explore, observe, and practice therapeutic conversations in a safe setting. Objective: This study explores the use of a virtual learning resource in the development of therapeutic competence among students training to become health care professionals. Methods: The study was set up using an approach inspired by action research, in the sense that researchers have been closely involved in the development and testing process. An important prerequisite was to facilitate systematic development and improvement based on students' experiences with using the learning resource. The testing of the learning resource was conducted with two different test groups, recruited from study program leaders at a faculty of health science. A total of twelve students participated. The students were interviewed in focus groups. Results: The results indicated that students experienced increased engagement and learning outcomes compared to traditional teaching methods. They reported that the interactive approach provided a deeper understanding of complex topics, such as legislative frameworks and therapeutic practice, and that the resource promoted the development of practical skills. Conclusions: The study concludes that VR technology can be valuable in healthcare education, helping to prepare students for challenges in professional practice.

  • Comparing ChatGPT and DeepSeek in Evaluating Multiple-choice Questions for Orthopedic Medical Education

    Date Submitted: Apr 7, 2025
    Open Peer Review Period: Apr 7, 2025 - Jun 2, 2025

    Background: With the advent of artificial intelligence (AI), large language models (LLMs), such as ChatGPT and DeepSeek, have emerged as potential tools for evaluating multiple-choice-question (MCQ) accuracy and efficiency. Objective: This study compared the performance of ChatGPT and DeepSeek in terms of correctness, response time, and reliability when answering multiple-choice questions (MCQs) from an orthopedic examination for medical students. Methods: This cross-sectional study included 209 orthopedic MCQs. ChatGPT (including the "Reason" function) and DeepSeek (including the "DeepThink" function) were used to identify the correct answers. Correctness and response times were recorded and compared using the chi-square test and Mann-Whitney U test where appropriate. The two AI models’ reliability was assessed using Cohen’s kappa coefficient. The MCQs for which all methods provided false answers were suspended for the next semester and reviewed by the orthopedic faculty. Results: ChatGPT achieved a correctness rate of 80.38%, while DeepSeek achieved 74.16% (p < 0.01). ChatGPT’s "Reason" function also outperformed DeepSeek’s "DeepThink" function (84.69% vs. 80.38%; p < 0.01). The average response time for ChatGPT was 10.40 ± 13.29 seconds, significantly shorter than DeepSeek’s 34.42 ± 25.48 seconds (p < 0.01). A completely false response by all methods was recorded in 7.66% of cases. Regarding reliability, ChatGPT demonstrated an almost perfect agreement (kappa = 0.81), whereas DeepSeek showed substantial agreement (kappa = 0.78). Conclusions: ChatGPT outperformed DeepSeek regarding correctness and response time, demonstrating its efficiency in evaluating orthopedic MCQs. This high reliability suggests its potential for integration into medical assessments. However, some MCQs required revisions to improve their clarity. Further studies are needed to evaluate AI’s role in other disciplines. Clinical Trial: Not applicable