@Article{info:doi/10.2196/66988,
author="Jitwiriyanont, Sujinat
and Rawan, Rattanasuwan
and Narajeenron, Khuansiri",
title="Advancing Politeness and Assertive Communication Through Tone of Voice in Crisis Team Situations: Pre-Post Acoustic Analysis Study of Team and Strategies to Enhance Performance and Patient Safety (TeamSTEPPS) Virtual Simulation for Interprofessional Education in Health Care Undergraduate Students",
journal="J Med Internet Res",
year="2025",
month="Apr",
day="21",
volume="27",
pages="e66988",
keywords="virtual simulation",
keywords="TeamSTEPPS",
keywords="acoustic analysis",
keywords="prosodic features",
keywords="interprofessional education",
keywords="politeness, assertive communication, tone of voice, confident, respect",
abstract="Background: Effective interprofessional communication, including politeness, respect for coworkers, and self-control, is crucial in emergency care. These values are emphasized by both Thai and US cultures. Notably, nurses place greater significance on respect and self-control than physicians, underscoring the need for physicians to recognize and adopt these attributes, especially in interactions with nursing staff. To develop these competencies, interprofessional education (IPE) programs are essential, with simulation-based IPE, particularly virtual simulations, showing promise in enhancing teamwork and communication. However, research on the tone of voice in emergency communication is limited, especially in Thailand, where standardized IPE curricula are lacking. Objective: This study aimed to assess the effectiveness of Team and Strategies to Enhance Performance and Patient Safety (TeamSTEPPS) virtual simulation IPE, using a 3D computer-based or virtual reality (VR) approach, in enhancing interprofessional communication among health care students, focusing on politeness and assertiveness in the tone of voice. Methods: An experimental design was used with 30 health care students from 5 disciplines, including medical, nursing, medical technology, radiological technology, and pharmacy students. Participants were recorded during pretraining and posttraining TeamSTEPPS sessions. Acoustic analysis focused on 3 cues: duration, intensity, and fundamental frequency (F0). Duration measured the length of utterances, whereas intensity (loudness) and F0 (pitch) were analyzed using parameters, such as maximum, minimum, mean, SD, and range. In total, 5663 utterances were analyzed, providing a dataset for identifying significant shifts in vocal delivery after training. Using the Wilcoxon signed-rank test, these 11 acoustic parameters were extracted and statistically analyzed to compare pre- and posttraining differences. Results: Significant improvements in the tone of voice were observed. Medical and nursing students exhibited changes in pitch (SD and mean of F0; P<.001) and loudness (mean of intensity, P<.001), suggesting more attentive communication. The increased utterance duration in core team members suggests that they engaged in more elaborate information sharing and verification, critical for patient safety. Medical technology and radiological technology students showed reduced pitch (mean of F0; P<.05 in medical technology students and P<.01 in radiological students) and intensity (mean of intensity; P<.01 in medical technology students), reflecting calmer, more controlled communication. Pharmacy students showed minor changes. Conclusions: TeamSTEPPS virtual simulation IPE, using a 3D computer-based or VR approach, effectively enhances interprofessional nonverbal communication by improving key acoustic features related to politeness and assertiveness within the Thai culture context. Medical and nursing students showed the most notable gains, whereas quieter more controlled communication styles emerged among the other groups. The results demonstrate the ways in which vocal modulations can reflect role-specific responsibilities and interpersonal sensitivity in clinical interactions. These findings highlight the significance of tailored virtual simulation IPE programs for improving teamwork and patient outcomes across health care disciplines. ",
doi="10.2196/66988",
url="https://www.jmir.org/2025/1/e66988"
}


@Article{info:doi/10.2196/65779,
author="Muthukumar, Radhakrishnan
and Thepwongsa, Isaraporn
and Sripa, Poompong
and Jindawong, Bangonsri
and Jenwitheesuk, Kamonwan
and Virasiri, Surapol",
title="Preclinical Medical Students' Perspectives and Experiences With Structured Web-Based English for Medical Purposes Courses: Cross-Sectional Study",
journal="JMIR Med Educ",
year="2025",
month="Mar",
day="27",
volume="11",
pages="e65779",
keywords="English for medical purposes",
keywords="online course",
keywords="online learning",
keywords="online education",
keywords="medical students",
keywords="medical school",
keywords="online",
keywords="online learners",
keywords="perspectives",
keywords="English",
keywords="English language",
keywords="medical research",
keywords="educational method",
keywords="lesson",
keywords="course",
keywords="instructional designs",
keywords="English for medical professional",
keywords="EMP",
keywords="barriers",
keywords="web-based",
abstract="Background: English for medical purposes (EMP) is essential for medical students as it serves as a foundational language for medical communication and education. However, students often undervalue its importance within the medical curriculum. Given their demanding schedules and workload, educational methods for EMP must align with their needs. Structured web-based learning offers flexibility and convenience, yet limited research has explored its exclusive application for EMP in undergraduate medical education. Objective: This study aimed to evaluate medical students' perspectives on structured web-based EMP courses and assess their impact on medical English proficiency using objective and subjective measures. Methods: Structured web-based EMP courses were developed based on evidence-based guidelines, addressing barriers to web-based learning during development and implementation. A cross-sectional study was conducted with 535 medical students who completed these courses. Data were collected via questionnaires, the learning management system, and the Khon Kaen University Medical English Test (KKUMET), which assessed proficiency in listening, reading, writing, and speaking. Data were analyzed using descriptive statistics. Results: Of the 535 students, 452 (84.5\%) completed the survey. Participants reported confidence in reading (mean 4.11, SD 0.87), vocabulary (mean 4.04, SD 0.84), and listening skills (mean 4, SD 0.89), but lower confidence in writing skills (mean 3.46, SD 1.07). The KKUMET results showed statistically significant improvements in all 4 language skills after course completion (P<.001). The top-rated benefits of the courses were convenience (mean 4.77, SD 0.59), sufficient instruction (mean 4.5, SD 0.85), and clear content (mean 4.41, SD 0.80). Conclusions: Structured web-based EMP courses are relevant and well received by medical students. These courses significantly improve students' medical English proficiency, as evidenced by both subjective feedback and objective measures. Medical educators should consider integrating structured web-based EMP programs to better support students' language proficiency in medical contexts. ",
doi="10.2196/65779",
url="https://mededu.jmir.org/2025/1/e65779"
}


@Article{info:doi/10.2196/67673,
author="Little, R. Jeanette
and Rivera-Nichols, Triana
and Pavliscsak, H. Holly
and Badawi, Omar
and Gaudaen, C. James
and Yeoman, R. Chevas
and Hall, S. Todd
and Quist, T. Ethan
and Stoor-Burning, L. Ericka",
title="Demonstrating Tactical Combat Casualty Care in Simulated Environments to Enable Passive, Autonomous Documentation: Protocol for a Prospective Simulation-Based Study",
journal="JMIR Res Protoc",
year="2025",
month="Mar",
day="17",
volume="14",
pages="e67673",
keywords="tactical combat casualty care",
keywords="TCCC, automation",
keywords="medical documentation",
keywords="DD form 1380",
keywords="combat casualty care",
keywords="artificial intelligence",
keywords="AI",
keywords="machine learning",
keywords="ML",
keywords="point of injury",
keywords="POI",
keywords="simulation",
keywords="military health",
keywords="passive data collection",
keywords="sensors",
keywords="algorithms",
keywords="medical record",
abstract="Background: The Telemedicine \& Advanced Technology Research Center (TATRC) commenced a new research portfolio specifically addressing Autonomous Casualty Care (AC2) in 2023. The first project within this portfolio addresses the current and historical challenges of capturing tactical combat casualty care (TCCC) data in operational settings. Objective: The initial autonomous casualty care effort, the Passive Data Collection using Autonomous Documentation research project, conducts systematic, simulated patient and casualty care scenarios, leveraging suites of passive sensor inputs to populate a data repository that will automate future combat care. Methods: To obtain the required datasets, TATRC will engage care provider participants who provided consent in one of 6 randomized simulated TCCC scenarios leveraging an institutional review board--approved office protocol (\#M-11057). These simulations will leverage mannikins (low and high fidelity) and live simulated patients (eg, human actors who provided consent). All consenting participants (eg, both the care providers and live simulated patients) will be equipped with suites of sensors that will passively collect data on care delivery actions and patient physiology. Simulated data is being collected at Fort Detrick, Maryland; Fort Sam Houston, Texas; Fort Indiantown Gap, Pennsylvania; Fort Liberty, North Carolina; and a commercial site in Greenville, North Carolina. Results: Across all research locations, TATRC will collect and annotate approximately 2500 simulation procedures tasks by March 2025. These study data will generate the first machine learning and artificial intelligence algorithms to populate Department of Defense (DD) Form 1380 fields accurately and reliably. Additional data collected past March 2025 will be used to continue to refine and mature the algorithm. Conclusions: The military health care system (MHS) lacks real-world datasets for TCCC care at the point of injury. Developing a data repository of simulated TCCC data is required as an essential step toward automating TCCC care. If TATRC's research efforts result in the ability to automate care delivery documentation, this will alleviate the cognitive burden of TCCC care providers in austere, chaotic environments. By generating a TCCC data repository through this Autonomous Documentation research project, TATRC will have opportunities to leverage this research data to create machine learning and artificial intelligence models to advance passive, automated medical documentation across the health care continuum. International Registered Report Identifier (IRRID): DERR1-10.2196/67673 ",
doi="10.2196/67673",
url="https://www.researchprotocols.org/2025/1/e67673"
}


@Article{info:doi/10.2196/63708,
author="Davoody, Nadia
and Stathakarou, Natalia
and Swain, Cara
and Bonacina, Stefano",
title="Exploring the Impact of the COVID-19 Pandemic on Learning Experience, Mental Health, Adaptability, and Resilience Among Health Informatics Master's Students: Focus Group Study",
journal="JMIR Med Educ",
year="2025",
month="Feb",
day="10",
volume="11",
pages="e63708",
keywords="COVID-19 pandemic",
keywords="eHealth",
keywords="blended learning",
keywords="health informatics",
keywords="higher education adaptation",
abstract="Background: The shift to online education due to the COVID-19 pandemic posed significant challenges and opportunities for students, affecting their academic performance, mental well-being, and engagement. Objective: This study aimed to explore the overall learning experience among health informatics master's students at Karolinska Institutet, Sweden, and the strategies they used to overcome learning challenges posed by the COVID-19 pandemic. Methods: Through 3 structured focus groups, this study explored health informatics master's students' experiences of shifting learning environments for classes that started in 2019, 2020, and 2021. All focus group sessions were recorded and transcribed verbatim. Inductive content analysis was used to analyze the data. Results: The results highlight the benefits of increased autonomy and flexibility and identify challenges such as technical difficulties, diminished social interactions, and psychological impacts. This study underscores the importance of effective online educational strategies, technological preparedness, and support systems to enhance student learning experiences during emergencies. The findings of this study highlight implications for educators, students, and higher education institutions to embrace adaptation and foster innovation. Implications for educators, students, and higher education institutions include the need for educators to stay current with the latest educational technologies and design teaching strategies and pedagogical approaches suited to both online and in-person settings to effectively foster student engagement. Students must be informed about the technological requirements for online learning and adequately prepared to meet them. Institutions play a critical role in ensuring equitable access to technology, guiding and supporting educators in adopting innovative tools and methods, and offering mental health resources to assist students in overcoming the challenges of evolving educational environments. Conclusions: This research contributes to understanding the complexities of transitioning to online learning in urgent circumstances and offers insights for better preparing educational institutions for future pandemics. ",
doi="10.2196/63708",
url="https://mededu.jmir.org/2025/1/e63708"
}


@Article{info:doi/10.2196/65146,
author="Yang, Zhichao
and Yao, Zonghai
and Tasmin, Mahbuba
and Vashisht, Parth
and Jang, Seok Won
and Ouyang, Feiyun
and Wang, Beining
and McManus, David
and Berlowitz, Dan
and Yu, Hong",
title="Unveiling GPT-4V's hidden challenges behind high accuracy on USMLE questions: Observational Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="7",
volume="27",
pages="e65146",
keywords="artificial intelligence",
keywords="natural language processing",
keywords="large language model",
keywords="LLM",
keywords="ChatGPT",
keywords="GPT",
keywords="GPT-4V",
keywords="USMLE",
keywords="Medical License Exam",
keywords="medical image interpretation",
keywords="United States Medical Licensing Examination",
keywords="NLP",
abstract="Background: Recent advancements in artificial intelligence, such as GPT-3.5 Turbo (OpenAI) and GPT-4, have demonstrated significant potential by achieving good scores on text-only United States Medical Licensing Examination (USMLE) exams and effectively answering questions from physicians. However, the ability of these models to interpret medical images remains underexplored. Objective: This study aimed to comprehensively evaluate the performance, interpretability, and limitations of GPT-3.5 Turbo, GPT-4, and its successor, GPT-4 Vision (GPT-4V), specifically focusing on GPT-4V's newly introduced image-understanding feature. By assessing the models on medical licensing examination questions that require image interpretation, we sought to highlight the strengths and weaknesses of GPT-4V in handling complex multimodal clinical information, thereby exposing hidden flaws and providing insights into its readiness for integration into clinical settings. Methods: This cross-sectional study tested GPT-4V, GPT-4, and ChatGPT-3.5 Turbo on a total of 227 multiple-choice questions with images from USMLE Step 1 (n=19), Step 2 clinical knowledge (n=14), Step 3 (n=18), the Diagnostic Radiology Qualifying Core Exam (DRQCE) (n=26), and AMBOSS question banks (n=150). AMBOSS provided expert-written hints and question difficulty levels. GPT-4V's accuracy was compared with 2 state-of-the-art large language models, GPT-3.5 Turbo and GPT-4. The quality of the explanations was evaluated by choosing human preference between an explanation by GPT-4V (without hint), an explanation by an expert, or a tie, using 3 qualitative metrics: comprehensive explanation, question information, and image interpretation. To better understand GPT-4V's explanation ability, we modified a patient case report to resemble a typical ``curbside consultation'' between physicians. Results: For questions with images, GPT-4V achieved an accuracy of 84.2\%, 85.7\%, 88.9\%, and 73.1\% in Step 1, Step 2 clinical knowledge, Step 3 of USMLE, and DRQCE, respectively. It outperformed GPT-3.5 Turbo (42.1\%, 50\%, 50\%, 19.2\%) and GPT-4 (63.2\%, 64.3\%, 66.7\%, 26.9\%). When GPT-4V answered correctly, its explanations were nearly as good as those provided by domain experts from AMBOSS. However, incorrect answers often had poor explanation quality: 18.2\% (10/55) contained inaccurate text, 45.5\% (25/55) had inference errors, and 76.3\% (42/55) demonstrated image misunderstandings. With human expert assistance, GPT-4V reduced errors by an average of 40\% (22/55). GPT-4V accuracy improved with hints, maintaining stable performance across difficulty levels, while medical student performance declined as difficulty increased. In a simulated curbside consultation scenario, GPT-4V required multiple specific prompts to interpret complex case data accurately. Conclusions: GPT-4V achieved high accuracy on multiple-choice questions with images, highlighting its potential in medical assessments. However, significant shortcomings were observed in the quality of explanations when questions were answered incorrectly, particularly in the interpretation of images, which could not be efficiently resolved through expert interaction. These findings reveal hidden flaws in the image interpretation capabilities of GPT-4V, underscoring the need for more comprehensive evaluations beyond multiple-choice questions before integrating GPT-4V into clinical settings. ",
doi="10.2196/65146",
url="https://www.jmir.org/2025/1/e65146"
}


@Article{info:doi/10.2196/59552,
author="Iembo, Tatiane
and Crist{\'o}v{\~a}o, Gon{\c{c}}alves Helena Landim
and Santos, dos Emerson Roberto
and Crist{\'o}v{\~a}o, Gon{\c{c}}alves Andr{\'e} Bavaresco
and Crist{\'o}v{\~a}o, Gon{\c{c}}alves Nath{\'a}lia Bavaresco
and Martins, Canato C{\'i}ntia
and Castro, Rodrigues Nat{\'a}lia Almeida de Arnaldo Silva
and Facio J{\'u}nior, Nestor Fernando
and Oliani, H{\'e}lio Ant{\^o}nio
and Lima, Abreu Alba Regina de
and Brienze, Sabadoto V{\^a}nia Maria
and Souza, Silva Doroteia Rossi
and Andr{\'e}, C{\'e}sar J{\'u}lio",
title="Challenges and Strategies Adopted for Remote Teaching of Biochemistry During the COVID-19 Pandemic: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2025",
month="Jan",
day="31",
volume="14",
pages="e59552",
keywords="COVID-19",
keywords="biochemistry",
keywords="education, distance",
keywords="teaching",
keywords="educational technology",
keywords="review",
keywords="digital learning",
keywords="virtual education",
keywords="teaching tools",
keywords="remote learning",
keywords="social support",
keywords="distance learning",
keywords="remote teaching",
abstract="Background: In March 2020, the global landscape witnessed widespread upheavals in both socioeconomic and educational spheres due to the onset of the COVID-19 pandemic. With measures imposed to control the virus's spread, educational institutions around the world embraced digital learning, introducing challenges in the adaptation to virtual education. This shift proved especially daunting in resource-limited nations with limited digital infrastructure. Objective: This scoping review aims to explore the experiences of biochemistry educators during the COVID-19 pandemic, focusing on successful pedagogical strategies used to overcome challenges in remote teaching. The goal is to compile valuable information applicable to health-related undergraduate and postgraduate courses. Methods: This review considers studies and experiences related to the transition to remote biochemistry education during the pandemic. It encompasses a variety of pedagogical approaches, including online teaching tools, interactive methods, and alternatives to practical laboratory classes. The search spans databases such as MEDLINE, the Cochrane Database of Systematic Reviews, and Joanna Briggs Institute (JBI) Evidence Synthesis, with a focus on identifying systematic or scoping reviews; however, none were identified in the preliminary search. Results: Starting in February 2022, the scoping review protocol was scheduled for completion by July 2024. From an initial pool of 1171 results, 85 articles were selected, with duplicate verification pending for the subsequent phase of the project. The findings from this review on biochemistry teaching strategies will be communicated using a combination of descriptive narrative, graphical, and tabular formats, emphasizing diverse pedagogical approaches pertinent to the subject. Dissemination will occur through regional and national scientific conference presentations, alongside publication in a peer-reviewed journal. Conclusions: This review aims to generate innovative pedagogical approaches and pinpoint learning activities, materials, and tools that support social and collaborative learning across various subjects, including biochemistry. Moreover, it will offer perspectives from students and educators on the implemented activities, with the intention of integrating them as supplementary methods to boost student participation, and thereby, improve learning outcomes and skill development. Trial Registration: Open Science Framework VZSA7; https://osf.io/VZSA7/ International Registered Report Identifier (IRRID): DERR1-10.2196/59552 ",
doi="10.2196/59552",
url="https://www.researchprotocols.org/2025/1/e59552"
}


@Article{info:doi/10.2196/63775,
author="Li, Rui
and Wu, Tong",
title="Evolution of Artificial Intelligence in Medical Education From 2000 to 2024: Bibliometric Analysis",
journal="Interact J Med Res",
year="2025",
month="Jan",
day="30",
volume="14",
pages="e63775",
keywords="artificial intelligence",
keywords="medical education",
keywords="bibliometric",
keywords="citation trends",
keywords="academic pattern",
keywords="VOSviewer",
keywords="Citespace",
keywords="AI",
abstract="Background: Incorporating artificial intelligence (AI) into medical education has gained significant attention for its potential to enhance teaching and learning outcomes. However, it lacks a comprehensive study depicting the academic performance and status of AI in the medical education domain. Objective: This study aims to analyze the social patterns, productive contributors, knowledge structure, and clusters since the 21st century. Methods: Documents were retrieved from the Web of Science Core Collection database from 2000 to 2024. VOSviewer, Incites, and Citespace were used to analyze the bibliometric metrics, which were categorized by country, institution, authors, journals, and keywords. The variables analyzed encompassed counts, citations, H-index, impact factor, and collaboration metrics. Results: Altogether, 7534 publications were initially retrieved and 2775 were included for analysis. The annual count and citation of papers exhibited exponential trends since 2018. The United States emerged as the lead contributor due to its high productivity and recognition levels. Stanford University, Johns Hopkins University, National University of Singapore, Mayo Clinic, University of Arizona, and University of Toronto were representative institutions in their respective fields. Cureus, JMIR Medical Education, Medical Teacher, and BMC Medical Education ranked as the top four most productive journals. The resulting heat map highlighted several high-frequency keywords, including performance, education, AI, and model. The citation burst time of terms revealed that AI technologies shifted from imaging processing (2000), augmented reality (2013), and virtual reality (2016) to decision-making (2020) and model (2021). Keywords such as mortality and robotic surgery persisted into 2023, suggesting the ongoing recognition and interest in these areas. Conclusions: This study provides valuable insights and guidance for researchers who are interested in educational technology, as well as recommendations for pioneering institutions and journal submissions. Along with the rapid growth of AI, medical education is expected to gain much more benefits. ",
doi="10.2196/63775",
url="https://www.i-jmr.org/2025/1/e63775"
}


@Article{info:doi/10.2196/64817,
author="Dunleavy, Kim
and Radunovich, Liss Heidi
and Beneciuk, M. Jason
and Hu, Boyi
and Yang, Yang
and Blythe, McCormick Janeen
and Gurka, K. Kelly",
title="Self-Management Strategies for Low Back Pain Among Horticulture Workers: Protocol for a Type II Hybrid Effectiveness-Implementation Study",
journal="JMIR Res Protoc",
year="2025",
month="Jan",
day="28",
volume="14",
pages="e64817",
keywords="low back pain",
keywords="self-management",
keywords="implementation",
keywords="horticulture workers",
keywords="video training",
keywords="video feedback",
keywords="text message reminders",
keywords="agriculture",
keywords="ergonomic",
keywords="nonpharmacological",
abstract="Background: Low back pain (LBP) is highly prevalent and disabling, especially in agriculture sectors. However, there is a gap in LBP prevention and intervention studies in these physically demanding occupations, and to date, no studies have focused on horticulture workers. Given the challenges of implementing interventions for those working in small businesses, self-management offers an attractive and feasible option to address work-related risk factors and manage LBP. Objective: This study will (1) investigate the effectiveness of self-management strategies for nursery and landscape workers by comparing within-subject control and intervention periods and (2) determine if adoption and effectiveness differs between participants randomly assigned to review self-management videos only and those who also receive multimodal implementation support. We will also identify contextual factors impacting effectiveness and implementation. Methods: A pragmatic, mixed methods, hybrid effectiveness and implementation design will be used to compare back pain with work tasks, disability, medication and substance use, and psychological factors between a baseline control and intervention periods. We aim to recruit 122 English- and Spanish-speaking horticulture workers with back pain, 30 supervisors, and 12 focus group participants. Participants will review short video modules designed to increase awareness of opioid risk and introduce self-management and ergonomic choices and use 1 self-management and 1 ergonomic strategy for 10 weeks. They will be randomly assigned to 2 implementation groups: video modules only or video + multimodal personalized support (checklist guidance, review of video feedback for ergonomic problem-solving, and text message reminders). Questionnaires will be administered at 3-month time points: baseline, pre- and postintervention, and at 3 and 6 months. Qualitative analysis of field notes, open-ended comments, and focus groups will expand understanding of results with comprehensive documentation of the context, barriers and facilitators, and reasons for adoption. Results: The project was funded on September 29, 2023 (Centers for Disease Control and Prevention National Institute of Occupational Health and Safety, CDC NIOSH; U54OH011230-07S1), as a core research grant for the Southeast Coastal Center for Agricultural Health and Safety. The design, creation, and editing of English and Spanish videos was completed in June 2024 after comprehensive formative evaluation. Enrollment began in June 2024 with anticipated completion in 2027. Conclusions: We hypothesize that both self-management interventions will result in reductions in work task pain and disability and that the video enhanced with multimodal personalized support will result in greater reductions than the video alone. If self-management is effective, mitigating pain positively impacts quality of life, productivity, and retention, while increasing the use of nonpharmacological alternatives to opioids addresses an important public health issue. Implementation aims will help inform reasons for results, barriers and facilitators, and potential for similar interventions in these and similar industries with physically challenging outdoor work. Trial Registration: ClinicalTrials.gov NCT06153199; http://clinicaltrials.gov/study/NCT06153199 International Registered Report Identifier (IRRID): DERR1-10.2196/64817 ",
doi="10.2196/64817",
url="https://www.researchprotocols.org/2025/1/e64817"
}


@Article{info:doi/10.2196/60255,
author="Nykiel-Bailey, Sydney
and Burrows, Kathryn
and Szafarowicz, E. Bianca
and Moquin, Rachel",
title="Faculty Perceptions on the Roles of Mentoring, Advising, and Coaching in an Anesthesiology Residency Program: Mixed Methods Study",
journal="JMIR Med Educ",
year="2025",
month="Jan",
day="21",
volume="11",
pages="e60255",
keywords="coaching",
keywords="faculty perceptions",
keywords="mentoring",
keywords="perception",
keywords="medical education",
keywords="anesthesia",
keywords="modality",
keywords="support",
keywords="Washington University",
keywords="university",
keywords="coaching skills",
keywords="training",
keywords="culture change",
keywords="culture",
keywords="flexibility",
keywords="systematic framework",
abstract="Background: Mentoring, advising, and coaching are essential components of resident education and professional development. Despite their importance, there is limited literature exploring how anesthesiology faculty perceive these practices and their role in supporting residents. Objective: This study aims to investigate anesthesiology faculty perspectives on the significance, implantation strategies, and challenges associated with mentorship, advising, and coaching in resident education. Methods: A comprehensive survey was administrated to 93 anesthesiology faculty members at Washington University School of Medicine. The survey incorporated quantitative Likert-scale questions and qualitative short-answer responses to assess faculty perceptions of the value, preferred formats, essential skills, and capacity for fulfilling multiple roles in these support practices. Additional areas of focus included the impact of staffing shortages, training requirements, and the potential of these practices to enhance faculty recruitment and retention. Results: The response rate was 44\% (n=41). Mentoring was identified as the most important aspect, with 88\% (n=36) of faculty respondents indicating its significance, followed by coaching, which was highlighted by 78\% (n=32) of respondents. The majority felt 1 faculty member can effectively hold multiple roles for a given trainee. The respondents desired additional training for roles and found roles to be rewarding. All roles were seen as facilitating recruitment and retention. Barriers included faculty burnout; confusion between roles; time constraints; and desire for specialized training, especially in coaching skills. Conclusions: Implementing structured mentoring, advising, and coaching can profoundly impact resident education but requires role clarity, protected time, culture change, leadership buy-in, and faculty development. Targeted training and operational investments could enable programs to actualize immense benefits from high-quality resident support modalities. Respondents emphasized that resident needs evolve over time, necessitating flexibility in appropriate faculty guidance. While coaching demands unique skills, advising hinges on expertise and mentoring depends on relationship-building. Systematic frameworks of coaching, mentoring, and advising programs could unlock immense potential. However, realizing this vision demands surmounting barriers such as burnout, productivity pressures, confusion about logistics, and culture change. Ultimately, prioritizing resident support through high-quality personalized guidance can recenter graduate medical education. ",
doi="10.2196/60255",
url="https://mededu.jmir.org/2025/1/e60255"
}


@Article{info:doi/10.2196/60210,
author="Varghese, Johny Kevin
and Singh, Som
and Kamali, Emily
and Qureshi, Fahad
and Jamal, Aleena
and Qureshi, Fawad",
title="Modern Digital Query Analytics of Patient Education Materials on Acanthosis Nigricans: Systematic Search and Content Analysis",
journal="JMIR Dermatol",
year="2025",
month="Jan",
day="6",
volume="8",
pages="e60210",
keywords="acanthosis nigricans",
keywords="dermatology",
keywords="patient education",
keywords="public health",
keywords="skin",
keywords="readability",
keywords="information resource",
keywords="DISCERN",
keywords="general public",
keywords="reading level",
keywords="information seeking",
keywords="information behavior",
abstract="Background: Online digital materials are integral to patient education and health care outcomes in dermatology. Acanthosis nigricans (AN) is a common condition, often associated with underlying diseases such as insulin resistance. Patients frequently search the internet for information related to this cutaneous finding. To our knowledge, the quality of online educational materials for AN has not been systematically examined. Objective: The primary objective of this study was to profile the readability and quality of the content of publicly available digital educational materials on AN and identify questions frequently asked by patients. Methods: This study analyzed publicly available internet sources to identify the most frequent questions searched by patients regarding AN using the Google Rankbrain algorithm. Furthermore, available articles on AN were evaluated for quality and reading level using metrics such as the Brief DISCERN score, and readability was determined using three specific scales including the Flesch-Kincaid score, Gunning Fog index, and the Coleman-Liau index, based on literature. Results: Patients most frequently accessed facts on AN from government sources, which comprised 30\% (n=15) of the analyzed sources. The available articles did not meet quality standards and were at a reading level not appropriate for the general public. The majority of articles (n=29/50, 58\%) had substandard Brief DISCERN scores, failing to meet the criteria for good quality. Conclusions: Clinicians should be aware of the paucity of valuable online educational material on AN and educate their patients accordingly. ",
doi="10.2196/60210",
url="https://derma.jmir.org/2025/1/e60210"
}


@Article{info:doi/10.2196/60223,
author="Tobiaszewska, Ma?gorzata
and Koweszko, Tytus
and Jurek, Jonasz
and Miko?ap, Karolina
and Gierus, Jacek
and Mikulski, Jantoni
and Waszkiewicz, Napoleon",
title="Personality Types of Medical Students in Terms of Their Choice of Medical Specialty: Cross-Sectional Study",
journal="Interact J Med Res",
year="2024",
month="Dec",
day="31",
volume="13",
pages="e60223",
keywords="personality type",
keywords="characteristics",
keywords="traits",
keywords="psychology",
keywords="psychometric",
keywords="medical students",
keywords="university",
keywords="burnout",
keywords="gender",
keywords="preferences",
keywords="professional",
keywords="job",
keywords="career",
keywords="specialty",
keywords="survey",
keywords="questionnaire",
abstract="Background: Research on personality types among doctors reveals its impact on medical specialty choices, suggesting that considering personality in career planning may enhance work satisfaction and reduce burnout risks. Objective: This study, encompassing 2104 medical students, explores how personality types, traits, and gender relate to specialty preferences. Methods: Participants of this study were medical students from various universities in Poland. The study surveyed 2104 participants. Each participant completed a general questionnaire and a NERIS Type Explorer personality test, based on the Myers-Briggs Type Indicator inventory and the ``Big Five'' personality traits concept. The questionnaire was distributed on social media groups for medical students from all Polish universities. An exploratory statistical analysis was performed to find relationships. For each tested relationship a Fisher exact test was conducted and the significance level was P<.05. Each test resulted in a P value and odds ratio (OR) with a CI. To ensure we included undecided students and obtained meaningful data, we allowed participants to select up to three medical specialties from the 77 available in Poland at the time of the study. Results: The findings unveil significant relationships between gender, personality types, traits, and specialty preferences. Women tended to favor Neonatology (OR 9.15, 95\% CI 3.02-45.46), while men leaned toward Orthopedics and traumatology of the locomotor system (OR 7.53, 95\% CI 4.87-11.94). Extroverted, Intuitive, Feeling, Prospecting, and Turbulent students showed a heightened interest in Psychiatry (OR 2.23, 95\% CI 1.64-3.01), whereas Introverted, Observant, Feeling, Judging, and Turbulent types favored Family Medicine (OR 2.98, 95\% CI 2.08-4.24) and Pediatrics (OR 2.13, 95\% CI 1.51-2.99). Conclusions: In conclusion, this research establishes a link between personality and medical specialty selection. Taking into account the significant role of personality traits, it should be considered to integrate them into the process of selecting a medical career or designing a medical curriculum. This approach may allow for the customization of programs to match students' traits, thereby cultivating improved clinical communication skills, fostering interprofessional collaboration and ultimately enhancing treatment outcomes and professional fulfillment among physicians. The main limitation of this study is that it was conducted on medical students, who lack the full knowledge of the work as a specific specialist. A study surveying medical doctors with longer internships across different wards could be conducted to check for any variabilities. Moreover, there are other significant factors that influence one's medical specialty choice. Certainly, this area could be further explored. ",
doi="10.2196/60223",
url="https://www.i-jmr.org/2024/1/e60223"
}


@Article{info:doi/10.2196/66114,
author="Zong, Hui
and Wu, Rongrong
and Cha, Jiaxue
and Wang, Jiao
and Wu, Erman
and Li, Jiakun
and Zhou, Yi
and Zhang, Chi
and Feng, Weizhe
and Shen, Bairong",
title="Large Language Models in Worldwide Medical Exams: Platform Development and Comprehensive Analysis",
journal="J Med Internet Res",
year="2024",
month="Dec",
day="27",
volume="26",
pages="e66114",
keywords="large language models",
keywords="LLMs",
keywords="generative pretrained transformer",
keywords="ChatGPT",
keywords="medical exam",
keywords="medical education",
keywords="artifical intelligence",
keywords="AI",
abstract="Background: Large language models (LLMs) are increasingly integrated into medical education, with transformative potential for learning and assessment. However, their performance across diverse medical exams globally has remained underexplored. Objective: This study aims to introduce MedExamLLM, a comprehensive platform designed to systematically evaluate the performance of LLMs on medical exams worldwide. Specifically, the platform seeks to (1) compile and curate performance data for diverse LLMs on worldwide medical exams; (2) analyze trends and disparities in LLM capabilities across geographic regions, languages, and contexts; and (3) provide a resource for researchers, educators, and developers to explore and advance the integration of artificial intelligence in medical education. Methods: A systematic search was conducted on April 25, 2024, in the PubMed database to identify relevant publications. Inclusion criteria encompassed peer-reviewed, English-language, original research articles that evaluated at least one LLM on medical exams. Exclusion criteria included review articles, non-English publications, preprints, and studies without relevant data on LLM performance. The screening process for candidate publications was independently conducted by 2 researchers to ensure accuracy and reliability. Data, including exam information, data process information, model performance, data availability, and references, were manually curated, standardized, and organized. These curated data were integrated into the MedExamLLM platform, enabling its functionality to visualize and analyze LLM performance across geographic, linguistic, and exam characteristics. The web platform was developed with a focus on accessibility, interactivity, and scalability to support continuous data updates and user engagement. Results: A total of 193 articles were included for final analysis. MedExamLLM comprised information for 16 LLMs on 198 medical exams conducted in 28 countries across 15 languages from the year 2009 to the year 2023. The United States accounted for the highest number of medical exams and related publications, with English being the dominant language used in these exams. The Generative Pretrained Transformer (GPT) series models, especially GPT-4, demonstrated superior performance, achieving pass rates significantly higher than other LLMs. The analysis revealed significant variability in the capabilities of LLMs across different geographic and linguistic contexts. Conclusions: MedExamLLM is an open-source, freely accessible, and publicly available online platform providing comprehensive performance evaluation information and evidence knowledge about LLMs on medical exams around the world. The MedExamLLM platform serves as a valuable resource for educators, researchers, and developers in the fields of clinical medicine and artificial intelligence. By synthesizing evidence on LLM capabilities, the platform provides valuable insights to support the integration of artificial intelligence into medical education. Limitations include potential biases in the data source and the exclusion of non-English literature. Future research should address these gaps and explore methods to enhance LLM performance in diverse contexts. ",
doi="10.2196/66114",
url="https://www.jmir.org/2024/1/e66114",
url="http://www.ncbi.nlm.nih.gov/pubmed/39729356"
}


@Article{info:doi/10.2196/60949,
author="Hammarberg, Karin
and Bandyopadhyay, Mridula
and Nguyen, Hau
and Cicuttini, Flavia
and Stanzel, Andrea Karin
and Brown, Helen
and Hickey, Martha
and Fisher, Jane",
title="Development and Evaluation of 4 Short, Animated Videos for Women in Midlife Promoting Positive Health Behaviors: Survey Study",
journal="Interact J Med Res",
year="2024",
month="Dec",
day="2",
volume="13",
pages="e60949",
keywords="health promotion",
keywords="healthy aging",
keywords="self-management",
keywords="midlife",
keywords="menopause",
keywords="internet",
keywords="video",
keywords="animation",
keywords="survey",
keywords="questionnaire",
keywords="education",
keywords="women",
keywords="gynecology",
abstract="Background: Health and health behaviors in midlife are important determinants of healthy aging. There is evidence of unmet needs for health-promoting information for women from culturally and linguistically diverse backgrounds and women with low literacy. Objective: This study aimed to (1) develop accessible short, animated videos viewable and downloadable from YouTube aimed at promoting positive health behaviors in women in midlife and (2) evaluate their accessibility, acceptability, understanding, and usability and whether this was influenced by the level of education or socioeconomic disadvantage. Methods: In collaboration with a video production company, a multidisciplinary team of academics and health professionals developed 2 short, animated videos on self-management of menopause health and 2 promoting joint health. Their accessibility, acceptability, understanding, and usability to women were evaluated in an anonymous web-based survey. Results: A total of 490 women viewed the videos and responded to the survey. Of these, 353 (72\%) completed all questions. Almost all (from 321/353, 91\% to 334/363, 92\%) agreed that the information in the videos was ``very easy to understand.'' The proportions reporting that all or some of the information in the video was new to them varied between videos from 36\% (137/386) to 66\% (233/353), the reported likelihood of using the practical tips offered in the videos varied from 70\% (271/386) to 89\% (331/373), and between 61\% (235/386) and 70\% (263/373) of respondents stated that they would recommend the videos to others. Education-level group comparisons revealed few differences in opinions about the videos, except that women with lower education were more likely than those with higher education to state that they would recommend the 2 joint health videos to others (36/45, 80\% vs 208/318, 65\%; P=.051 for video 3; and 36/44, 80\% vs 197/309, 64\%; P=.04 for video 4). There were no differences between women living in the least advantaged areas (Socioeconomic Indexes for Areas quintile areas 1 and 2) and those living in the most advantaged areas (Socioeconomic Indexes for Areas quintile areas 3, 4, and 5) in their responses to any of the questions about the 4 videos. Conclusions: Most women found the videos easy to understand, learned something new from watching them, planned to use the practical tips they offered, and were likely to recommend them to other women. This suggests that short, animated videos about health self-management strategies in midlife to improve the chance of healthy aging are perceived as accessible, acceptable, easy to understand, and useful by women. ",
doi="10.2196/60949",
url="https://www.i-jmr.org/2024/1/e60949",
url="http://www.ncbi.nlm.nih.gov/pubmed/39621404"
}


@Article{info:doi/10.2196/54919,
author="Chang, Annie
and Young, Jade
and Para, Andrew
and Lamb, Angela
and Gulati, Nicholas",
title="Efficacy of ChatGPT in Educating Patients and Clinicians About Skin Toxicities Associated With Cancer Treatment",
journal="JMIR Dermatol",
year="2024",
month="Nov",
day="20",
volume="7",
pages="e54919",
keywords="artificial intelligence",
keywords="ChatGPT",
keywords="oncodermatology",
keywords="cancer therapy",
keywords="language learning model",
doi="10.2196/54919",
url="https://derma.jmir.org/2024/1/e54919"
}


@Article{info:doi/10.2196/56844,
author="M{\o}rk, Gry
and Bonsaksen, Tore
and Larsen, S{\o}nnik Ole
and Kunnikoff, Martin Hans
and Lie, Stangeland Silje",
title="Virtual Reality Simulation in Undergraduate Health Care Education Programs: Usability Study",
journal="JMIR Med Educ",
year="2024",
month="Nov",
day="19",
volume="10",
pages="e56844",
keywords="360{\textdegree} videos",
keywords="health professions education",
keywords="virtual reality",
keywords="usability study",
keywords="undergraduates",
keywords="university",
keywords="students",
keywords="simulation",
abstract="Background: Virtual reality (VR) is increasingly being used in higher education for clinical skills training and role-playing among health care students. Using 360{\textdegree} videos in VR headsets, followed by peer debrief and group discussions, may strengthen students' social and emotional learning. Objective: This study aimed to explore student-perceived usability of VR simulation in three health care education programs in Norway. Methods: Students from one university participated in a VR simulation program. Of these, students in social education (n=74), nursing (n=45), and occupational therapy (n=27) completed a questionnaire asking about their perceptions of the usability of the VR simulation and the related learning activities. Differences between groups of students were examined with Pearson chi-square tests and with 1-way ANOVA. Qualitative content analysis was used to analyze data from open-ended questions. Results: The nursing students were most satisfied with the usability of the VR simulation, while the occupational therapy students were least satisfied. The nursing students had more often prior experience from using VR technology (60\%), while occupational therapy students less often had prior experience (37\%). Nevertheless, high mean scores indicated that the students experienced the VR simulation and the related learning activities as very useful. The results also showed that by using realistic scenarios in VR simulation, health care students can be prepared for complex clinical situations in a safe environment. Also, group debriefing sessions are a vital part of the learning process that enhance active involvement with peers. Conclusions: VR simulation has promise and potential as a pedagogical tool in health care education, especially for training soft skills relevant for clinical practice, such as communication, decision-making, time management, and critical thinking. ",
doi="10.2196/56844",
url="https://mededu.jmir.org/2024/1/e56844"
}


@Article{info:doi/10.2196/60626,
author="Kvestad, Ingrid
and Adolfsen, Frode
and Angeles, Corinne Renira
and Brandseth, Lekve Oda
and Breivik, Kyrre
and Evertsen, Grete Janne
and Foer, Kv{\aa}le Irene
and Haaland, Morten
and Homola, Millerjord Birgit
and Hoseth, Elisabeth Gro
and Jonsson, Josefine
and Kjerstad, Egil
and Kyrrestad, Henriette
and Martinussen, Monica
and Moberg, Annelene
and Moberg, Karianne
and Skogstrand, Anita
and Solberg, Remme Line
and Aasheim, Merete",
title="Effectiveness of a Bullying Intervention (Be-Prox) in Norwegian Early Childhood and Education Care Centers: Protocol for a Cluster Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2024",
month="Oct",
day="24",
volume="13",
pages="e60626",
keywords="peer bullying in early childhood education and care",
keywords="The Bernese Program",
keywords="cluster randomized controlled trial",
keywords="bullying",
keywords="child",
keywords="preschool",
keywords="program evaluation",
abstract="Background: A new and growing body of research has studied bullying among children in early childhood education and care centers (ECECs). The Bernese Program (Be-Prox) is designed to systematically prevent and handle bullying between children in Swiss ECECs. However, the effectiveness of the Be-Prox intervention has not yet been explored in a Norwegian ECEC setting. Objective: This study aims to evaluate the effectiveness of Be-Prox in preventing and handling bullying among peers in Norwegian ECECs. Methods: ECECs from 2 Norwegian municipalities were invited to participate in a cluster randomized controlled trial (RCT) to evaluate the effectiveness of the Be-Prox intervention on peer bullying in Norwegian ECECs. After baseline measures were taken, project ECECs were randomized to either an intervention or a control arm. The Be-Prox intervention was introduced to ECECs in the intervention arm through 6 modules over a 9-month period immediately after the randomization. ECECs in the control arm participated in the data collection and were offered the Be-Prox intervention the following year. The primary outcome of the effect evaluation is the mean sum of negative behavior between peers after the Be-Prox training is completed in the intervention arm. Secondary outcomes include child bystander behavior, teacher self-efficacy, and ECEC's authoritative climate. An extensive implementation and process evaluation, as well as cost-effectiveness analyses, will be conducted alongside the RCT. Results: Baseline data collection was conducted in September 2023, and the postintervention data collection started in May 2024. At baseline, we collected data on 708 children and 413 personnel from 38 project ECECs in the 2 Norwegian municipalities. The results from the study will be available in late 2024 at the earliest. Conclusions: The proposed project includes a comprehensive evaluation of the effectiveness of Be-Prox in Norwegian ECECs directly targeting the prevention and handling of bullying, including implementation and cost-effectiveness evaluations. The results from the project have the potential to fill in identified knowledge gaps in the understanding of negative behavior and bullying between peers in ECECs, and how these may be prevented. If proven efficient, our ambition is to offer Be-Prox to Norwegian ECECs as an evidence-based practice to prevent and handle bullying among preschool children. Trial Registration: ClinicalTrials.gov NCT06040437; https://clinicaltrials.gov/study/NCT06040437 International Registered Report Identifier (IRRID): DERR1-10.2196/60626 ",
doi="10.2196/60626",
url="https://www.researchprotocols.org/2024/1/e60626"
}


@Article{info:doi/10.2196/57229,
author="Gouvea Silva, Gabriela
and Costa, Silva Carlos Dario da
and Gon{\c{c}}alves, Cardoso Bruno
and Vianney Cidr{\~a}o Nunes, Luiz
and dos Santos, Roberto Emerson
and Lopes, Maciel Sonia Maria
and Lima, Abreu Alba Regina de
and Brienze, Sabadoto V{\^a}nia Maria
and Bizotto, Gastardelo Tha{\'i}s Santana
and Andr{\'e}, C{\'e}sar J{\'u}lio",
title="Learning Styles of Medical Students, Surgical Residents, Medical Staff, and General Surgery Teachers When Learning Surgery: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2024",
month="Oct",
day="11",
volume="13",
pages="e57229",
keywords="general surgery",
keywords="medical staff",
keywords="students",
keywords="medical faculty",
keywords="medical student",
keywords="surgery",
keywords="surgical resident",
keywords="internship",
keywords="clinician",
keywords="teaching method",
keywords="residency program",
keywords="residency",
keywords="training",
keywords="leaning style",
keywords="health care education",
keywords="Kolb",
keywords="Kolbs model",
keywords="experiential learning",
keywords="Felder and Silverman",
abstract="Background: Learning styles are biological and developmental configurations of personal characteristics that make the same teaching method effective for some and ineffective for others. Studies support a relationship between learning style and career choices in medicine, resulting in learning style patterns being observed in different residency programs, including in general surgery, from medical school to the last stages of training. The methodologies, populations, and contexts of the few studies pertinent to the matter are very different from one another, and a scoping review on this theme will enhance and organize what is already known. Objective: The goal of this study is to identify and map out data from studies on the learning styles of medical students, surgical residents, medical staff, and surgical teachers. Methods: The review will consider studies on the learning styles of medical students in a clinical cycle or internship, surgical residents with no restriction on year of residency, medical staff in general surgery, or general surgery's medical faculty. Primary studies published in English, with no specific time frame, will be considered. The search will be carried out in four databases, and reference lists will be searched for additional studies. Duplicates will be removed, and two independent reviewers will screen the titles, abstracts, and full texts of the selected studies. Data collection will be performed using a tool developed by the researchers. A results summary will be presented with figures, narratives, and tables. A quantitative and qualitative analysis will be carried out and further results will be shared. Results: The search was funded on September 25, 2023. Data collection was performed in the two following months. Of the 213 articles found, 135 were excluded due to duplication. The remaining 78 articles will have their titles and abstracts analyzed by three of the researchers independently to select those that meet the eligibility criteria. This data is expected to be published in the first semester of 2025. Conclusions: Conducting a scoping review is the best way to map what is known about a subject. Understanding how students, residents, staff, and even teachers prefer to learn surgery is key to staying up to date and knowing how to best educate those pursuing a surgical career. Trial Registration: Open Science Framework 75ku4; https://osf.io/75ku4 International Registered Report Identifier (IRRID): DERR1-10.2196/57229 ",
doi="10.2196/57229",
url="https://www.researchprotocols.org/2024/1/e57229"
}


@Article{info:doi/10.2196/55333,
author="Flato, Prync Uri Adrian
and Beffa dos Santos, Jos{\'e} Emilio
and Bispo Diaz T Martins, Isabella
and Rossignoli, Gazin Vinicius
and Dias Midega, Thais
and Kallas-Silva, Lucas
and Ferreira Mendes de Oliveira, Ricardo
and do Socorro Lima Figueiredo Flato, Adriana
and Vicente Guimar{\~a}es, Mario
and Penna Guimar{\~a}es, H{\'e}lio",
title="Interactive Serious Game to Teach Basic Life Support Among Schoolchildren in Brazil: Design and Rationale",
journal="JMIR Serious Games",
year="2024",
month="Oct",
day="9",
volume="12",
pages="e55333",
keywords="cardiopulmonary resuscitation",
keywords="basic life support",
keywords="serious game",
keywords="CPR training",
keywords="usability",
keywords="cardiopulmonary",
keywords="emergency",
keywords="life support",
keywords="CPR",
keywords="training",
keywords="education",
keywords="game",
keywords="gaming",
keywords="educational",
keywords="resuscitation",
keywords="survey",
keywords="satisfaction",
keywords="SUS",
keywords="user experience",
keywords="System Usability Scale",
doi="10.2196/55333",
url="https://games.jmir.org/2024/1/e55333"
}


@Article{info:doi/10.2196/56632,
author="P{\'e}rez-Mu{\~n}oz, Milagros
and Rodr{\'i}guez-Costa, Isabel
and Lebrijo-P{\'e}rez, Gerard
and Pecos-Mart{\'i}n, Daniel
and Gallego-Izquierdo, Tom{\'a}s
and P{\'e}rez-Mart{\'i}n, Yolanda",
title="Design of a Health Education Program to Manage Chronic Neck Pain: Protocol for a Development Study",
journal="JMIR Res Protoc",
year="2024",
month="Oct",
day="1",
volume="13",
pages="e56632",
keywords="neck pain",
keywords="chronic pain",
keywords="physiotherapy",
keywords="health education",
keywords="emotional expression",
keywords="biopsychosocial model",
abstract="Background: Chronic neck pain (CNP) needs attention to its physical, cognitive, and social dimensions. Objective: We aimed to design a health education program (HEP) with a biopsychosocial approach for patients with CNP. Methods: A literature search on CNP, health education, and biopsychosocial models was carried out. Seven physiotherapists with expertise in HEPs and chronic pain participated in three teams that evaluated the literature and prepared a synthesis document in relation to the three target topics. Experts compiled the information obtained and prepared a proposal for an HEP with a biopsychosocial approach aimed at patients with CNP. This proposal was tested in the physiotherapy units of primary care health centers belonging to the East Assistance Directorate of Madrid, and suggestions were included in the final program. Results: The HEP for CNP with a biopsychosocial approach consists of 5 educational sessions lasting between 90 and 120 minutes, carried out every other day. Cognitive, emotional, and physical dimensions were addressed in all sessions, with particular attention to the psychosocial factors associated with people who have CNP. Conclusions: The proposed HEP with a biopsychosocial approach emphasizes emotional management, especially stress, without neglecting the importance of physical and recreational exercises for the individual's return to social activities. The objective of this program was to achieve a clinically relevant reduction in perceived pain intensity and functional disability as well as an improvement in quality of life in the short and medium term. Trial Registration: ClinicalTrials.gov NCT02703506; https://clinicaltrials.gov/study/NCT02703506 International Registered Report Identifier (IRRID): DERR1-10.2196/56632 ",
doi="10.2196/56632",
url="https://www.researchprotocols.org/2024/1/e56632",
url="http://www.ncbi.nlm.nih.gov/pubmed/39353191"
}


@Article{info:doi/10.2196/59848,
author="Huang, Zhilian
and Ow, Teng Jing
and Tang, Ee Wern
and Chow, Angela",
title="An Evidence-Based Serious Game App for Public Education on Antibiotic Use and Resistance: Randomized Controlled Trial",
journal="JMIR Serious Games",
year="2024",
month="Sep",
day="5",
volume="12",
pages="e59848",
keywords="serious game application",
keywords="randomized controlled trial",
keywords="antimicrobial resistance",
keywords="antibiotic use",
keywords="public education",
keywords="mobile phone",
abstract="Background: The misuse and overuse of antibiotics accelerate the development of antimicrobial resistance (AMR). Serious games, any form of games that serve a greater purpose other than entertainment, could augment public education above ongoing health promotion efforts. Hence, we developed an evidence-based educational serious game app---SteWARdS Antibiotic Defence---to educate players on good antibiotic use practices and AMR through a game quest comprising 3 minigames and interaction with the nonplayer characters. Objective: We aimed to evaluate the effectiveness of the SteWARdS Antibiotic Defence app in improving the knowledge of, attitude toward, and perceptions (KAP) of appropriate antibiotic use and AMR among the public in Singapore. Methods: We conducted a 2-arm parallel randomized controlled trial, recruiting visitors aged 18-65 years from 2 polyclinics in Singapore. Intervention group participants had to download the SteWARdS Antibiotic Defence app (available only in English and on the Android platform) on their smartphones and complete the quest in the app. Participants took half a day to 2 weeks to complete the quest. The control group received no intervention. Knowledge questions on antibiotic use and AMR (11 binary questions) were self-administered at baseline, immediately after the intervention, and 6-10 weeks post intervention, while attitudes and perception questions (14 three-point Likert-scale questions) were self-administered at baseline and 6-10 weeks post intervention. We also collected participants' feedback on app usage. Results: Participants (n=348; intervention: n=142, control: n=206) had a mean age of 36.9 years. Intervention group participants showed a statistically significant improvement in mean knowledge score (effect size: 0.58 [95\% CI 0.28-0.87]) compared with controls after accounting for age, educational level, and exposure to advertisements on antibiotics and AMR. Intervention participants also showed a statistically significant improvement in mean attitude-perception scores (effect size: 0.98 (95\% CI 0.44-1.52)) after adjusting for marital status and race. A majority of participants agreed that the ``SteWARdS Antibiotic Defence'' app improved their awareness on antibiotic use (135/142, 95.1\%) and AMR (136/142, 95.8\%). About 73.9\% (105/142) of the participants agreed that the app is easy to use, 70.4\% (100/142) agreed that the app was enjoyable, and 85.2\% (121/142) would recommend the app to others. Conclusions: Our educational serious game app improves participants' KAP on appropriate antibiotic use and AMR. Public education apps should be engaging, educational, easy to use, and have an attractive user interface. Future research should assess the effectiveness of interventions in facilitating long-term knowledge retention and long-lasting behavioral change. Trial Registration: ClinicalTrials.gov NCT05445414; https://clinicaltrials.gov/ct2/show/NCT05445414 International Registered Report Identifier (IRRID): RR2-10.2196/45833 ",
doi="10.2196/59848",
url="https://games.jmir.org/2024/1/e59848",
url="http://www.ncbi.nlm.nih.gov/pubmed/39235853"
}


@Article{info:doi/10.2196/63220,
author="Zhu, Shimin
and Hu, Yuxi
and Wang, Ruobing
and Qi, Di
and Lee, Paul
and Ngai, Wa So
and Cheng, Qijin
and Wong, Ching Paul Wai",
title="Effects of a Parent-Child Single-Session Growth Mindset Intervention on Adolescent Depression and Anxiety Symptoms: Protocol of a 3-Arm Waitlist Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2024",
month="Aug",
day="30",
volume="13",
pages="e63220",
keywords="implicit theory",
keywords="fixed mindset",
keywords="mental health",
keywords="secondary school students",
keywords="belief in change",
abstract="Background: Depression and anxiety are common mental health problems among adolescents worldwide. Extant research has found that intelligence, emotion, and failure-is-debilitating beliefs (fixed mindsets) are closely related to more depression and anxiety symptoms, hopelessness, and suicidality. Recent research also points to the importance of parental mindset, which can strongly influence children's affect, behavior, and mental health. However, the effects of parent-child mindset interventions on a child's internalizing problems have not yet been empirically examined. As recent evidence has shown the promise of single-session interventions in reducing and preventing youth internalizing problems, this study develops and examines a parent and child single-session intervention on mindsets of intelligence, failure, and emotion (PC-SMILE) to tackle depression and anxiety in young people. Objective: Using a 3-arm randomized controlled trial, this study will examine the effectiveness of PC-SMILE in reducing depression and anxiety symptoms among children. We hypothesize that compared to the waitlist control group, the PC-SMILE group and child single-session intervention on mindsets of intelligence, failure, and emotion (C-SMILE) group will significantly improve child depression and anxiety (primary outcome) and significantly improve secondary outcomes, including children's academic self-efficacy, hopelessness, psychological well-being, and parent-child interactions and relationships, and the PC-SMILE is more effective than the C-SMILE. Methods: A total of 549 parent-child dyads will be recruited from 8 secondary schools and randomly assigned to either the PC-SMILE intervention group, the C-SMILE intervention group, or the no-intervention waitlist control group. The 45-minute interventions include parent-version and child-version. Both parents and students in the PC-SMILE group receive the intervention. Students in C-SMILE group receive intervention and their parents will receive intervention after all follow-up ends. Students in 3 groups will be assessed at 3 time points, baseline before intervention, 2 weeks post intervention, and 3 months post intervention, and parents will be assessed in baseline and 3-month follow-up. The intention-to-treat principle and linear-regression-based maximum likelihood multilevel models will be used for data analysis. Results: Recruitment started in September 2023. The first cohort of data collection is expected to begin in May 2024 and the second cohort will begin in September 2024. The final wave of data is expected to be collected by the end of the first quarter of 2025. The results are expected to demonstrate improved anxiety and depression among students assigned to the intervention condition, as well as the secondary outcomes compared to those in the control group. The efficacy and effectiveness of the intervention will be discussed. Conclusions: This study is the first attempt to develop a web-based single-session intervention for students and their parents to enhance their well-being in Hong Kong and beyond, which potentially contributes to providing evidence-based recommendations for the implementation of brief digital parent-child interventions. International Registered Report Identifier (IRRID): PRR1-10.2196/63220 ",
doi="10.2196/63220",
url="https://www.researchprotocols.org/2024/1/e63220"
}


@Article{info:doi/10.2196/58727,
author="Guerra-Paiva, Sofia
and Mira, Joaqu{\'i}n Jos{\'e}
and Strametz, Reinhard
and Fernandes, Joana
and Klemm, Victoria
and Madarasova Geckova, Andrea
and Knezevic, Bojana
and Potura, Eva
and Buttigieg, Sandra
and Carrillo, Irene
and Sousa, Paulo",
title="Application and Evaluation of a Multimodal Training on the Second Victim Phenomenon at the European Researchers' Network Working on Second Victims Training School: Mixed Methods Study",
journal="JMIR Form Res",
year="2024",
month="Aug",
day="30",
volume="8",
pages="e58727",
keywords="patient safety",
keywords="second victim",
keywords="training",
keywords="education",
keywords="healthcare",
abstract="Background: Health care workers (HCWs) are often impacted by distressing situations during patient care and can experience the second victim phenomenon (SVP). Addressing an adequate response, training, and increasing awareness of the SVP can increase HCWs' well-being and ultimately improve the quality of care and patient safety. Objective: This study aims to describe and evaluate a multimodal training organized by the European Researchers' Network Working on Second Victims to increase knowledge and overall awareness of SVP and second victim programs. Methods: We implemented a multimodal training program, following an iterative approach based on a continuous quality improvement process, to enhance the methodology and materials of the training program over the duration of 2 years. We conducted web-based surveys and group interviews to evaluate the scope and design of the training, self-directed learning materials, and face-to-face activities. Results: Out of 42 accepted candidates, 38 (90\%) participants attended the 2 editions of the Training School program. In the second edition, the level of participants' satisfaction increased, particularly when adjusting the allocated time for the case studies' discussion (P<.001). After the multimodal training, participants stated that they had a better awareness and understanding of the SVP, support interventions, and its impact on health care. The main strengths of this Training School were the interdisciplinary approach as well as the contact with multiple cultures, the diversity of learning materials, and the commitment of the trainers and organizing team. Conclusions: This multimodal training is suitable for different stakeholders of the health care community, including HCWs, clinical managers, patient safety and quality-of-care teams, academicians, researchers, and postgraduate students, regardless of their prior experience with SVP. Furthermore, this study represents a pioneering effort in elucidating the materials and methodology essential for extending this training approach to similar contexts. ",
doi="10.2196/58727",
url="https://formative.jmir.org/2024/1/e58727"
}


@Article{info:doi/10.2196/63656,
author="Poteat, C. Tonia
and Reisner, L. Sari
and Wirtz, L. Andrea
and Mayo-Wilson, Jennings Larissa
and Brown, Carter
and Kornbluh, Wiley
and Humphrey, Ash
and Perrin, Nancy",
title="A Microfinance Intervention With or Without Peer Support to Improve Mental Health Among Transgender and Nonbinary Adults (the Creating Access to Resources and Economic Support Study): Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2024",
month="Aug",
day="26",
volume="13",
pages="e63656",
keywords="clinical trial",
keywords="depression",
keywords="anxiety",
keywords="peer support",
keywords="minority stress",
keywords="cash transfer",
keywords="COVID-19",
abstract="Background: Transgender and nonbinary (TNB) people experience economic and psychosocial inequities that make them more likely to be subject to financial and mental health harms exacerbated by the COVID-19 pandemic. Sustainable, multilevel interventions are needed to address these harms. The onset of the COVID-19 pandemic galvanized many TNB-led organizations to provide emergency financial and peer support for TNB people negatively impacted by the pandemic. However, the efficacy of these interventions has not been evaluated. The Creating Access to Resources and Economic Support (CARES) study seeks to assess the efficacy of feasible, acceptable, and community-derived interventions to reduce economic and psychological harms experienced by transgender people in the wake of the COVID-19 pandemic. Objective: The study aims to (1) compare the efficacy of microgrants with peer mentoring with that of microgrants without peer mentoring in reducing psychological distress, (2) examine mechanisms by which microgrants with or without peer mentoring may impact psychological distress, and (3) explore participants' intervention experiences and perceived efficacy. Methods: We will enroll 360 TNB adults into an embedded, mixed methods, 3-arm, and 12-month randomized controlled trial. Participants will be randomized 1:1:1 to arm A (enhanced usual care), which will receive a single microgrant plus monthly financial literacy education, arm B (extended microgrants), which will receive enhanced usual care plus monthly microgrants, or arm C (peer mentoring), which will receive extended microgrants combined with peer mentoring. All intervention arms last for 6 months, and participants complete semiannual, web-based surveys at 0, 6, and 12 months as well as brief process measures at 3 and 6 months. A subset of 36 participants, 12 (33\%) per arm, will complete longitudinal in-depth interviews at 3 and 9 months. Results: Full recruitment began on January 8, 2024, and, as of July 26, 2024, a total of 138 participants have enrolled. Recruitment is expected to be completed no later than March 31, 2025, and the final study visit will take place in March 2026. Conclusions: This national, web-based study will demonstrate whether an intervention tailored to reduce material hardship and improve peer support among TNB adults will reduce psychological distress. Its equitable, community-academic partnership will ensure the rapid dissemination of study findings. Trial Registration: ClinicalTrials.gov NCT05971160; https://clinicaltrials.gov/study/NCT05971160 International Registered Report Identifier (IRRID): DERR1-10.2196/63656 ",
doi="10.2196/63656",
url="https://www.researchprotocols.org/2024/1/e63656"
}


@Article{info:doi/10.2196/52533,
author="Vallabhajosyula, Ranganath
and Perumal, Vivek
and Chandrasekaran, Ramya
and Mogali, Reddy Sreenivasulu",
title="Preuniversity Students' Perceptions and Attitudes About an Anatomy and Physiology Outreach Program: Survey Study and Inductive Thematic Analysis",
journal="JMIR Form Res",
year="2024",
month="Aug",
day="12",
volume="8",
pages="e52533",
keywords="anatomy",
keywords="physiology",
keywords="educational outreach",
keywords="preuniversity outreach",
keywords="team-based learning",
keywords="anatomy workshop",
keywords="medical education",
keywords="health profession education",
keywords="health professions",
keywords="health care careers",
keywords="student",
keywords="students",
keywords="outreach activity",
keywords="physiological",
keywords="school",
keywords="university",
keywords="Singapore",
keywords="thematic analysis",
keywords="learning",
keywords="education",
keywords="motivation",
keywords="health care",
keywords="health profession",
keywords="medical school",
abstract="Background: Science and health outreach activities are aimed at motivating and sparking interest among prospective students to pursue careers in these fields; however, research studies supporting this hypothesis are limited. Objective: The aim of our study was to organize an integrated Anatomy and Physiology outreach to examine preuniversity students' learning experiences (learning tools, activities, and facilitators) and motivation to pursue a career in health care and to gather evidence on their attitudes and perceptions of such activities. Methods: A 2-day course on cardiorespiratory and gastrointestinal anatomical systems was presented at the Lee Kong Chian School of Medicine in Singapore using its key pedagogies, that is, multimodal practical and team-based learning. Ninety preuniversity students from 21 preuniversity institutions in Singapore participated in this 2-day course, and their experiences were evaluated using a 4-point Likert scale and open-ended survey questions. Free-text comments were analyzed using inductive thematic analysis. Results: The survey using the 4-point Likert scale was completed by 81 (92\%) of the 88 participants. Most students felt that the course materials were adequate (mean 3.57, SD 0.57) and met the learning objectives (mean 3.73, SD 0.52). The students felt that the instructors were clear (mean 3.73, SD 0.52) and effective (mean 3.70, SD 0.53). They liked the organization of the outreach session (mean 3.64, SD 0.48) and were highly motivated to study medicine or allied/biomedical sciences (mean 3.69, SD 0.54). Practical and team-based learning were regarded as exceedingly satisfactory (mean 3.63, SD 0.53 and mean 3.58, SD 0.54, respectively). All the respondents said that they would recommend this course to peers. Thematic analysis revealed that the participants gained a new perspective of the human body structure and function, they liked the unique learning settings, they were motivated to pursue a career in health care, they were satisfied with the sessions, and interactions with the facilitators increased their understanding of the human anatomy and physiology. Conclusions: Structured health outreach activities provide students with unique opportunities to experience a preclinical learning environment in a medical school, deepen their understanding of human body structure and function, and increase their motivation and interest in science. Further, outreach programs may lay the foundations for potential students aiming to pursue health profession education. ",
doi="10.2196/52533",
url="https://formative.jmir.org/2024/1/e52533"
}


@Article{info:doi/10.2196/50667,
author="Rohani, Narjes
and Sowa, Stephen
and Manataki, Areti",
title="Identifying Learning Preferences and Strategies in Health Data Science Courses: Systematic Review",
journal="JMIR Med Educ",
year="2024",
month="Aug",
day="12",
volume="10",
pages="e50667",
keywords="health data science",
keywords="bioinformatics",
keywords="learning approach",
keywords="learning preference",
keywords="learning tactic",
keywords="learning strategy",
keywords="interdisciplinary",
keywords="systematic review",
keywords="medical education",
abstract="Background: Learning and teaching interdisciplinary health data science (HDS) is highly challenging, and despite the growing interest in HDS education, little is known about the learning experiences and preferences of HDS students. Objective: We conducted a systematic review to identify learning preferences and strategies in the HDS discipline. Methods: We searched 10 bibliographic databases (PubMed, ACM Digital Library, Web of Science, Cochrane Library, Wiley Online Library, ScienceDirect, SpringerLink, EBSCOhost, ERIC, and IEEE Xplore) from the date of inception until June 2023. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included primary studies written in English that investigated the learning preferences or strategies of students in HDS-related disciplines, such as bioinformatics, at any academic level. Risk of bias was independently assessed by 2 screeners using the Mixed Methods Appraisal Tool, and we used narrative data synthesis to present the study results. Results: After abstract screening and full-text reviewing of the 849 papers retrieved from the databases, 8 (0.9\%) studies, published between 2009 and 2021, were selected for narrative synthesis. The majority of these papers (7/8, 88\%) investigated learning preferences, while only 1 (12\%) paper studied learning strategies in HDS courses. The systematic review revealed that most HDS learners prefer visual presentations as their primary learning input. In terms of learning process and organization, they mostly tend to follow logical, linear, and sequential steps. Moreover, they focus more on abstract information, rather than detailed and concrete information. Regarding collaboration, HDS students sometimes prefer teamwork, and sometimes they prefer to work alone. Conclusions: The studies' quality, assessed using the Mixed Methods Appraisal Tool, ranged between 73\% and 100\%, indicating excellent quality overall. However, the number of studies in this area is small, and the results of all studies are based on self-reported data. Therefore, more research needs to be conducted to provide insight into HDS education. We provide some suggestions, such as using learning analytics and educational data mining methods, for conducting future research to address gaps in the literature. We also discuss implications for HDS educators, and we make recommendations for HDS course design; for example, we recommend including visual materials, such as diagrams and videos, and offering step-by-step instructions for students. ",
doi="10.2196/50667",
url="https://mededu.jmir.org/2024/1/e50667"
}


@Article{info:doi/10.2196/59066,
author="Hersh, William",
title="A Quarter-Century of Online Informatics Education: Learners Served and Lessons Learned",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="6",
volume="26",
pages="e59066",
keywords="distance education",
keywords="online learning",
keywords="asynchronous education",
keywords="biomedical and health informatics",
keywords="learning",
keywords="biomedical",
keywords="health informatics",
keywords="education",
keywords="educational",
keywords="educational technology",
keywords="online program",
keywords="online course",
keywords="teaching",
keywords="students",
doi="10.2196/59066",
url="https://www.jmir.org/2024/1/e59066"
}


@Article{info:doi/10.2196/54473,
author="Mikkonen, Kasperi
and Helminen, Eeva-Eerika
and Saarni, I. Samuli
and Saarni, E. Suoma",
title="Learning Outcomes of e-Learning in Psychotherapy Training and Comparison With Conventional Training Methods: Systematic Review",
journal="J Med Internet Res",
year="2024",
month="Jul",
day="29",
volume="26",
pages="e54473",
keywords="mental health",
keywords="psychotherapy",
keywords="digital learning",
keywords="Kirkpatrick model",
keywords="e-learning",
keywords="online health",
keywords="psychotherapy training",
keywords="learning outcome",
keywords="learning outcomes",
keywords="systematic review",
keywords="training methods",
keywords="mental disorders",
keywords="mental disorder",
keywords="accessibility",
keywords="evidence-based",
keywords="scalability",
keywords="cost-effectiveness",
keywords="internet",
keywords="education",
abstract="Background: Mental disorders pose a major public health problem in most western countries. The demand for services for common mental health disorders has been on the rise despite the widespread accessibility of medication. Especially, the supply and demand for evidence-based psychotherapy do not align. Large-scale increase of modern psychotherapy is difficult with current methods of training which are often expensive, time consuming, and dependent on a small number of top-level professionals as trainers. E-learning has been proposed to enhance psychotherapy training accessibility, quality, and scalability. Objective: This systematic review aims to provide an overview of the current evidence regarding e-learning in psychotherapy training. In particular, the review examines the usability, acceptability, and learning outcomes associated with e-learning. Learning outcomes are assessed in different modalities including trainee experiences, knowledge acquisition, skill acquisition, and application of trained content in daily practice. Furthermore, the equivalence of web-based training and conventional training methods is evaluated. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a search from Ovid, MEDLINE, PsycINFO, and Scopus databases between 2008 and June 2022 was conducted. Inclusion criteria required studies to describe e-learning systems for psychotherapy training and assess acceptability, feasibility, or learning outcomes. The risk of bias was evaluated for both randomized and nonrandomized studies. Learning outcomes were categorized using the Kirkpatrick model. Effect sizes comparing e-learning and traditional methods were calculated. Results: The search yielded 3380 publications, of which 34 fulfilled the inclusion criteria. Positive learning outcomes are generally associated with various e-learning programs in psychotherapy training including trainee satisfaction, knowledge, and skill acquisition, and in application of trained content in clinical practice. Learning outcomes generally show equivalence between e-learning and conventional training methods. The overall effect size, indicating this disparity, was 0.01, suggesting no significant difference. This literature displays a high level of heterogeneity in e-learning solutions and assessment methods. Conclusions: e-Learning seems to have good potential to enhance psychotherapy training by increasing access, scalability, and cost-effectiveness while maintaining quality in terms of learning outcomes. Results are congruent with findings related to e-learning in health education in general where e-learning as a pedagogy is linked to an opportunity to carry out learner-centric practices. Recommendations for conducting psychotherapy training programs in blended settings supported by activating learning methods are presented. However, due to the heterogeneity and limitations in the existing literature, further research is necessary to replicate these findings and to establish global standards for e-learning, as well as for the assessment of training outcomes in psychotherapy education. Research is especially needed on the effects of training on patient outcomes and optimal ways to combine e-learning and conventional training methods in blended learning settings. ",
doi="10.2196/54473",
url="https://www.jmir.org/2024/1/e54473",
url="http://www.ncbi.nlm.nih.gov/pubmed/39073862"
}


@Article{info:doi/10.2196/58743,
author="De Martinis, Massimo
and Ginaldi, Lia",
title="Digital Skills to Improve Levels of Care and Renew Health Care Professions",
journal="JMIR Med Educ",
year="2024",
month="May",
day="1",
volume="10",
pages="e58743",
keywords="digital competence",
keywords="telehealth",
keywords="nursing",
keywords="health care workforce",
keywords="health care professionals",
keywords="informatics",
keywords="education",
keywords="curriculum",
keywords="interdisciplinary education",
keywords="health care education",
doi="10.2196/58743",
url="https://mededu.jmir.org/2024/1/e58743"
}


@Article{info:doi/10.2196/46764,
author="Soneson, Emma
and Howarth, Emma
and Weir, Alison
and Jones, B. Peter
and Fazel, Mina",
title="Empowering School Staff to Support Pupil Mental Health Through a Brief, Interactive Web-Based Training Program: Mixed Methods Study",
journal="J Med Internet Res",
year="2024",
month="Apr",
day="23",
volume="26",
pages="e46764",
keywords="mental health",
keywords="children",
keywords="schools",
keywords="teachers",
keywords="training",
keywords="digital intervention",
keywords="pupil mental health",
keywords="mental health training",
keywords="intervention",
keywords="empowerment",
keywords="student",
keywords="pupil",
keywords="support",
keywords="school staff",
keywords="web-based training",
abstract="Background: Schools in the United Kingdom and elsewhere are expected to protect and promote pupil mental health. However, many school staff members do not feel confident in identifying and responding to pupil mental health difficulties and report wanting additional training in this area. Objective: We aimed to explore the feasibility of Kognito's At-Risk for Elementary School Educators, a brief, interactive web-based training program that uses a simulation-based approach to improve school staff's knowledge and skills in supporting pupil mental health. Methods: We conducted a mixed methods, nonrandomized feasibility study of At-Risk for Elementary School Educators in 6 UK primary schools. Our outcomes were (1) school staff's self-efficacy and preparedness to identify and respond to pupil mental health difficulties, (2) school staff's identification of mental health difficulties and increased risk of mental health difficulties, (3) mental health support for identified pupils (including conversations about concerns, documentation of concerns, in-class and in-school support, and referral and access to specialist mental health services), and (4) the acceptability and practicality of the training. We assessed these outcomes using a series of questionnaires completed at baseline (T1), 1 week after the training (T2), and 3 months after the training (T3), as well as semistructured qualitative interviews. Following guidance for feasibility studies, we assessed quantitative outcomes across time points by comparing medians and IQRs and analyzed qualitative data using reflexive thematic analysis. Results: A total of 108 teachers and teaching assistants (TAs) completed T1 questionnaires, 89 (82.4\%) completed T2 questionnaires, and 70 (64.8\%) completed T3 questionnaires; 54 (50\%) completed all 3. Eight school staff members, including teachers, TAs, mental health leads, and senior leaders, participated in the interviews. School staff reported greater confidence and preparedness in identifying and responding to mental health difficulties after completing the training. The proportion of pupils whom they identified as having mental health difficulties or increased risk declined slightly over time (medianT1=10\%; medianT2=10\%; medianT3=7.4\%), but findings suggested a slight increase in accuracy compared with a validated screening measure (the Strengths and Difficulties Questionnaire). In-school mental health support outcomes for identified pupils improved after the training, with increases in formal documentation and communication of concerns as well as provision of in-class and in-school support. Referrals and access to external mental health services remained constant. The qualitative findings indicated that school staff perceived the training as useful, practical, and acceptable. Conclusions: The findings suggest that brief, interactive web-based training programs such as At-Risk for Elementary School Educators are a feasible means to improve the identification of and response to mental health difficulties in UK primary schools. Such training may help address the high prevalence of mental health difficulties in this age group by helping facilitate access to care and support. ",
doi="10.2196/46764",
url="https://www.jmir.org/2024/1/e46764",
url="http://www.ncbi.nlm.nih.gov/pubmed/38652534"
}


@Article{info:doi/10.2196/51112,
author="Rettinger, Lena
and Putz, Peter
and Aichinger, Lea
and Javorszky, Maria Susanne
and Widhalm, Klaus
and Ertelt-Bach, Veronika
and Huber, Andreas
and Sargis, Sevan
and Maul, Lukas
and Radinger, Oliver
and Werner, Franz
and Kuhn, Sebastian",
title="Telehealth Education in Allied Health Care and Nursing: Web-Based Cross-Sectional Survey of Students' Perceived Knowledge, Skills, Attitudes, and Experience",
journal="JMIR Med Educ",
year="2024",
month="Mar",
day="21",
volume="10",
pages="e51112",
keywords="telehealth",
keywords="health care education",
keywords="student perspectives",
keywords="curriculum",
keywords="interdisciplinary education",
abstract="Background: The COVID-19 pandemic has highlighted the growing relevance of telehealth in health care. Assessing health care and nursing students' telehealth competencies is crucial for its successful integration into education and practice. Objective: We aimed to assess students' perceived telehealth knowledge, skills, attitudes, and experiences. In addition, we aimed to examine students' preferences for telehealth content and teaching methods within their curricula. Methods: We conducted a cross-sectional web-based study in May 2022. A project-specific questionnaire, developed and refined through iterative feedback and face-validity testing, addressed topics such as demographics, personal perceptions, and professional experience with telehealth and solicited input on potential telehealth course content. Statistical analyses were conducted on surveys with at least a 50\% completion rate, including descriptive statistics of categorical variables, graphical representation of results, and Kruskal Wallis tests for central tendencies in subgroup analyses. Results: A total of 261 students from 7 bachelor's and 4 master's health care and nursing programs participated in the study. Most students expressed interest in telehealth (180/261, 69\% very or rather interested) and recognized its importance in their education (215/261, 82.4\% very or rather important). However, most participants reported limited knowledge of telehealth applications concerning their profession (only 7/261, 2.7\% stated profound knowledge) and limited active telehealth experience with various telehealth applications (between 18/261, 6.9\% and 63/261, 24.1\%). Statistically significant differences were found between study programs regarding telehealth interest (P=.005), knowledge (P<.001), perceived importance in education (P<.001), and perceived relevance after the pandemic (P=.004). Practical training with devices, software, and apps and telehealth case examples with various patient groups were perceived as most important for integration in future curricula. Most students preferred both interdisciplinary and program-specific courses. Conclusions: This study emphasizes the need to integrate telehealth into health care education curricula, as students state positive telehealth attitudes but seem to be not adequately prepared for its implementation. To optimally prepare future health professionals for the increasing role of telehealth in practice, the results of this study can be considered when designing telehealth curricula. ",
doi="10.2196/51112",
url="https://mededu.jmir.org/2024/1/e51112",
url="http://www.ncbi.nlm.nih.gov/pubmed/38512310"
}


@Article{info:doi/10.2196/54401,
author="Shikino, Kiyoshi
and Nishizaki, Yuji
and Fukui, Sho
and Yokokawa, Daiki
and Yamamoto, Yu
and Kobayashi, Hiroyuki
and Shimizu, Taro
and Tokuda, Yasuharu",
title="Development of a Clinical Simulation Video to Evaluate Multiple Domains of Clinical Competence: Cross-Sectional Study",
journal="JMIR Med Educ",
year="2024",
month="Feb",
day="29",
volume="10",
pages="e54401",
keywords="discrimination index",
keywords="General Medicine In-Training Examination",
keywords="clinical simulation video",
keywords="postgraduate medical education",
keywords="video",
keywords="videos",
keywords="training",
keywords="examination",
keywords="examinations",
keywords="medical education",
keywords="resident",
keywords="residents",
keywords="postgraduate",
keywords="postgraduates",
keywords="simulation",
keywords="simulations",
keywords="diagnosis",
keywords="diagnoses",
keywords="diagnose",
keywords="general medicine",
keywords="general practice",
keywords="general practitioner",
keywords="skill",
keywords="skills",
abstract="Background: Medical students in Japan undergo a 2-year postgraduate residency program to acquire clinical knowledge and general medical skills. The General Medicine In-Training Examination (GM-ITE) assesses postgraduate residents' clinical knowledge. A clinical simulation video (CSV) may assess learners' interpersonal abilities. Objective: This study aimed to evaluate the relationship between GM-ITE scores and resident physicians' diagnostic skills by having them watch a CSV and to explore resident physicians' perceptions of the CSV's realism, educational value, and impact on their motivation to learn. Methods: The participants included 56 postgraduate medical residents who took the GM-ITE between January 21 and January 28, 2021; watched the CSV; and then provided a diagnosis. The CSV and GM-ITE scores were compared, and the validity of the simulations was examined using discrimination indices, wherein ?0.20 indicated high discriminatory power and >0.40 indicated a very good measure of the subject's qualifications. Additionally, we administered an anonymous questionnaire to ascertain participants' views on the realism and educational value of the CSV and its impact on their motivation to learn. Results: Of the 56 participants, 6 (11\%) provided the correct diagnosis, and all were from the second postgraduate year. All domains indicated high discriminatory power. The (anonymous) follow-up responses indicated that the CSV format was more suitable than the conventional GM-ITE for assessing clinical competence. The anonymous survey revealed that 12 (52\%) participants found the CSV format more suitable than the GM-ITE for assessing clinical competence, 18 (78\%) affirmed the realism of the video simulation, and 17 (74\%) indicated that the experience increased their motivation to learn. Conclusions: The findings indicated that CSV modules simulating real-world clinical examinations were successful in assessing examinees' clinical competence across multiple domains. The study demonstrated that the CSV not only augmented the assessment of diagnostic skills but also positively impacted learners' motivation, suggesting a multifaceted role for simulation in medical education. ",
doi="10.2196/54401",
url="https://mededu.jmir.org/2024/1/e54401",
url="http://www.ncbi.nlm.nih.gov/pubmed/38421691"
}


@Article{info:doi/10.2196/53072,
author="Goncalves, Aurelie
and Lespiau, Florence
and Briet, Ga{\"e}tan
and Vaillant-Coindard, Eug{\'e}nie
and Palermo, Ang{\`e}le
and Decobert, Elsa
and Allegret-Bourdon, Nathan
and Charbonnier, Elodie",
title="Exploring the Use of a Learning-Based Exergame to Enhance Physical Literacy, Soft Skills, and Academic Learning in School-Age Children: Pilot Interventional Study",
journal="JMIR Serious Games",
year="2024",
month="Feb",
day="23",
volume="12",
pages="e53072",
keywords="learning support",
keywords="exergaming",
keywords="physics playground",
keywords="educational games",
keywords="primary school",
keywords="children",
abstract="Background: There is ample evidence that most children do not perform enough physical activity (PA). To address this major public health problem, the French government implemented 30 minutes of daily PA (DPA) at schools but did not provide any supplemental resources or concrete guidance. Considering both children's interest in video games and the need for teachers to complete their curriculum, the use of a learning-based exergame that combines PA and learning appears particularly relevant. Objective: The first objective of this study was to evaluate the feasibility of implementing 30 minutes of DPA through exergaming among school-age children. The second objective was to examine the effects of an exergaming program on physical literacy, academic learning, and soft skills (motivation, self-efficacy, and concentration). Methods: This interventional study had a pre-post design and used the Play L{\"U} exergame platform. The study included 79 children with a mean age of 8.9 (SD 1.2) years from grade 2 (7 years old) to grade 5 (11 years old). Play L{\"U} requires players to throw balls against a wall to reach a target or to activate an object and provides an interactive game area for educational activities linked to specific learning themes. After a 4-session familiarization phase during which the teachers chose to prioritize mathematics learning in 30-minute DPA sessions, students took part in DPA sessions over a period of 3 weeks with Play L{\"U} and a motor skills circuit behind the L{\"U} setup to keep them continuously active. All sessions were carried out by PA specialists. Each session started with a warm-up using the Gr{\"o}{\"o}ve application, continued with main activities promoting mathematics learning adapted to each grade level, and ended with a 3-minute meditation for returning to a calm and serene state using the Ga{\"i}a application. Before (T0) and after (T1) the program, students completed a self-evaluation booklet to assess their levels of physical literacy, academic performance, and soft skills. Results: The implementation of this exergaming program was welcomed by the school's administration, teaching staff, and parents. After the program, we observed increased scores for physical literacy (difference +2.6, percentage change +3.6\%; W=933.0; P=.002; rrb=?0.39, 95\% CI ?0.58 to ?0.16) and motivation in mathematics (+0.7, +9.8\%; W=381.5; P=.005; rrb=?0.44, 95\% CI ?0.66 to ?0.16). In addition, it is important to note that some measures progressed differently across learning levels and age groups. Conclusions: The study results indicate positive impacts of learning-based exergaming on physical literacy and motivation in mathematics among school-age children. ",
doi="10.2196/53072",
url="https://games.jmir.org/2024/1/e53072",
url="http://www.ncbi.nlm.nih.gov/pubmed/38393767"
}


@Article{info:doi/10.2196/53372,
author="Bevens, William
and Davenport, Rebekah
and Neate, Sandra
and Yu, Maggie
and Jelinek, Pia
and Jelinek, Alexander George
and Reece, Jeanette",
title="Web-Based Health Information Seeking by People Living With Multiple Sclerosis: Qualitative Investigation of the Multiple Sclerosis Online Course",
journal="J Med Internet Res",
year="2024",
month="Feb",
day="9",
volume="26",
pages="e53372",
keywords="information-seeking behavior",
keywords="self-management",
keywords="lifestyle",
keywords="digital health",
abstract="Background: Digital technologies have afforded people living with multiple sclerosis (MS) access to telehealth consultations, diagnostic tools, and monitoring. Although health care professionals remain the most trusted source of information, the internet has emerged as a valuable resource for providing MS-related information, particularly during the COVID-19 pandemic. Notably, people living with MS are increasingly seeking educational content for a range of topics related to the self-management of MS; however, web-based information seeking remains largely underevaluated. To address this gap and ensure that web-based health-related information is accessible and engaging, this study used qualitative methods to analyze the reflections from participants of web-based educational programs for people living with MS. Objective: This study aimed to explore the motivations, behaviors, and expectations of web-based health information seeking for people living with MS. Methods: We conducted semistructured interviews for 38 people living with MS 1 month after they completed the novel MS Online Course, which provided information on modifiable lifestyle-related risk factors for people living with MS. Of the 38 participants, 22 (58\%) completed the intervention course and 16 (42\%) completed the standard care course. Inductive thematic analysis was used within a qualitative paradigm, and 2 authors coded each interview separately and arrived at themes with consensus. Results: We identified 2 themes: motivation to learn and MS information on the web. The diagnosis of MS was described as a pivotal moment for precipitating web-based information seeking. People living with MS sought lifestyle-related information to facilitate self-management and increase control of their MS. Although social media sites and MS websites were considered useful for providing both support and information, discretion was needed to critically appraise information. Recognizable institutions were frequently accessed because of their trustworthiness. Conclusions: This study provided novel insights into the motivations of people living with MS for seeking web-based health information. Furthermore, their preferences for the content and format of the web-based information accessed and their experiences and reactions to this information were explored. These findings may guide educators, researchers, and clinicians involved in MS care to optimize the engagement and processing of web-based health information seeking by people living with MS. ",
doi="10.2196/53372",
url="https://www.jmir.org/2024/1/e53372",
url="http://www.ncbi.nlm.nih.gov/pubmed/38335016"
}


@Article{info:doi/10.2196/43943,
author="Zhang, Xiaojuan
and Wen, Justin Yingkun
and Han, Ning
and Jiang, Yawen",
title="The Effect of a Video-Assisted Health Education Program Followed by Peer Education on the Health Literacy of COVID-19 and Other Infectious Diseases Among School Children: Quasi-Randomized Controlled Trial",
journal="JMIR Hum Factors",
year="2024",
month="Jan",
day="29",
volume="11",
pages="e43943",
keywords="infectious diseases",
keywords="primary school students",
keywords="quasi-randomized controlled trial",
keywords="video-assisted health education",
keywords="peer education",
keywords="item response theory",
keywords="IRT",
abstract="Background: To improve the engagement and effectiveness of traditional health programs, it is necessary to explore alternative models of health education including video-assisted lectures and peer education. Objective: This study aimed to evaluate the effects of a combination of video-assisted lectures and peer education on health literacy related to infectious diseases among students. Methods: Third-grade classes from 11 pilot schools in Longgang District of Shenzhen, China, were randomized to the intervention and control groups. In the intervention group, a video-assisted interactive health education program was conducted twice over a time span of 5 months. Each of the 2 sessions included a 40-minute lecture on COVID-19 and other common infectious diseases in schools and a 5-minute science video. In addition, 5 ``little health supervisors'' at the end of the first session were elected in each class, who were responsible for helping class members to learn health knowledge and develop good hygiene habits. Students answered the same quiz before the first and after the second session. Models based on item response theory (IRT) were constructed to score the students' knowledge of infectious diseases based on the quiz. Results: In total, 52 classes and 2526 students (intervention group: n=1311; control group: n=1215) were enrolled. Responses of the baseline survey were available for 2177 (86.2\%; intervention group: n=1306; control group: n=871) students and those of the postintervention survey were available for 1862 (73.7\%; intervention group: n=1187; control group: n=675). There were significant cross-group differences in the rates of correctly answering questions about influenza symptoms, transmission, and preventive measures; chicken pox symptoms; norovirus diarrhea symptoms; mumps symptoms; and COVID-19 symptoms. Average IRT scores of questions related to infectious diseases in the intervention and control groups were, respectively, --0.0375 (SD 0.7784) and 0.0477 (SD 0.7481) before the intervention (P=.01), suggesting better baseline knowledge in the control group. After the intervention, the average scores of the intervention and control groups were 0.0543 (SD 0.7569) and --0.1115 (SD 0.7307), respectively (P<.001), suggesting not only significantly better scores but also greater improvement in the intervention group. Conclusions: After the health education project, the correct answer rate of infectious disease questions in the intervention group was higher than that of the control group, which indicates significant effects of the combination of video-assisted lectures and peer education for the promotion of health literacy. In addition, the intervention effect of the first session persisted for at least 4 months up to the second session. As such, the proposed program was effective in improving the health literacy of school children in relation to infectious diseases and should be considered for massive health promotion campaigns during pandemics. Trial Registration: ISRCTN ISRCTN49297995; https://www.isrctn.com/ISRCTN49297995 ",
doi="10.2196/43943",
url="https://humanfactors.jmir.org/2024/1/e43943",
url="http://www.ncbi.nlm.nih.gov/pubmed/38285496"
}


@Article{info:doi/10.2196/43705,
author="Monahan, Ken
and Gould, Edward
and Rice, Todd
and Wright, Patty
and Vasilevskis, Eduard
and Harrell, Frank
and Drago, Monique
and Mitchell, Sarah",
title="Impact of the COVID-19 Pandemic on Medical Grand Rounds Attendance: Comparison of In-Person and Remote Conferences",
journal="JMIR Med Educ",
year="2024",
month="Jan",
day="3",
volume="10",
pages="e43705",
keywords="continuing medical education",
keywords="COVID-19",
keywords="distance education",
keywords="professional development",
keywords="virtual learning",
abstract="Background: Many academic medical centers transitioned from in-person to remote conferences due to the COVID-19 pandemic, but the impact on faculty attendance is unknown. Objective: This study aims to evaluate changes in attendance at medical grand rounds (MGR) following the transition from an in-person to remote format and as a function of the COVID-19 census at Vanderbilt Medical Center. Methods: We obtained the faculty attendee characteristics from Department of Medicine records. Attendance was recorded using a SMS text message--based system. The daily COVID-19 census was recorded independently by hospital administration. The main attendance metric was the proportion of eligible faculty that attended each MGR. Comparisons were made for the entire cohort and for individual faculty. Results: The observation period was from March 2019 to June 2021 and included 101 MGR conferences with more than 600 eligible faculty. Overall attendance was unchanged during the in-person and remote formats (12,536/25,808, 48.6\% vs 16,727/32,680, 51.2\%; P=.44) and did not change significantly during a surge in the COVID-19 census. Individual faculty members attendance rates varied widely. Absolute differences between formats were less than --20\% or greater than 20\% for one-third (160/476, 33.6\%) of faculty. Pulmonary or critical care faculty attendance increased during the remote format compared to in person (1450/2616, 55.4\% vs 1004/2045, 49.1\%; P<.001). A cloud-based digital archive of MGR lectures was accessed by <1\% of faculty per conference. Conclusions: Overall faculty attendance at MGR did not change following the transition to a remote format, regardless of the COVID-19 census, but individual attendance habits fluctuated in a bidirectional manner. Incentivizing the use of a digital archive may represent an opportunity to increase faculty consumption of MGR. ",
doi="10.2196/43705",
url="https://mededu.jmir.org/2024/1/e43705",
url="http://www.ncbi.nlm.nih.gov/pubmed/38029287"
}


@Article{info:doi/10.2196/42354,
author="Alkuran, Oqba
and Al-Mehaisen, Lama
and Abu Mahfouz, Ismaiel
and Al-Kuran, Lena
and Asali, Fida
and Khamees, Almu'atasim
and AL-Shatanawi, Tariq
and Jaber, Hatim",
title="Distance Electronic Learning Strategy in Medical Teaching During the COVID-19 Pandemic: Cross-Sectional Survey Study",
journal="JMIR Med Educ",
year="2023",
month="Dec",
day="5",
volume="9",
pages="e42354",
keywords="COVID-19",
keywords="distant electronic learning",
keywords="medical",
keywords="medicine",
keywords="school",
keywords="medical school",
keywords="medical education",
keywords="clinical skill",
keywords="teaching hospital",
keywords="questionnaire",
keywords="distance learning",
keywords="distance education",
keywords="web-based education",
keywords="web-based learning",
keywords="medical student",
abstract="Background: Teaching hospitals have been regarded as the primary settings where doctors teach and practice high-quality medicine, as well as where medical students learn the profession and acquire their initial clinical skills. A percentage of instruction is now done over the internet or via electronic techniques. The present COVID-19 epidemic has pushed distance electronic learning (DEL) to the forefront of education at all levels, including medical institutions. Objective: This study aimed to observe how late-stage medical students felt about DEL, which was put in place during the recent COVID-19 shutdown in Jordan. Methods: We conducted a prospective, cross-sectional, web-based, questionnaire-based research study during the COVID-19 pandemic lockdown between March 15 and May 1, 2020. During this period, all medical schools in Jordan shifted to DEL. Results: A total of 380 students responded to a request to fill out the questionnaire, of which 256 completed the questionnaire. The data analysis showed that 43.6\% (n=112) of respondents had no DEL experience, and 53.1\% (n=136)of respondents perceived the DEL method as user-friendly. On the other hand, 64.1\% (n=164) of students strongly believed that DEL cannot substitute traditional clinical teaching. There was a significant positive correlation between the perception of user-friendliness and the clarity of the images and texts used. Moreover, there was a strong positive correlation between the perception of sound audibility and confidence in applying knowledge gained through DEL to clinical practice. Conclusions: DEL is a necessary and important tool in modern medical education, but it should be used as an auxiliary approach in the clinical setting since it cannot replace conventional personal instruction. ",
doi="10.2196/42354",
url="https://mededu.jmir.org/2023/1/e42354",
url="http://www.ncbi.nlm.nih.gov/pubmed/38051556"
}


@Article{info:doi/10.2196/49231,
author="Ganek, Emily
and Sazon, P. Romy Antonnette
and Gray, Lauren
and Sherry, Daisy",
title="An Introduction to Faculty Diversity, Equity, and Inclusion for Excellence in Nurse Education: Literature Review",
journal="Asian Pac Isl Nurs J",
year="2023",
month="Dec",
day="1",
volume="7",
pages="e49231",
keywords="nursing education",
keywords="diversity",
keywords="equity",
keywords="inclusion",
keywords="inclusive",
keywords="nursing",
keywords="allied health",
keywords="medical education",
keywords="nurse",
keywords="nurses",
keywords="health care education",
keywords="curriculum",
keywords="DEI",
keywords="teaching",
keywords="educator",
keywords="educators",
keywords="hiring",
keywords="recruiting",
keywords="recruitment",
keywords="teacher",
keywords="teachers",
abstract="Background: The diversity of the world's population is increasing, along with the health inequities of underrepresented minority populations. To provide high-quality care to all patients, nurses require an understanding of diversity, equity, and inclusion (DEI) as well as how to implement best practices. Nurse educators are the ones to lead the way for DEI education for students. Objective: This paper aims to describe the findings of a literature review that introduces DEI concepts for excellence in nurse education and their related benefits. Best practices for actions to address DEI in nursing education will be described. Methods: After institutional review board approval, a literature search yielded 61 articles using 15 distinct keywords in 4 global, peer-reviewed literature databases. Melynk and Fineout-Overholt's (2023) Levels of Evidence guided the process of selecting 26 peer-reviewed articles and resources. Results: Common themes for best practices in DEI were identified. These themes included recruiting underrepresented minority nursing faculty, incorporating DEI into an institution's mission statement, addressing DEI topics in curricula, providing leadership, having a DEI strategic plan, developing education, developing data-based interventions, instilling policy change, partnering in outreach, targeting impact on hiring committees, recognizing DEI work, and providing mentorship. Conclusions: In summary, this literature review provides several strategies to address DEI for nurse educators. Committing to DEI efforts and improving diversity in the nurse educator workforce are integral steps in improving the quality and inclusivity of nursing education and ultimately improving the health of our communities. ",
doi="10.2196/49231",
url="https://apinj.jmir.org/2023/1/e49231",
url="http://www.ncbi.nlm.nih.gov/pubmed/38039066"
}


@Article{info:doi/10.2196/49013,
author="Davoudi, Kaveh
and Rakhecha, Tushar
and Corriero, Chiara Anna
and Ko, Natalie Kar Chang
and Ismail, Roseanne
and King, B. Esther R.
and Holl{\'e}n, Linda",
title="The Impact of UK Medical Students' Demographics and Socioeconomic Factors on Their Self-Reported Familiarity With the Postgraduate Training Pathways and Application Process: Cross-Sectional Study",
journal="JMIR Med Educ",
year="2023",
month="Nov",
day="24",
volume="9",
pages="e49013",
keywords="age",
keywords="career progression",
keywords="clinicians",
keywords="cross-sectional study",
keywords="demographics",
keywords="ethnicity",
keywords="gender",
keywords="leadership",
keywords="medical students demographics",
keywords="medical students",
keywords="online survey",
keywords="research",
keywords="students",
keywords="teaching",
keywords="training",
abstract="Background: UK medical graduates can apply for specialty training after completing a 2-year internship (foundation training). Postfoundation training application requirements vary depending on specialty but fundamentally require key skills such as teaching, research, and leadership. Objective: This study investigated whether medical student demographics impact their self-reported familiarity with the Post-Foundation Training Pathways (PFTPs) and Post-Foundation Application Process (PFAP). Methods: This was a cross-sectional study using a Bristol Online Survey. We invited all UK medical students to answer a range of questions about their demographics. Students were then asked to rank their familiarity with PFTPs and PFAP on a scale of 1 to 5 (1=least familiar and 5=most familiar). The responses were collected between March 2022 and April 2022 and exported for further analysis. Statistical analysis was conducted in Stata (version 17.1; StataCorp) using chi-square tests. Results: A total of 850 students from 31 UK medical schools took part. There was a significant difference between gender and self-reported familiarity with PFTPs (P<.001) and PFAP (P<.001), with male students expressing higher familiarity. Similarly, there was a difference between ethnicity and self-reported familiarity with PFTPs (P=.02) and PFAP (P<.001), with White students more likely to express higher familiarity than their Black, Asian, or Mixed Ethnic counterparts. Lastly, there was an overall difference between medical background and age and self-reported familiarity with PFTPs and PFAP (all P<.001), with students from medical backgrounds and older students being more likely to express higher familiarity. Conclusions: The impact of gender, ethnicity, age, and medical background on students' self-reported familiarity with PFTPs and PFAP is significant. Further studies are required to evaluate the impact of these factors on tested knowledge of PFTPs and PFAP and whether this impacts the success rate of postfoundation applications. ",
doi="10.2196/49013",
url="https://mededu.jmir.org/2023/1/e49013",
url="http://www.ncbi.nlm.nih.gov/pubmed/37999951"
}


@Article{info:doi/10.2196/50638,
author="Mesk{\'o}, Bertalan",
title="Prompt Engineering as an Important Emerging Skill for Medical Professionals: Tutorial",
journal="J Med Internet Res",
year="2023",
month="Oct",
day="4",
volume="25",
pages="e50638",
keywords="artificial intelligence",
keywords="AI",
keywords="digital health",
keywords="future",
keywords="technology",
keywords="ChatGPT",
keywords="GPT-4",
keywords="large language models",
keywords="language model",
keywords="LLM",
keywords="prompt",
keywords="prompts",
keywords="prompt engineering",
keywords="AI tool",
keywords="engineering",
keywords="healthcare professional",
keywords="decision-making",
keywords="LLMs",
keywords="chatbot",
keywords="chatbots",
keywords="conversational agent",
keywords="conversational agents",
keywords="NLP",
keywords="natural language processing",
doi="10.2196/50638",
url="https://www.jmir.org/2023/1/e50638",
url="http://www.ncbi.nlm.nih.gov/pubmed/37792434"
}


@Article{info:doi/10.2196/52509,
author="Jain, Shikha
and Allan, M. Jessica
and Bhayani, K. Rakhee",
title="System-Wide Change Is Essential to Value the Contributions of Women in Medicine and Science",
journal="J Med Internet Res",
year="2023",
month="Sep",
day="22",
volume="25",
pages="e52509",
keywords="women",
keywords="women physicians",
keywords="women scientists",
keywords="gender equity",
keywords="health care",
keywords="diversity",
keywords="leadership",
keywords="intersectionality",
keywords="minority tax",
keywords="gratitude tax",
keywords="glass ceiling",
keywords="glass cliff",
keywords="academia",
keywords="academic medicine",
keywords="hierarchy",
keywords="change",
doi="10.2196/52509",
url="https://www.jmir.org/2023/1/e52509",
url="http://www.ncbi.nlm.nih.gov/pubmed/37738082"
}


@Article{info:doi/10.2196/48263,
author="Fulton-Ward, Taylor
and Bain, Robert
and Khoury, G. Emma
and Keshwara, M. Sumirat
and Joseph, S. Prince Josiah
and Selby, Peter
and Millward, P. Christopher",
title="Benefits of Mentoring in Oncology Education for Mentors and Mentees: Pre-Post Interventional Study of the British Oncology Network for Undergraduate Societies' National Oncology Mentorship Scheme",
journal="JMIR Med Educ",
year="2023",
month="Sep",
day="11",
volume="9",
pages="e48263",
keywords="mentoring",
keywords="medical education",
keywords="oncology",
keywords="medical student",
keywords="teaching",
keywords="undergraduate",
keywords="graduate",
keywords="student",
keywords="cancer",
keywords="mentor",
keywords="mentee",
keywords="mentors",
keywords="mentees",
abstract="Background: Formal education of oncology is lacking in many undergraduate medical curricula. Mentoring schemes can expose participants to specific areas of medicine and may address the shortfalls in oncology education. Few mentoring schemes have been designed within the United Kingdom, especially within oncology. There is a need to understand reasons for mentor and mentee participation in such schemes and to identify ways to minimize barriers to engagement. Objective: This study identifies motivations for participation in an oncology mentoring scheme and its benefits and limitations to both the mentee and the mentor. Methods: The British Oncology Network for Undergraduate Societies launched a National Oncology Mentorship Scheme (NOMS) on September 1, 2021. Mentees (medical student or foundation doctor) were paired with mentors (specialty registrar or consultant), for 6 months of mentoring. In total, 86 mentors and 112 mentees were recruited to the scheme. The mentees and mentors were asked to meet at least 3 times during this period and suggestions were provided on the content of mentoring. Mentees and mentors were invited to complete a prescheme questionnaire, exploring motivations for involvement in the scheme, current experiences within oncology, and knowledge and interests in the field. At the end of the scheme, mentors and mentees were asked to complete a postscheme questionnaire exploring experiences and benefits or limitations of participation. Paired analysis was performed using the Wilcoxon signed-rank test. For free text data, content analysis was applied to summarize the main themes in the data. Results: Of the 66 (59\%) mentees who completed the prescheme questionnaire, 41 (62\%) were clinical, 21 (32\%) preclinical medical students, and the remainder were junior doctors. For mentees, networking was the primary reason for joining the scheme (n=25, 38\%). Mentees ranked experience of oncology at medical school at 3 on 10 (IQR 2-5). In this, 46 (53\%) mentors completed the prescheme questionnaire, 35 (76\%) were registrar level, and the remainder were consultant level (n=11). The most common reason for mentor participation was to increase awareness and interest in the field (n=29, 63\%). Of those who completed the prescheme questionnaire, 23 (35\%) mentees and 25 (54\%) mentors completed the postscheme questionnaire. Knowledge in all areas of oncology assessed significantly increased during the scheme (P<.001). Most mentees (n=21, 91\%) and mentors (n=18, 72\%) felt they had benefited from the scheme. Mentees cited gaining insights into oncology as most beneficial; and mentors, opportunities to develop professionally. Whilst mentees did not report any barriers to participating in the scheme, mentors stated lack of time as the greatest barrier to mentoring. Conclusions: British Oncology Network for Undergraduate Societies' NOMS is expanding and is beneficial for mentees through increasing knowledge, providing exposure, and career advice in oncology. Mentors benefit from improving their mentoring skills and personal satisfaction. ",
doi="10.2196/48263",
url="https://mededu.jmir.org/2023/1/e48263",
url="http://www.ncbi.nlm.nih.gov/pubmed/37695662"
}


@Article{info:doi/10.2196/44240,
author="Martindale, M. Jaclyn
and Carrasquillo, A. Rachel
and Otallah, Ireland Scott
and Brooks, K. Amber
and Denizard-Thompson, Nancy
and Pharr, Emily
and Choate, Nakiea
and Sokolosky, Mitchell
and Strauss, Doyle Lauren",
title="Local Culture and Community Through a Digital Lens: Viewpoint on Designing and Implementing a Virtual Second Look Event for Residency Applicants",
journal="JMIR Med Educ",
year="2023",
month="Sep",
day="11",
volume="9",
pages="e44240",
keywords="medical education",
keywords="graduate medical education",
keywords="residency application",
keywords="virtual interviews",
keywords="match",
keywords="recruitment",
abstract="Background: The COVID-19 pandemic altered how residency interviews occur. Despite 2 years of web-based interviews, these are still perceived as inferior to in-person experiences. Showcasing a program and location is critical for recruitment; however, it is difficult to highlight the program's location and community digitally. This article presents the authors' viewpoints on designing and implementing a virtual second look for residency applicants. Objective: Our objective was to host a web-based event to feature the benefits of living in Winston-Salem, North Carolina, for residency applicants, enhance recruitment efforts, and ensure a successful residency match. The goal was to cover topics that interested all applicants, highlight how Winston-Salem is a special place to live, involve current residents, and engage community members. Methods: Three programs--child neurology, neurology, and family medicine were chosen for a pilot virtual second look. All residency program directors' were asked to recommend community contacts and help identify residents and faculty who may serve as content experts on one of the topics in the panel discussions. A total of 24 community leaders from restaurants, venues, schools, and businesses were contacted, and 18 agreed to participate. The panel discussions included living in and raising a family in Winston-Salem, experiencing Winston-Salem arts and music, where to eat and drink like a local, and enjoying sports and outdoors in the area. The 2-hour event was hosted on Zoom. Postevent feedback assessments were automatically sent to each registrant through Research Electronic Data Capture (REDCap). This study was deemed exempt from Wake Forest University Health Sciences institutional review board review (IRB00088703). Results: There were 51 registrants for the event, and 28 of 48 registrants provided postevent feedback, which was positive. The authors found in the MATCH residency results that 2 of 2 child neurology positions, 4 of 6 adult neurology positions, and 1 of 10 family medicine positions attended our second look event. One adult neurology resident who did not participate was an internal candidate. All respondents agreed or strongly agreed that the session was valuable, well organized, and met their expectations or goals. Furthermore, all respondents gained new information during this web-based event not obtained during their interview day. Conclusions: The virtual second look event for residency attendees featured the benefits of living in Winston-Salem, and the perspectives of current residents. Feedback from the session was overall positive; however, a top desire would be devoting more time for the applicants to ask questions directly to the community leaders and our resident trainees. This program could be reproducible by other institutions. It could be broadened to a graduate medical education--wide virtual second look event where all medical and surgical programs could opt to participate, facilitating an equitable opportunity for prospective applicants. ",
doi="10.2196/44240",
url="https://mededu.jmir.org/2023/1/e44240",
url="http://www.ncbi.nlm.nih.gov/pubmed/37695665"
}


@Article{info:doi/10.2196/48299,
author="Benton, Mark",
title="Experience and Impact of COVID-19 on a Newly Formed Rural University Medical Office: Survey Study",
journal="JMIR Form Res",
year="2023",
month="Sep",
day="7",
volume="7",
pages="e48299",
keywords="remote",
keywords="access",
keywords="COVID-19",
keywords="learning",
keywords="survey",
keywords="office",
keywords="HOPE",
keywords="administration",
keywords="administrative",
keywords="medical education",
keywords="education system",
keywords="education systems",
abstract="Background: The COVID-19 pandemic had large social effects, particularly in the fields of medicine and medical education. Medical organizations in the United States operate in overlapping contexts with interrelated goals inside multiple organizations, and the context of work strongly influenced how organizations were able to respond to COVID-19 restrictions. Objective: This research examines the experience and impact of COVID-19 on the implementation of a Health Resources and Services Administration grant in a newly formed university medical office with the interrelated goals of health policy, health outreach, and medical education. The goal is to understand how COVID-19 created different experiences and challenges for leaders and their collaborators working in medical education compared to those working in public health outreach or health policy. Methods: A survey about COVID-19 opportunities and challenges was administered to work unit leaders and their project collaborators. The most common experiences and challenges are shown, direct educational and other respondents' experiences and challenges are compared, and open-ended comment segments are analyzed. Results: Helping others adjust to digital work, remoteness, and coordination were common experiences during COVID-19. Common challenges include coordination and an inability to make comparisons to previous program years. On average, respondents had 11.3 (SD 7.8) experiences and 8.3 (SD 6.9) challenges considered in the survey. While all units were influenced by COVID-19 restrictions, medical education units had more experiences and challenges. Those involved directly in medical education experienced 69\% (18.6/27) of their possible experiences and 54\% (14.7/27) of their possible challenges on average compared to 35\% (7/20) and 21\% (4.2/20) among other respondents (P<.001). COVID-19 restrictions increased the complexity of project work and presented challenges, especially in terms of coordinating responses and access to locations. Conclusions: The findings suggest that COVID-19 made the overall administration of programs more complex and drew attention from other medical and public health programs. While remoteness is appropriate for some medical education tasks, it is less appropriate for clinical learning. Remoteness presents an especially large challenge to clinical education. Employees now have expectations for remoteness to be built into programs and workplaces. Program administrators will have to integrate remoteness' benefits and drawbacks into their organization for the foreseeable future. ",
doi="10.2196/48299",
url="https://formative.jmir.org/2023/1/e48299",
url="http://www.ncbi.nlm.nih.gov/pubmed/37676708"
}


@Article{info:doi/10.2196/47777,
author="Gisondi, Albert Michael
and Keyes, Timothy
and Zucker, Shana
and Bumgardner, Deila",
title="Teaching LGBTQ+ Health, a Web-Based Faculty Development Course: Program Evaluation Study Using the RE-AIM Framework",
journal="JMIR Med Educ",
year="2023",
month="Jul",
day="21",
volume="9",
pages="e47777",
keywords="lesbian, gay, bisexual, transgender, queer",
keywords="LGBTQ+",
keywords="queer",
keywords="faculty development",
keywords="medical education",
keywords="continuing education",
keywords="sexual and gender minority",
keywords="web-based learning",
keywords="asynchronous learning",
keywords="education technology",
keywords="diversity, equity, inclusion",
keywords="DEI",
abstract="Background: Many health professions faculty members lack training on fundamental lesbian, gay, bisexual, transgender, and queer (LGBTQ+) health topics. Faculty development is needed to address knowledge gaps, improve teaching, and prepare students to competently care for the growing LGBTQ+ population. Objective: We conducted a program evaluation of the massive open online course Teaching LGBTQ+ Health: A Faculty Development Course for Health Professions Educators from the Stanford School of Medicine. Our goal was to understand participant demographics, impact, and ongoing maintenance needs to inform decisions about updating the course. Methods: We evaluated the course for the period from March 27, 2021, to February 24, 2023, guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. We assessed impact using participation numbers, evidence of learning, and likelihood of practice change. Data included participant demographics, performance on a pre- and postcourse quiz, open-text entries throughout the course, continuing medical education (CME) credits awarded, and CME course evaluations. We analyzed demographics using descriptive statistics and pre- and postcourse quiz scores using a paired 2-tailed t test. We conducted a qualitative thematic analysis of open-text responses to prompts within the course and CME evaluation questions. Results: Results were reported using the 5 framework domains. Regarding Reach, 1782 learners participated in the course, and 1516 (85.07\%) accessed it through a main course website. Of the different types of participants, most were physicians (423/1516, 27.9\%) and from outside the sponsoring institution and target audience (1452/1516, 95.78\%). Regarding Effectiveness, the median change in test scores for the 38.1\% (679/1782) of participants who completed both the pre- and postcourse tests was 3 out of 10 points, or a 30\% improvement (P<.001). Themes identified from CME evaluations included LGBTQ+ health as a distinct domain, inclusivity in practices, and teaching LGBTQ+ health strategies. A minority of participants (237/1782, 13.3\%) earned CME credits. Regarding Adoption, themes identified among responses to prompts in the course included LGBTQ+ health concepts and instructional strategies. Most participants strongly agreed with numerous positive statements about the course content, presentation, and likelihood of practice change. Regarding Implementation, the course cost US \$57,000 to build and was intramurally funded through grants and subsidies. The course faculty spent an estimated 600 hours on the project, and educational technologists spent another 712 hours. Regarding Maintenance, much of the course is evergreen, and ongoing oversight and quality assurance require minimal faculty time. New content will likely include modules on transgender health and gender-affirming care. Conclusions: Teaching LGBTQ+ Health improved participants' knowledge of fundamental queer health topics. Overall participation has been modest to date. Most participants indicated an intention to change clinical or teaching practices. Maintenance costs are minimal. The web-based course will continue to be offered, and new content will likely be added. ",
doi="10.2196/47777",
url="https://mededu.jmir.org/2023/1/e47777",
url="http://www.ncbi.nlm.nih.gov/pubmed/37477962"
}


@Article{info:doi/10.2196/37140,
author="Gardiner, Heather
and Siminoff, Laura
and Gordon, J. Elisa
and Alolod, Gerard
and Richardson, Briana
and Schupler, Melanie
and Benitez, Amanda
and Hernandez, Ilda
and Guinansaca, Nancy
and Ramos, Lori
and Bergeron, D. Caroline
and Pappaterra, Lianette
and Norden, Robert
and Daly, Theresa",
title="Direct and Indirect Effects of a Web-Based Educational and Communication Skills Intervention ``Promotoras de Donaci{\'o}n'' to Increase Donor Designation in Latinx Communities: Evaluation Study",
journal="J Med Internet Res",
year="2023",
month="Jul",
day="10",
volume="25",
pages="e37140",
keywords="Latinx",
keywords="Latino",
keywords="Latina",
keywords="Spanish",
keywords="Hispanic organ donation",
keywords="organ donor",
keywords="donor registration",
keywords="donor designation",
keywords="education",
keywords="e-learning",
keywords="digital learning",
keywords="promotoras",
keywords="program evaluation",
keywords="community outreach",
keywords="community engagement",
keywords="awareness",
abstract="Background: Latinx populations are severely underrepresented among organ donors compared with the non-Hispanic White population. The Promotoras de Donaci{\'o}n e-learning module was developed to train Latinx lay health educators (ie, promotoras) to discuss deceased organ donation and promote donor designation within their communities. Objective: This paper described the results of 2 studies designed to assess the direct and indirect effects of the module on promotoras' and mature Latinas' organ donation and donor designation knowledge, attitudes, and behaviors. Methods: In partnership with 4 community-based promotoras organizations, we designed 2 nonrandomized, quasiexperimental pragmatic studies to evaluate the Promotoras de Donaci{\'o}n e-learning module, with participating promotoras and mature Latinas serving as their own controls. Brief surveys were administered to participating promotoras before and after module completion to assess changes in organ donation knowledge and support and communication confidence (study 1). Promotoras participating in the first study were asked to hold at least 2 group conversations about organ donation and donor designation with mature Latinas (study 2); paper-pencil surveys were completed by all participants before and after the group conversations. Descriptive statistics, means and SDs, and counts and percentages were used as appropriate to categorize the samples. Paired sample 2-tailed t test was used to assess changes in knowledge of and support for organ donation and confidence in discussing donation and promoting donor designation from pre- to posttest. Results: Overall, 40 promotoras completed this module (study 1). Increases in organ donation knowledge (mean 6.0, SD 1.9 to mean 6.2, SD 2.9) and support (mean 3.4, SD 0.9 to mean 3.6, SD 0.9) were observed from pre- to posttest; however, these changes did not reach statistical significance. A statistically significant increase in communication confidence was found (mean 692.1, SD 232.4 to mean 852.3, SD 139.7; P=.01). The module was well received, with most participants deeming it well organized, presenting new information, and providing realistic and helpful portrayals of donation conversations. A total of 52 group discussions with 375 attendees were led by 25 promotoras (study 2). The trained promotora-led group discussions about organ donation resulted in increased support for organ donation in promotoras and mature Latinas from pre- to posttest. Knowledge of the steps to become an organ donor and belief that the process is easy to perform increased in mature Latinas from pre- to posttest by 30.7\% and 15.2\%, respectively. In total, 5.6\% (21/375) of attendees submitted completed organ donation registration forms. Conclusions: This evaluation provides preliminary support for the module's direct and indirect effects on organ donation knowledge, attitudes, and behaviors. The need for additional modifications to and future evaluations of the module are discussed. ",
doi="10.2196/37140",
url="https://www.jmir.org/2023/1/e37140",
url="http://www.ncbi.nlm.nih.gov/pubmed/37428526"
}


@Article{info:doi/10.2196/44116,
author="Islam, Aminul Md
and Rabbani, Golam Md
and Rahaman, Zamilur
and Joarder, Taufique",
title="Professional Relationship Between Physicians and Journalists in Bangladesh: Web-Based Cross-Sectional Study",
journal="Interact J Med Res",
year="2023",
month="Jul",
day="10",
volume="12",
pages="e44116",
keywords="medicine",
keywords="media",
keywords="physician",
keywords="journalist",
keywords="communication",
keywords="health policy",
keywords="Bangladesh",
abstract="Background: A health care system is intertwined with multiple stakeholders, including government institutions, pharmaceutical companies, patients, hospitals and clinics, health care professionals, health researchers and scientific medical experts, patients and consumer organizations, and media organizations. Physicians and journalists are the key actors who play a significant role in making health care services and health information accessible to the people of a country. Objective: The aim of this study was to explore the tensions and alliances between physicians and journalists in Bangladesh, along with identifying strategies that could potentially improve the often contentious relationship and quality of medical journalism. Methods: We conducted a web-based cross-sectional survey using the snowball sampling technique from September 2021 to March 2022. Adult Bangladeshi citizens belonging to the two selected professional groups (physicians and journalists), who understood the survey content, and agreed to participate in the survey were considered eligible for inclusion in the study. Both descriptive and logistic regression analyses, including the Mann-Whitney U test and Wilcoxon signed-rank test, were performed to determine the differences between groups concerning selected perception-related variables, and the associations of perceptions about lack of trust in each other's knowledge, skills, and professional integrity with background characteristics. Results: A total of 419 participants completed the survey, including 219 physicians and 200 journalists. Among physicians, 53.4\% (117/219) reported lower trust toward journalists' professional domain and expertise, whereas 43.5\% (87/200) of journalists had lower trust toward physicians' professional domain and expertise. In terms of perception about not having respect for each other, the median value for the physicians was 5 (strongly agree), whereas it was only 3 (agree) for the journalists. We also found that male physicians (adjusted odds ratio [AOR] 0.45, compared with female physicians) and medical officers (AOR 0.30, compared with specialists) had significantly higher odds of lacking trust in journalists' knowledge, skills, and professional integrity. When rating the statement ``Regular professional interaction between journalists and doctors may improve the relationship between the professional groups,'' most physicians (186/219, 84.9\%) chose ``neither agree nor disagree,'' whereas most journalists (106/200, 53.0\%) stated that they ``slightly agree.'' Conclusions: Both physicians and journalists in Bangladesh have negative perceptions of each other's professions. However, physicians have a more negative perception of journalists than journalists have of the physicians. Strategies such as a legal framework to identify medical-legal issues in reporting, constructive discussion, professional interaction, and capacity-building training programs may significantly improve the relationship between physicians and journalists. ",
doi="10.2196/44116",
url="https://www.i-jmr.org/2023/1/e44116",
url="http://www.ncbi.nlm.nih.gov/pubmed/37428550"
}


@Article{info:doi/10.2196/43231,
author="Alsuwaidi, Laila
and Otaki, Farah
and Hassan Khamis, Amar
and AlGurg, Reem
and Lakhtakia, Ritu",
title="Selected Skill Sets as Building Blocks for High School-to-Medical School Bridge: Longitudinal Study Among Undergraduate Medical Students",
journal="JMIR Med Educ",
year="2023",
month="Jul",
day="4",
volume="9",
pages="e43231",
keywords="transition",
keywords="undergraduate",
keywords="medical",
keywords="education",
keywords="academic performance",
keywords="self-regulated learning",
abstract="Background: The high school--to--medical school education transition is a significant milestone in the students' academic journey, which is characterized by multiple stressors. Although this crucial transition has been repetitively explored, the concept of proactively intervening to support this transition is still novel. Objective: In this study, we investigated the efficacy of a web-based multidimensional resilience building intervention in developing selected soft skills that are believed to drive the learner's success in any learning setting. The association between the students' academic performance over time and their proficiency in selected modules addressing skill sets, including Time Management, Memory and Study, Listening and Taking Notes, and College Transition, was also assessed to test the impact of the intervention on the students' learning. Methods: A longitudinal study was conducted on 1 cohort of students of a Bachelor of Medicine, Bachelor of Surgery program (MBBS). The medical students were offered a learning intervention around 4 skill sets during the first year of the 6-year program. Quantitative analyses were conducted using deidentified data, relating to the students' proficiency in the 4 skill sets and to the students' academic performance: grade point average (GPA). Descriptive analyses constituted computing an overall score of skill sets' proficiency (of all 4 selected skill sets). The mean and SD (and percentage of the mean) were also calculated for each skill set component, independently, and for the overall score of skill sets' proficiency. Bivariate Pearson correlations were used to assess the extent to which the academic performance of the students can be explained by the corresponding students' level of proficiency in each skill set component and by all 4 sets together. Results: Out of the 63 admitted students, 28 participated in the offered intervention. The means and SDs of the annual GPA of the students for years 1 and 2 (GPA range 1-4) were 2.83 (SD 0.74) and 2.83 (SD 0.99), respectively. The mean and SD of the cumulative GPA toward the end of year 2 was 2.92 (SD 0.70). Correlation analysis showed that the overall score of skill sets proficiency was significantly associated with the annual GPA of year 1 (r=0.44; P=.02) but was not associated with their annual GPA of year 2. The cumulative GPA (toward the end of year 2) appeared to be significantly associated with the overall score (r=0.438; P=.02). Conclusions: Developing purposefully selected skill sets among medical students holds the potential of facilitating the high school--to--medical school education transition and is likely to improve their academic performance. As the medical student progresses, the acquired skills need to be continuously reinforced and effectively built upon. ",
doi="10.2196/43231",
url="https://mededu.jmir.org/2023/1/e43231",
url="http://www.ncbi.nlm.nih.gov/pubmed/37402145"
}


@Article{info:doi/10.2196/46575,
author="Brehon, Katelyn
and MacIsaac, Rob
and Bhatia, Zahra
and Buck, Taryn
and Charbonneau, Rebecca
and Crochetiere, Steven
and Donia, Scott
and Daoust, Jason
and Ho, Chester
and Kainth, Hardeep
and Loewen, Janee
and Lorch, Brandice
and Mastrodimos, Kiesha
and Neunzig, Brittney
and Papathanassoglou, Elizabeth
and Parmar, Rajvir
and Pohar Manhas, Kiran
and Tenove, Terry
and Velji, Elysha
and Loyola-Sanchez, Adalberto",
title="Outcomes of Implementing a Webinar-Based Strategy to Improve Spinal Cord Injury Knowledge and Community Building: Convergent Mixed Methods Study",
journal="JMIR Rehabil Assist Technol",
year="2023",
month="Jun",
day="23",
volume="10",
pages="e46575",
keywords="spinal cord injury",
keywords="telehealth",
keywords="webinars",
keywords="mixed methods",
keywords="implementation",
abstract="Background: COVID-19 disrupted services received by persons with spinal cord injury (SCI) worldwide. The International Disability Alliance declared the need for a disability-inclusive response to the COVID-19 crisis, as decreased access to health care services for individuals living with varying levels of function was unacceptable. As a result, an SCI community in Canada created a novel webinar-based strategy aimed at improving access to self-management information for people living with SCI and other stakeholders. However, although telehealth practices have previously been used effectively in SCI management and rehabilitation, little to no scholarship has investigated the outcomes of implementing a webinar-based telehealth strategy in this population. Objective: This study aims to understand the outcomes of implementing the webinar series. Specifically, the authors aimed to determine the reach of the series; understand its impact on social connectedness, perceptions of disability, and overall quality of interactions among persons with SCI, their families, service providers, and the public at large; and explore the long-term sustainability of the initiative. Methods: The authors implemented a community-based participatory strategy to define a convergent mixed methods design to triangulate qualitative and quantitative data collected simultaneously. Quantitative methods included pop-up questions administered during the live webinars, surveys administered following webinars, and an analysis of YouTube analytics. Qualitative methods included semistructured interviews with persons with SCI and health care providers who attended at least one webinar. The results were integrated, following methods adapted from Creswell and Clark. Results: A total of 234 individuals attended at least 1 of the 6 webinars that took place during the 6-month study period. In total, 13.2\% (31/234) of the participants completed the postwebinar survey, and 23\% (7/31) participated in the semistructured interviews. The reach of the webinar series was mainly to persons with SCI, followed by health professionals, with most of them living in urban areas. The topics sexuality and research were the most viewed on YouTube. The knowledge disseminated during the webinars was mainly perceived as valid and useful, related to the fact that the presentation format involved people with lived experience and clinical experts. The webinars did not necessarily help build a new extended community of people involved in SCI but helped strengthen the existing community of people with SCI in Alberta. The webinar positively influenced the perceptions of normality and disability regarding people with SCI. The webinar format was perceived as highly usable and accessible. Conclusions: The webinar series was associated with improved participant knowledge of what is possible to achieve after an SCI and their perceptions of disability. The long-term implementation of this initiative is feasible, but further considerations to increase its reach to rural areas and ensure the integration of diverse individuals should be taken. ",
doi="10.2196/46575",
url="https://rehab.jmir.org/2023/1/e46575",
url="http://www.ncbi.nlm.nih.gov/pubmed/37351945"
}


@Article{info:doi/10.2196/47933,
author="Allan, M. Jessica
and Brooks, K. Amber
and Crusto, Cindy
and Feld, D. Lauren
and Oxentenko, S. Amy
and Spector, D. Nancy
and Verduzco-Gutierrez, Monica
and Silver, K. Julie",
title="Five Strategies Leaders in Academic Medicine Can Implement Now to Enhance Gender Equity",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="13",
volume="25",
pages="e47933",
keywords="gender equity",
keywords="diversity",
keywords="leadership",
keywords="academic medicine",
keywords="gender",
keywords="medicine",
keywords="women in medicine",
keywords="strategies",
keywords="equity",
doi="10.2196/47933",
url="https://www.jmir.org/2023/1/e47933",
url="http://www.ncbi.nlm.nih.gov/pubmed/37310782"
}


@Article{info:doi/10.2196/47641,
author="Allen, Jay-Sheree
and Oxentenko, Amy",
title="Four Lessons Learned From Career Pivots in Academic Medicine",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="13",
volume="25",
pages="e47641",
keywords="women",
keywords="academic medicine",
keywords="career",
keywords="pivot",
keywords="transition",
keywords="women in medicine",
doi="10.2196/47641",
url="https://www.jmir.org/2023/1/e47641",
url="http://www.ncbi.nlm.nih.gov/pubmed/37310784"
}


@Article{info:doi/10.2196/48965,
author="Pendergrast, Tricia",
title="Description of the Novel Networking, Open Discussion, Engagement, and Self-Promotion (NODES) Framework for the Advancement of Women Physicians on Social Media",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="8",
volume="25",
pages="e48965",
keywords="social media",
keywords="gender equity",
keywords="women in medicine",
keywords="woman physician",
keywords="NODES framework",
keywords="self-promotion",
keywords="networking",
keywords="open discussion",
doi="10.2196/48965",
url="https://www.jmir.org/2023/1/e48965",
url="http://www.ncbi.nlm.nih.gov/pubmed/37289490"
}


@Article{info:doi/10.2196/47800,
author="Kays, N. Marah
and Rupert, D. Deborah
and Negris, Olivia
and Thompson, Beatrix
and Clayman, L. Marla
and Mordell, Lisa
and Pendergrast, Tricia
and Bloomgarden, Eve
and Bhayani, K. Rakhee
and Jain, Shikha",
title="Flattening Hierarchical Structures to Empower Women Trainee Leaders on Social Media Teams",
journal="J Med Internet Res",
year="2023",
month="Jun",
day="5",
volume="25",
pages="e47800",
keywords="social media",
keywords="medical education",
keywords="gender equity",
keywords="women",
keywords="empowerment",
keywords="pyramidal hierarchy",
keywords="residency",
keywords="medical training",
keywords="health care",
keywords="women empowerment",
doi="10.2196/47800",
url="https://www.jmir.org/2023/1/e47800",
url="http://www.ncbi.nlm.nih.gov/pubmed/37276011"
}


@Article{info:doi/10.2196/47783,
author="Zhong, Lydia
and Lee, Koeun
and Baggstrom, Q. Maria
and Bhayani, K. Rakhee",
title="Investing in Women Trainees: Building a Women in Medicine Group at an Academic Institution",
journal="J Med Internet Res",
year="2023",
month="May",
day="31",
volume="25",
pages="e47783",
keywords="gender equity",
keywords="graduate medical education",
keywords="women in medicine",
keywords="trainee wellness",
keywords="women",
keywords="gender gap",
keywords="inequity",
keywords="medical training",
keywords="medicine",
doi="10.2196/47783",
url="https://www.jmir.org/2023/1/e47783",
url="http://www.ncbi.nlm.nih.gov/pubmed/37256684"
}


@Article{info:doi/10.2196/48037,
author="Silver, K. Julie
and Gavini, Nara",
title="The Push-Pull Mentoring Model: Ensuring the Success of Mentors and Mentees",
journal="J Med Internet Res",
year="2023",
month="May",
day="25",
volume="25",
pages="e48037",
keywords="mentorship",
keywords="mentor",
keywords="medical education",
keywords="diversity",
keywords="equity",
keywords="Push-Pull Mentoring Model",
doi="10.2196/48037",
url="https://www.jmir.org/2023/1/e48037",
url="http://www.ncbi.nlm.nih.gov/pubmed/37227764"
}


@Article{info:doi/10.2196/47799,
author="Silver, K. Julie",
title="Six Practical Strategies to Mentor and Sponsor Women in Academic Medicine",
journal="J Med Internet Res",
year="2023",
month="May",
day="25",
volume="25",
pages="e47799",
keywords="diversity",
keywords="women",
keywords="women in medicine",
keywords="mentorship",
keywords="sponsorship",
keywords="academic medicine",
doi="10.2196/47799",
url="https://www.jmir.org/2023/1/e47799",
url="http://www.ncbi.nlm.nih.gov/pubmed/37227763"
}


@Article{info:doi/10.2196/42060,
author="Tewfik, George
and Naftalovich, Rotem
and Rodriguez-Aponte, Carlos
and Ezzat, Bishoy",
title="Intervention for Intraoperative Teaching in Anesthesiology Using Weekly Keyword Program: Development and Usability Study",
journal="Interact J Med Res",
year="2023",
month="May",
day="18",
volume="12",
pages="e42060",
keywords="resident teaching",
keywords="intraoperative teaching",
keywords="educational strategies",
keywords="teaching",
keywords="anesthesiology",
keywords="education",
keywords="efficacy",
keywords="survey",
keywords="electronic",
keywords="medical residents",
keywords="operation",
abstract="Background: Learning in the operating room (OR) for residents in anesthesiology is difficult but essential for successful resident education. Numerous approaches have been attempted in the past to varying degrees of success, with efficacy often judged afterward using surveys distributed to participants. The OR presents a particularly complex set of challenges for academic faculty due to the pressures required by concurrent patient care, production pressures, and a noisy environment. Often, educational reviews in ORs are personnel specific, and instruction may or may not take place in this setting, as it is left to the discretion of the parties without regular direction. Objective: This study aims to determine if a structured intraoperative keyword training program could be used to implement a curriculum to improve teaching in the OR and to facilitate impactful discussion between residents and faculty. A structured curriculum was chosen to allow for the standardization of the educational material to be studied and reviewed by faculty and trainees. Given the reality that educational reviews in the OR tend to be personnel specific and are often focused on the clinical cases of the day, this initiative sought to increase both the time and efficiency of learning interactions between learners and teachers in the stressful environment of the OR. Methods: The American Board of Anesthesiology keywords from the Open Anesthesia website were used to construct a weekly intraoperative didactic curriculum, which was distributed by email to all residents and faculty. A weekly worksheet from this curriculum included 5 keywords with associated questions for discussion. The residents and faculty were instructed to complete these questions on a weekly basis. After 2 years, an electronic survey was distributed to the residents to evaluate the efficacy of the keyword program. Results: A total of 19 teaching descriptors were polled for participants prior to and following the use of the intraoperative keyword program to assess the efficacy of the structured curriculum. The survey results showed no improvement in intraoperative teaching based on respondent perception, despite a slight improvement in teaching time, though this was statistically insignificant. The respondents reported some favorable aspects of the program, including the use of a set curriculum, suggesting that greater structure may be beneficial to facilitate more effective intraoperative teaching in anesthesiology. Conclusions: Although learning is difficult in the OR for residents, the use of a formalized didactic curriculum, centered on daily keywords, does not appear to be a useful solution for residents and faculty. Further efforts are required to improve intraoperative teaching, which is well known to be a difficult endeavor for both teachers and trainees. A structured curriculum may be used to augment other educational modalities to improve the overall intraoperative teaching for anesthesia residents. ",
doi="10.2196/42060",
url="https://www.i-jmr.org/2023/1/e42060",
url="http://www.ncbi.nlm.nih.gov/pubmed/37200082"
}


@Article{info:doi/10.2196/41671,
author="Bojic, Iva
and Mammadova, Maleyka
and Ang, Chin-Siang
and Teo, Lung Wei
and Diordieva, Cristina
and Pienkowska, Anita
and Ga{\vs}evi{\'c}, Dragan
and Car, Josip",
title="Empowering Health Care Education Through Learning Analytics: In-depth Scoping Review",
journal="J Med Internet Res",
year="2023",
month="May",
day="17",
volume="25",
pages="e41671",
keywords="distance education and web-based learning",
keywords="distributed learning environments",
keywords="data science applications in education",
keywords="21st century abilities",
keywords="cooperative and collaborative learning",
keywords="COVID-19",
keywords="education",
keywords="digital",
keywords="data",
keywords="student",
abstract="Background: Digital education has expanded since the COVID-19 pandemic began. A substantial amount of recent data on how students learn has become available for learning analytics (LA). LA denotes the ``measurement, collection, analysis, and reporting of data about learners and their contexts, for purposes of understanding and optimizing learning and the environments in which it occurs.'' Objective: This scoping review aimed to examine the use of LA in health care professions education and propose a framework for the LA life cycle. Methods: We performed a comprehensive literature search of 10 databases: MEDLINE, Embase, Web of Science, ERIC, Cochrane Library, PsycINFO, CINAHL, ICTP, Scopus, and IEEE Explore. In total, 6 reviewers worked in pairs and performed title, abstract, and full-text screening. We resolved disagreements on study selection by consensus and discussion with other reviewers. We included papers if they met the following criteria: papers on health care professions education, papers on digital education, and papers that collected LA data from any type of digital education platform. Results: We retrieved 1238 papers, of which 65 met the inclusion criteria. From those papers, we extracted some typical characteristics of the LA process and proposed a framework for the LA life cycle, including digital education content creation, data collection, data analytics, and the purposes of LA. Assignment materials were the most popular type of digital education content (47/65, 72\%), whereas the most commonly collected data types were the number of connections to the learning materials (53/65, 82\%). Descriptive statistics was mostly used in data analytics in 89\% (58/65) of studies. Finally, among the purposes for LA, understanding learners' interactions with the digital education platform was cited most often in 86\% (56/65) of papers and understanding the relationship between interactions and student performance was cited in 63\% (41/65) of papers. Far less common were the purposes of optimizing learning: the provision of at-risk intervention, feedback, and adaptive learning was found in 11, 5, and 3 papers, respectively. Conclusions: We identified gaps for each of the 4 components of the LA life cycle, with the lack of an iterative approach while designing courses for health care professions being the most prevalent. We identified only 1 instance in which the authors used knowledge from a previous course to improve the next course. Only 2 studies reported that LA was used to detect at-risk students during the course's run, compared with the overwhelming majority of other studies in which data analysis was performed only after the course was completed. ",
doi="10.2196/41671",
url="https://www.jmir.org/2023/1/e41671",
url="http://www.ncbi.nlm.nih.gov/pubmed/37195746"
}


@Article{info:doi/10.2196/36380,
author="Amod, Hafaza
and Mkhize, Wellington Sipho",
title="Supporting Midwifery Students During Clinical Practice: Results of a Systematic Scoping Review",
journal="Interact J Med Res",
year="2023",
month="Apr",
day="21",
volume="12",
pages="e36380",
keywords="clinical support",
keywords="mentorship training program",
keywords="midwifery clinical education",
keywords="midwife",
keywords="midwifery",
keywords="mentor",
keywords="mentorship",
keywords="clinical education training",
keywords="midwifery student",
keywords="South Africa",
keywords="Africa",
keywords="framework",
keywords="medical education",
abstract="Background: Midwifery educators are highly concerned about the quality of clinical support offered to midwifery students during clinical placement. The unpreparedness of midwifery practitioners in mentorship roles and responsibilities affects the competence levels of the next-generation midwives being produced. Objective: The aim of this paper is to highlight various clinical support interventions to support midwifery students globally and propose a framework to guide mentorship training in South Africa. Methods: This paper adopts a mixed methodology approach guided by the Arksey and O'Malley framework. Keywords such as midwifery students, clinical support, mentorship, preceptorship, and midwifery clinical practice were used during the literature search. The review included primary quantitative, qualitative, and mixed methods design papers published between 2010 and 2020, and studies on clinical support interventions available to midwifery students during clinical placement. The search strategy followed a 3-stage system of title, abstract, and full-text screening using inclusion and exclusion criteria. All included papers were quality appraised with a mixed methods appraisal tool. Extracted data were analyzed and presented in themes following a thematic content analysis approach. Results: The screening results attained 10 papers for data extraction. In total, 7 of the 10 (70\%) studies implemented a mentorship training program, 2 (20\%) used a training workshop, and 1 (10\%) used an intervention guide to support midwifery students in clinical practice. Of these 10 papers, 5 were qualitative, 4 mixed methods, and 1 quantitative in approach. In total, 9 of the 10 (90\%) studies were conducted in high-income countries with only 1 study done in Uganda but supported by the United Kingdom. The quality of included papers ranged between 50\% and 100\%, showing moderate to high appraisal results. Significant findings highlighted that the responsibility of mentorship is shared between key role players (midwifery practitioners, students, and educators) and thus a 3-fold approach to mentorship. Mentorship training and support are essential to strengthen the clinical support of midwifery students during placement. The main findings produced 2 main themes and 2 subthemes each. The main themes included strengthening partnerships and consultation; and providing mentor support through training. The 4 subthemes were: establishing stronger partnerships between nursing education institutions and clinical facilities; improving consultation between midwifery educators, practitioners, and students; the quality of clinical support depends on the training content; and the training duration and structure. Hence, the researchers proposed these subthemes in a framework to guide mentorship training. Conclusions: Mentorship training and support for midwifery practitioners will likely strengthen the quality of midwifery clinical support. A framework to guide mentorship training will encourage midwifery educators to develop and conduct mentorship training with ease. More studies using quantitative approaches in research and related to midwifery clinical support are required in African countries. International Registered Report Identifier (IRRID): RR2-10.2196/29707 ",
doi="10.2196/36380",
url="https://www.i-jmr.org/2023/1/e36380",
url="http://www.ncbi.nlm.nih.gov/pubmed/37083750"
}


@Article{info:doi/10.2196/42868,
author="Xing, Zhaoquan
and Ji, Meng
and Dong, Zhaogang
and Xu, Xiaofei
and Shan, Yi",
title="Factors Associated With Limited Digital Health Literacy Among Chinese Male Populations: Cross-sectional Study",
journal="JMIR Form Res",
year="2023",
month="Apr",
day="19",
volume="7",
pages="e42868",
keywords="factor",
keywords="older age",
keywords="lower education attainment",
keywords="lower functional, communicative, and critical health literacy",
keywords="weaker belief and self-confidence",
keywords="limited eHealth literacy",
keywords="Chinese population",
keywords="logistic regression",
abstract="Background: eHealth resources and interventions promise to promote favorable behavior change, self-efficacy, and knowledge acquisition, thereby improving health literacy. However, individuals with limited eHealth literacy may find it difficult to identify, understand, and benefit from eHealth use. It is necessary to identify the self-assessed eHealth literacy of those who use eHealth resources to classify their eHealth literacy levels and to determine the demographic characteristics associated with higher and lower eHealth literacy skills. Objective: This study aimed to identify notable factors closely associated with limited eHealth literacy among Chinese male populations to provide some implications for clinical practice, health education, medical research, and public health policy making. Methods: We hypothesized that participants' eHealth literacy status was associated with various demographic characteristics. Therefore, we elicited the following information in the questionnaire: age and education, self-assessed disease knowledge, 3 well-developed health literacy assessment tools (ie, the All Aspects of Health Literacy Scale, eHealth Literacy Scale, and General Health Numeracy Test), and the 6 Internal items on health beliefs and self-confidence in the Multidimensional Health Locus of Control Scales. Using randomized sampling, we recruited survey participants from Qilu Hospital of Shandong University, China. After validating the data collected through a web-based questionnaire survey via wenjuanxing, we coded all valid data according to predefined coding schemes of Likert scales with different point (score) ranges. We then calculated the total scores of the subsections of the scales or the entire scale. Finally, we used logistic regression modeling to associate the scores of the eHealth Literacy Scale with the scores of the All Aspects of Health Literacy Scale, the General Health Numeracy Test-6, and age and education to ascertain factors considerably associated with limited eHealth literacy among Chinese male populations. Results: All data from the 543 returned questionnaires were valid according to the validation criteria. By interpreting these descriptive statistics, we found that 4 factors were significantly correlated with participants' limited eHealth literacy: older age, lower education attainment, lower levels of all aspects of health literacy (functional, communicative, and critical), and weaker beliefs and self-confidence in internal drivers and strengths to stay healthy. Conclusions: By applying logistic regression modeling, we ascertained 4 factors that were significantly correlated with limited eHealth literacy among Chinese male populations. These relevant factors identified can inform stakeholders engaging in clinical practice, health education, medical research, and health policy making. ",
doi="10.2196/42868",
url="https://formative.jmir.org/2023/1/e42868",
url="http://www.ncbi.nlm.nih.gov/pubmed/37074760"
}


@Article{info:doi/10.2196/42042,
author="Plack, L. Daniel
and Abcejo, S. Arnoley
and Kraus, B. Molly
and Renew, Ross J.
and Long, R. Timothy
and Sharpe, E. Emily",
title="Postgraduate-Year-1 Residents' Perceptions of Social Media and Virtual Applicant Recruitment: Cross-sectional Survey Study",
journal="Interact J Med Res",
year="2023",
month="Mar",
day="21",
volume="12",
pages="e42042",
keywords="COVID-19",
keywords="resident match",
keywords="social media",
keywords="Twitter",
keywords="Instagram",
keywords="virtual interview",
keywords="residency",
keywords="medical education",
keywords="dissemination",
keywords="residency program",
keywords="residency recruitment",
abstract="Background: The dissemination of information about residency programs is a vital step in residency recruitment. Traditional methods of distributing information have been printed brochures, websites, in-person interviews, and increasingly, social media. Away rotations and in-person interviews were cancelled, and interviews were virtual for the first time during the COVID-19 pandemic. Objective: The purpose of our study was to describe postgraduate-year-1 (PGY1) residents' social media habits in regard to residency recruitment and their perceptions of the residency programs' social media accounts in light of the transition to virtual interviews. Methods: A web-based 33-question survey was developed to evaluate personal social media use, perceptions of social media use by residency programs, and perceptions of the residency program content. Surveys were sent in 2021 to PGY1 residents at Mayo Clinic in Arizona, Florida, and Minnesota who participated in the 2020-2021 interview cycle. Results: Of the 31 program directors contacted, 22 (71\%) provided permission for their residents to complete the survey. Of 219 residents who received the survey, 67 (30\%) completed the survey. Most respondents applied to a single specialty, and greater than 61\% (41/67) of respondents applied to more than 30 programs. The social media platforms used most regularly by the respondents were Instagram (42/67, 63\%), Facebook (36/67, 54\%), and Twitter (22/67, 33\%). Respondents used the program website (66/67, 99\%), residents (47/67, 70\%), and social media (43/67, 64\%) as the most frequent resources to research programs. The most commonly used social media platforms to research programs were Instagram (38/66, 58\%), Twitter (22/66, 33\%), and Doximity (20/66, 30\%). The type of social media post ranked as most interesting by the respondents was ``resident life outside of the hospital.'' In addition, 68\% (39/57) of the respondents agreed or strongly agreed that their perception of a program was positively influenced by the residency program's social media account. Conclusions: In this multispecialty survey of PGY1 residents participating in the 2020-2021 virtual interview season, respondents preferred Instagram to Twitter or Facebook for gathering information on prospective residency programs. In addition, the program website, current residents, and social media platforms were the top-ranked resources used by prospective applicants. Having an up-to-date website and robust social media presence, particularly on Instagram, may become increasingly important in the virtual interview environment. ",
doi="10.2196/42042",
url="https://www.i-jmr.org/2023/1/e42042",
url="http://www.ncbi.nlm.nih.gov/pubmed/36943340"
}


@Article{info:doi/10.2196/40082,
author="Zeng, Minrui
and Cai, Yiyuan
and Cao, Jin
and He, Qianyu
and Wang, Xiaohui
and Lu, Yun
and Liang, Huijuan
and Xu, Dong
and Liao, Jing",
title="The Agreement Between Virtual Patient and Unannounced Standardized Patient Assessments in Evaluating Primary Health Care Quality: Multicenter, Cross-sectional Pilot Study in 7 Provinces of China",
journal="J Med Internet Res",
year="2022",
month="Dec",
day="2",
volume="24",
number="12",
pages="e40082",
keywords="virtual patient",
keywords="unannounced standardized patient",
keywords="primary health care",
keywords="primary care",
keywords="quality assessment",
keywords="quality improvement",
keywords="scenario",
keywords="simulation",
keywords="simulate",
keywords="medical education",
keywords="cross-sectional",
keywords="digital health",
keywords="eHealth",
abstract="Background: The unannounced standardized patient (USP) is the gold standard for primary health care (PHC) quality assessment but has many restrictions associated with high human and resource costs. Virtual patient (VP) is a valid, low-cost software option for simulating clinical scenarios and is widely used in medical education. It is unclear whether VP can be used to assess the quality of PHC. Objective: This study aimed to examine the agreement between VP and USP assessments of PHC quality and to identify factors influencing the VP-USP agreement. Methods: Eleven matched VP and USP case designs were developed based on clinical guidelines and were implemented in a convenience sample of urban PHC facilities in the capital cities of the 7 study provinces. A total of 720 USP visits were conducted, during which on-duty PHC providers who met the inclusion criteria were randomly selected by the USPs. The same providers underwent a VP assessment using the same case condition at least a week later. The VP-USP agreement was measured by the concordance correlation coefficient (CCC) for continuity scores and the weighted $\kappa$ for diagnoses. Multiple linear regression was used to identify factors influencing the VP-USP agreement. Results: Only 146 VP scores were matched with the corresponding USP scores. The CCC for medical history was 0.37 (95\% CI 0.24-0.49); for physical examination, 0.27 (95\% CI 0.12-0.42); for laboratory and imaging tests, --0.03 (95\% CI --0.20 to 0.14); and for treatment, 0.22 (95\% CI 0.07-0.37). The weighted $\kappa$ for diagnosis was 0.32 (95\% CI 0.13-0.52). The multiple linear regression model indicated that the VP tests were significantly influenced by the different case conditions and the city where the test took place. Conclusions: There was low agreement between VPs and USPs in PHC quality assessment. This may reflect the ``know-do'' gap. VP test results were also influenced by different case conditions, interactive design, and usability. Modifications to VPs and the reasons for the low VP-USP agreement require further study. ",
doi="10.2196/40082",
url="https://www.jmir.org/2022/12/e40082",
url="http://www.ncbi.nlm.nih.gov/pubmed/36459416"
}


@Article{info:doi/10.2196/40580,
author="Khalaf, Zahra
and Khan, Shaheer",
title="Education During Ward Rounds: Systematic Review",
journal="Interact J Med Res",
year="2022",
month="Nov",
day="9",
volume="11",
number="2",
pages="e40580",
keywords="education",
keywords="learning",
keywords="rounds",
keywords="trainee",
keywords="ward rounds",
keywords="medical education",
keywords="simulation-based learning",
keywords="digital health",
keywords="digital learning",
keywords="education intervention",
abstract="Background: Enhancing the educational experience provided by ward rounds requires an understanding of current perceptions of the educational value of rounds. Objective: This systematic review examines perceptions of education in ward rounds, educational activities in ward rounds, barriers to learning, and perceptions of simulation-based ward rounds. Methods: The 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. MEDLINE (EBSCO), Cochrane, and Scopus were searched on May 29, 2022, for studies assessing learning during ward rounds. The search terms included ``ward rounds,'' ``education,'' and ``trainees.'' Then, the selected articles were reference searched. In total, 354 articles were retrieved. The articles were assessed for eligibility by 2 independent reviewers who screened titles, abstracts, and full-length texts. Articles addressing trainees' education in all ward rounds were included. Articles were excluded if they were specific to certain disciplines, were reviews, were not published in scholarly journals, were published before 2015, were published in languages other than English, or did not concern human participants. Following the removal of 63 duplicates, a total of 268 articles were excluded. The risk of bias within the selected articles was also assessed via the Critical Appraisal Skills Programme checklist for qualitative research. Qualitative data were used to describe results in a narrative synthesis and in tables. Results: A total of 23 articles were included. Perceptions of teaching in rounds were addressed by 6 studies, of which 3 showed negative perceptions among participants, 2 reported ambivalent perceptions, and 1 showed positive perceptions. Perceived barriers to teaching during rounds were assessed by 7 studies. The reported barriers included time constraints, workloads, schedules, interruptions, the service-oriented nature of rounds, the lack of feedback, hierarchies, the lack of opportunities to ask questions and be engaged in patient management, and divergent learner needs. Further, 8 studies identified types of educational activities, including observation, patient-specific teaching, and discussion. Perceptions of learning through simulated ward rounds were assessed by 8 studies, and a consensus of satisfaction was noted among learners. The interventions that were explored to improve education included using teaching frameworks, involving clinical librarians, and changing the setting of ward rounds. Conclusions: The main limitations of this review are the predominant use of qualitative data in the included articles and the lack of standardization for the educational compositions of ward rounds among articles, which made the articles hard to compare. In conclusion, learning opportunities in ward rounds are often missed, and trainees perceive rounds to have low educational value. It is important to recognize the barriers to education during ward rounds and address them to maximize the benefits of ward rounds. Finally, there is a need to develop plans that incorporate teaching regularly during ward rounds in the inpatient setting. Trial Registration: PROSPERO CRD42022337736; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=337736 ",
doi="10.2196/40580",
url="https://www.i-jmr.org/2022/2/e40580",
url="http://www.ncbi.nlm.nih.gov/pubmed/36285742"
}


@Article{info:doi/10.2196/35079,
author="Alyami, Mohsen
and Serlachius, Anna
and Law, Mikaela
and Murphy, Rinki
and Almigbal, H. Turky
and Lyndon, Mataroria
and Batais, A. Mohammed
and Algaw, K. Rawabi
and Broadbent, Elizabeth",
title="Utility and Acceptability of a Brief Type 2 Diabetes Visual Animation: Mixed Methods Feasibility Study",
journal="JMIR Form Res",
year="2022",
month="Aug",
day="9",
volume="6",
number="8",
pages="e35079",
keywords="illness perception",
keywords="visualization",
keywords="animation",
keywords="intervention",
keywords="mobile phone",
keywords="type 2 diabetes mellitus",
abstract="Background: Visualizations of illness and treatment processes are promising interventions for changing unhelpful perceptions and improving health outcomes. However, these are yet to be tested in patients with type 2 diabetes mellitus (T2DM). Objective: This study assesses the cross-cultural acceptability and potential effectiveness of a brief visual animation of T2DM at changing unhelpful illness and treatment perceptions and self-efficacy among patients and family members in 2 countries, New Zealand and Saudi Arabia. Health care professionals' views on visualization are also explored. Methods: A total of 52 participants (n=39, 75\% patients and family members and n=13, 25\% health care professionals) were shown a 7-minute T2DM visual animation. Patients and family members completed a questionnaire on illness and treatment perceptions and self-efficacy before and immediately after the intervention and completed semistructured interviews. Health care professionals completed written open-ended questions. Means and 95\% CIs are reported to estimate potential effectiveness. Inductive thematic analysis was conducted on qualitative data. Results: All participants rated the visual animation as acceptable and engaging. Four main themes were identified: animation-related factors, impact of the animation, animation as an effective format for delivering information, and management-related factors. Effect sizes (ranged from 0.10 to 0.56) suggested potential effectiveness for changing illness and treatment perceptions and self-efficacy among patients and family members. Conclusions: Visualizations are acceptable and may improve the perceptions of patients' with diabetes in a short time frame. This brief visual animation has the potential to improve current T2DM education. A subsequent randomized controlled trial to investigate the effects on illness and treatment perceptions, adherence, glycemic control, and unplanned hospital admission is being prepared. ",
doi="10.2196/35079",
url="https://formative.jmir.org/2022/8/e35079",
url="http://www.ncbi.nlm.nih.gov/pubmed/35943787"
}


@Article{info:doi/10.2196/35878,
author="R{\o}ynesdal, {\O}ystein
and Magnus, H. Jeanette
and Moen, Anne",
title="Pedagogical Approaches and Learning Activities, Content, and Resources Used in the Design of Massive Open Online Courses (MOOCs) in the Health Sciences: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2022",
month="May",
day="30",
volume="11",
number="5",
pages="e35878",
keywords="MOOC",
keywords="scoping review",
keywords="collaborative learning",
keywords="PhD",
keywords="postgraduate",
keywords="education",
keywords="health sciences",
keywords="massive open online course",
abstract="Background: Developing online, widely accessible educational courses, such as Massive Open Online Courses (MOOCs), offer novel opportunities to advancing academic research and the educational system in resource-constrained countries. Despite much literature on the use of design-related features and principles of different pedagogical approaches when developing MOOCs, there are reports of inconsistency between the pedagogical approach and the learning activities, content, or resources in MOOCs. Objective: We present a protocol for a scoping review aiming to systematically identify and synthesize literature on the pedagogical approaches used, and the learning activities, content, and resources used to facilitate social interaction and collaboration among postgraduate learners in MOOCs across the health sciences. Methods: We will follow a 6-step procedure for scoping reviews to conduct a search of published and gray literature in the following databases: Medline via Ovid, ERIC, SCOPUS, Web of Science, and PsychINFO. Two reviewers will screen titles, abstracts, and relevant full texts independently to determine eligibility for inclusion. The team will extract data using a predefined charting form and synthesize results in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. Results: The scoping review is currently ongoing. As of March 2022, we have performed initial data searches and screened titles and abstracts of the studies we found but revised the search string owing to inaccurate results. We aim to start analyzing the data in June 2022 and expect to complete the scoping review by February 2023. Conclusions: With the results of this review, we hope to report on the use of pedagogical approaches and what learning activities, content, and resources foster social and collaborative learning processes, and to further elucidate how practitioners and academics can harvest our findings to bridge the gap between pedagogics and learning activities in the instructional design of MOOCs for postgraduate students in the health sciences. International Registered Report Identifier (IRRID): DERR1-10.2196/35878 ",
doi="10.2196/35878",
url="https://www.researchprotocols.org/2022/5/e35878",
url="http://www.ncbi.nlm.nih.gov/pubmed/35635750"
}


@Article{info:doi/10.2196/33840,
author="Nopiyani, Sri Ni Made
and Januraga, Putu Pande
and Wirawan, Ady I. Md
and Bakta, Made I.",
title="Comprehensive Travel Health Education for Tour Guides: Protocol for an Exploratory Sequential Mixed Methods Research",
journal="JMIR Res Protoc",
year="2022",
month="May",
day="23",
volume="11",
number="5",
pages="e33840",
keywords="travel health",
keywords="health education",
keywords="tour guides",
keywords="tourists",
keywords="health promotion",
abstract="Background: Tourists are at risk of experiencing health problems during their travel. However, even though tour guides have the potential to become travel health promoters, their participation has not been optimal. Objective: This study aims to develop a comprehensive travel health education model to help tour guides improve health information delivery to tourists. Methods: This is an exploratory sequential mixed methods research. The first phase consisted of a qualitative study with an informed grounded theory design. In-depth interviews were carried out with tour guides from all language divisions and policymakers of the Indonesian Tour Guide Association Bali Branch or Himpunan Pramuwisata Indonesia Daerah Bali (HPI Bali). The interview guidelines were developed based on the theory of planned behavior and identity theory. Qualitative data were analyzed thematically. In the interim phase, a travel health education model and questionnaire were developed based on the qualitative findings. The initial model and its instruments were finetuned after consultation with travel medicine and health promotion experts. Furthermore, the validity and reliability of the questionnaire were tested on 30 tour guides. The second phase consisted of a quantitative study with a randomized pretest-posttest control group design. A total of 76 tour guides in the intervention group received comprehensive travel health education, while 76 in the control group received no specific intervention. Outcome variables (ie, attitudes, subjective norms, perceived behavioral control, actual behavioral control, role identity, and behavioral intention) were measured at baseline (T0), after the online training (T1), before information sharing via WhatsApp (T2), a month after the start of the WhatsApp intervention (T3), and at the end of the WhatsApp intervention (T4). The mean difference of each outcome variable before and after the intervention will be compared between the intervention and control groups. Thereafter, the quantitative and qualitative findings will be integrated into a joint display. Results: The qualitative phase was conducted through in-depth interviews with 21 informants who included tour guides and policymakers from HPI Bali from May to June 2021. The education model, educational materials, and questionnaire were developed based on the qualitative findings and consultation with experts. The education model consists of online training and information sharing through WhatsApp and was trialed with tour guides from November 2021 to February 2022. As of April 2022, this study is in the quantitative data analysis stage. Conclusions: A travel health education model was developed based on qualitative findings and consultation with experts. The model was tested with tour guides, and a series of self-administered questionnaires were completed. This study is in the quantitative data analysis stage and will continue by integrating qualitative and quantitative findings into a joint display. Trial Registration: ClinicalTrials.gov NCT04961983; https://clinicaltrials.gov/ct2/show/NCT04961983 ",
doi="10.2196/33840",
url="https://www.researchprotocols.org/2022/5/e33840",
url="http://www.ncbi.nlm.nih.gov/pubmed/35604754"
}


@Article{info:doi/10.2196/33360,
author="Peng, XinYun
and Wang-Trexler, Nicole
and Magagna, William
and Land, Susan
and Peck, Kyle",
title="Learning Agility of Learning and Development Professionals in the Life Sciences Field During the COVID-19 Pandemic: Empirical Study",
journal="Interact J Med Res",
year="2022",
month="Apr",
day="26",
volume="11",
number="1",
pages="e33360",
keywords="COVID-19",
keywords="learning agility",
keywords="learning and development professionals",
keywords="life sciences professionals",
keywords="training and development",
keywords="mixed methods",
abstract="Background: The COVID-19 pandemic has impacted the life sciences field worldwide. Life sciences organizations (eg, pharmaceutical and med-tech companies) faced a rapidly increasing need for vital medical products, patient support, and vaccine development. Learning and development (L\&D) departments play a crucial role in life sciences organizations as they apply learning initiatives to organizational strategy within a constantly evolving sector. During the COVID-19 pandemic, the work of L\&D professionals in life sciences organizations changed profoundly during the abrupt shift to remote work, since learning and training normally occur in a face-to-face environment. Given the complex and dynamic situation of the pandemic, both individuals and organizations needed to learn quickly and apply what they learned to solve new, unprecedented problems. This situation presents an opportunity to study how characteristics of learning agility were evidenced by life sciences organizations and individual employees in the remote working mode. Objective: In collaboration with Life Sciences Trainers \& Educators Networks (LTEN), this study investigated the responses and learning agility of L\&D professionals and their organizational leadership within the life sciences sector to the work changes due to the pandemic. The study answered the following questions: (1) How did L\&D professionals in the life sciences sector respond to the changes in their work environment during the COVID-19 pandemic? (2) How did L\&D professionals in the life sciences sector demonstrate learning agility during remote working? Methods: We adopted a mixed methods approach that included a semistructured interview and a survey. Participants who were life sciences or health care L\&D practitioners and in relevant positions were recruited via email through the LTEN and its partner pharmaceutical, biotech, or medical devices organizations. Interviews with 12 L\&D professionals were conducted between June and August 2020 through phone or online conferencing, covering 22 open-ended questions to stimulate ideas that could be explored further in the survey. The semistructured interview questions were grounded in theory on learning agility. In total, 4 themes were developed from the interviews, which formed the basis for developing the survey items. The subsequent survey regarding 4 specific themes was conducted from August to October 2020 using Qualtrics. Both interview and survey data were analyzed based on a learning agility framework. Results: Findings revealed generally positive organizational and individual responses toward the changes brought about by the pandemic. Results also indicated that a disruptive crisis, such as the shift from working in the office to working from home (WFH), required professionals' learning agility to both self-initiate their own learning and to support the learning agility of others in the organization. Conclusions: This study was designed to better understand education and training in the life sciences field, particularly during the unique circumstances of the global COVID-19 pandemic. We put forward several directions for future research on the learning agility of L\&D professionals in life sciences organizations. ",
doi="10.2196/33360",
url="https://www.i-jmr.org/2022/1/e33360",
url="http://www.ncbi.nlm.nih.gov/pubmed/35417403"
}


@Article{info:doi/10.2196/32996,
author="Cercel, Ovidiu Mihai",
title="Gamification in Diplomacy Studies as an Effective Tool for Knowledge Transfer: Questionnaire Study",
journal="JMIR Serious Games",
year="2022",
month="Apr",
day="25",
volume="10",
number="2",
pages="e32996",
keywords="modern diplomacy",
keywords="international relations",
keywords="innovations in learning experience",
keywords="gamification",
keywords="serious games",
keywords="role play design",
keywords="knowledge transfer",
keywords="competency development",
abstract="Background: Graduate education in modern diplomacy poses several challenges, as it requires several competencies to be developed before diplomatic service is joined. Incorporation of simulation games can have a positive impact on the design of international relations and diplomacy learning process. We have designed a novel role play game (MAEDRI) to simulate part of the activities of a typical Ministry of Foreign Affairs. Objective: This study aims to evaluate the effectiveness of MAEDRI in transferring knowledge in international relations education programs at the National University of Political Studies and Public Administration, Bucharest, Romania, across a 4-year period. Methods: The game enrolled master's level graduate students. The data were collected through a voluntary and anonymous questionnaire between 2017 and 2020. At the end of each of the 4 editions we organized debriefing sessions that gave students the opportunity to provide feedback on their experience with this exercise, level of collaboration within the team, lessons learned, and to make suggestions for improvements. Using an online questionnaire, we measured the participants' perception regarding the level of effectiveness in increasing knowledge transfer, motivation, and engagement. Questionnaire data were consolidated in percentages for each item. Results: A total of 49 participants completed the study. A total of 24 skills (13 professional and 11 social skills) were assessed. We identified a strong positive correlation between stress management and conflict management (r=.86; P<.001) as well as significantly positive correlations between building relations within the team and the ability to dialog and be persuasive (r=.7; P<.001), between procedure compliance and planning and organizing the work (r=.69; P<.001), and between analysis capacity and decision based on data received (r=.68; P<.001). Among social skills, self-control, confidence, and flexibility were the most substantially improved. Conclusions: We describe several benefits of a novel game, used as an education tool to enhance a series of competencies necessary in international relations studies. Our results demonstrate a significant level of student engagement and motivation while playing MAEDRI, improvement of several essential skills, and enhanced knowledge transfer to real-life situations. While the data are encouraging, further research is needed to evaluate the full impact of role play as an effective experiential learning method. ",
doi="10.2196/32996",
url="https://games.jmir.org/2022/2/e32996",
url="http://www.ncbi.nlm.nih.gov/pubmed/35468081"
}


@Article{info:doi/10.2196/28276,
author="Ntalindwa, Theoneste
and Nduwingoma, Mathias
and Uworwabayeho, Alphonse
and Nyirahabimana, Pascasie
and Karangwa, Evariste
and Rashid Soron, Tanjir
and Westin, Thomas
and Karunaratne, Thashmee
and Hansson, Henrik",
title="Adapting the Use of Digital Content to Improve the Learning of Numeracy Among Children With Autism Spectrum Disorder in Rwanda: Thematic Content Analysis Study",
journal="JMIR Serious Games",
year="2022",
month="Apr",
day="19",
volume="10",
number="2",
pages="e28276",
keywords="autism",
keywords="learning",
keywords="ICT",
keywords="e-learning",
keywords="education",
keywords="children",
keywords="ASD",
keywords="teaching",
keywords="teachers",
keywords="communication",
keywords="communication technology",
keywords="online content",
keywords="Rwanda",
keywords="gamification",
keywords="school",
keywords="school-age children",
keywords="behavior",
abstract="Background: Many teachers consider it challenging to teach children with autism spectrum disorder (ASD) in an inclusive classroom due to their unique needs and challenges. The integration of information communication technology (ICT) in the education system allows children with ASD to improve their learning. However, these ICT tools should meet their needs to lead a productive life. Objective: This study aimed to examine the possibilities of re-creating and adapting digital content to improve the learning of numeracy among children with ASD in inclusive school settings. Methods: We conducted 7 focus group discussions (FGDs) with 56 teachers from 7 schools and 14 parents from April to November 2019. Each of the FGDs took around 1 hour. Two clustered sets of questions were used: (1) general knowledge about teaching children with ASD and (2) analysis of selected online educational video content of early math (specifically, counting numbers). The researchers used video to understand current methodologies used in teaching children with ASD, possibilities of adaptation of the content in the current teaching environment, future challenges when the content is adapted, and possible solutions to overcome those challenges. All data, including audio recordings, field notes, and participants' comments, were transcribed, recorded, and analyzed following the steps recommended in qualitative data analysis. Results: The researchers identified ten themes from the analysis of the data: (1) awareness of the existence of ASD among children in schools and the community, (2) acceptance of children with ASD in an inclusive classroom and the community, (3) methods and models used when teaching children with ASD, (4)realia used to improve the learning of children with ASD, (5) the design of educational digital content, (6) the accessibility of online educational content, (7) quality of the content of the educational multimedia, (8) the opportunity of using the translated and re-created content inside and outside the classroom, (9) the relevance of the digital content in the Rwandan educational system, and (10) enhancement of the accessibility and quality of the digital content. We found that participants assumed that the content translation, gamification, and re-creation would help teach children with ASD. Moreover, they recommended contextualizing the content, increasing access to digital devices, and further research in the education of different subjects. Conclusions: Although many studies have identified the possibilities of using ICT to support children with ASD, few studies have documented the possibilities of integrating the existing technologies tested in the international community. This study is charting new territory to investigate online content to suit the context of schools. This study recommends further exploration of possible methodologies, such as applied behavior analysis or verbal behavior therapy, and the development of contextualized technologies that respond to the educational needs of children with ASD. ",
doi="10.2196/28276",
url="https://games.jmir.org/2022/2/e28276",
url="http://www.ncbi.nlm.nih.gov/pubmed/35438638"
}


@Article{info:doi/10.2196/33416,
author="Preuhs, Katharina
and van Keulen, Hilde
and Andree, Rosa
and Wins, Sophie
and van Empelen, Pepijn",
title="A Tailored Web-Based Video Intervention (ParentCoach) to Support Parents With Children With Sleeping Problems: User-Centered Design Approach",
journal="JMIR Form Res",
year="2022",
month="Apr",
day="19",
volume="6",
number="4",
pages="e33416",
keywords="positive parenting",
keywords="usability testing",
keywords="lower health literacy",
keywords="user-centered design",
keywords="iterative development",
keywords="eHealth",
keywords="web-based intervention",
keywords="mobile health",
keywords="mHealth",
keywords="parenting",
abstract="Background: Many parents frequently struggle with undesirable or problematic behavior (ie, temper tantrums and whining) displayed by their child. To support parents in promoting positive parenting skills (ie, recognizing challenging situations and reacting appropriately), the interactive video e-learning tool ParentCoach was developed. The tool aims to teach parents generic behavioral responses by means of situational learning, tailoring, and problem solving. The first demonstration focused on sleeping problems. Objective: The aim of this paper is to illustrate the user-centered development of ParentCoach. Methods: We conducted usability, understandability, and acceptance tests among the target group (29 parents, 7 youth health care professionals, and 4 individuals with former lower health literacy) in different phases of the development process via focus groups, interviews, and surveys. This allowed for relevant insights on specifications and user requirements to guide the development and revision of the tool in each iteration. Results: Iterative testing and development allowed for the final demonstration of ParentCoach to be experienced as a relevant and accessible parenting intervention that can be used as a stand-alone program or in combination with another program. Conclusions: This paper elaborates on the iterative development process and its benefits for the final demonstration of ParentCoach. ",
doi="10.2196/33416",
url="https://formative.jmir.org/2022/4/e33416",
url="http://www.ncbi.nlm.nih.gov/pubmed/35438640"
}


@Article{info:doi/10.2196/33630,
author="Sanavro, M. Sanne
and van der Worp, Henk
and Jansen, Danielle
and Koning, Paul
and Blanker, H. Marco
and ",
title="Evaluation of the First Year(s) of Physicians Collaboration on an Interdisciplinary Electronic Consultation Platform in the Netherlands: Mixed Methods Observational Study",
journal="JMIR Hum Factors",
year="2022",
month="Apr",
day="1",
volume="9",
number="2",
pages="e33630",
keywords="primary care",
keywords="digital consultation",
keywords="interdisciplinary",
keywords="specialist care",
abstract="Background: Complexity of health problems and aging of the population create an ongoing burden on the health care system with the general practitioner (GP) being the gatekeeper in primary care. In GPs daily practice, collaboration with specialists and exchange of knowledge from the secondary care play a crucial role in this system. Communication between primary and secondary care has shortcomings for health care workers that want to practice sustainable patient-centered health care. Therefore, a new digital interactive platform was developed: Prisma. Objective: This study aims to describe the development of a digital consultation platform (Prisma) to connect GPs with hospital specialists via the Siilo application and to evaluate the first year of use, including consultations, topic diversity, and number of participating physicians. Methods: We conducted a mixed methods observational study, analyzing qualitative and quantitative data for cases posted on the platform between June 2018 and May 2020. Any GP can post questions to an interdisciplinary group of secondary care specialists, with the platform designed to facilitate discussion and knowledge exchange for all users. Results: In total, 3674 cases were posted by 424 GPs across 16 specialisms. Most questions and answers concerned diagnosis, nonmedical treatment, and medication. Mean response time was 76 minutes (range 44-252). An average of 3 users engaged with each case (up to 7 specialists). Almost half of the internal medicine cases received responses from at least two specialisms in secondary care, contrasting with about one-fifth for dermatology. Of note, the growth in consultations was steepest for dermatology. Conclusions: Digital consultations offer the possibility for GPs to receive quick responses when seeking advice. The interdisciplinary approach of Prisma creates opportunities for digital patient-centered networking. ",
doi="10.2196/33630",
url="https://humanfactors.jmir.org/2022/2/e33630",
url="http://www.ncbi.nlm.nih.gov/pubmed/35363155"
}


@Article{info:doi/10.2196/34698,
author="Vanden Bempt, Femke
and Economou, Maria
and Dehairs, Ward
and Vandermosten, Maaike
and Wouters, Jan
and Ghesqui{\`e}re, Pol
and Vanderauwera, Jolijn",
title="Feasibility, Enjoyment, and Language Comprehension Impact of a Tablet- and GameFlow-Based Story-Listening Game for Kindergarteners: Methodological and Mixed Methods Study",
journal="JMIR Serious Games",
year="2022",
month="Mar",
day="23",
volume="10",
number="1",
pages="e34698",
keywords="serious gaming",
keywords="language comprehension",
keywords="enjoyment",
keywords="feasibility",
keywords="GameFlow",
abstract="Background: Enjoyment plays a key role in the success and feasibility of serious gaming interventions. Unenjoyable games will not be played, and in the case of serious gaming, learning will not occur. Therefore, a so-called GameFlow model has been developed, which intends to guide (serious) game developers in the process of creating and evaluating enjoyment in digital (serious) games. Regarding language learning, a variety of serious games targeting specific language components exist in the market, albeit often without available assessments of enjoyment or feasibility. Objective: This study evaluates the enjoyment and feasibility of a tablet-based, serious story-listening game for kindergarteners, developed based on the principles of the GameFlow model. This study also preliminarily explores the possibility of using the game to foster language comprehension. Methods: Within the framework of a broader preventive reading intervention, 91 kindergarteners aged 5 years with a cognitive risk for dyslexia were asked to play the story game for 12 weeks, 6 days per week, either combined with a tablet-based phonics intervention or control games. The story game involved listening to and rating stories and responding to content-related questions. Game enjoyment was assessed through postintervention questionnaires, a GameFlow-based evaluation, and in-game story rating data. Feasibility was determined based on in-game general question response accuracy (QRA), reflecting the difficulty level, attrition rate, and final game exposure and training duration. Moreover, to investigate whether game enjoyment and difficulty influenced feasibility, final game exposure and training duration were predicted based on the in-game initial story ratings and initial QRA. Possible growth in language comprehension was explored by analyzing in-game QRA as a function of the game phase and baseline language skills. Results: Eventually, data from 82 participants were analyzed. The questionnaire and in-game data suggested an overall enjoyable game experience. However, the GameFlow-based evaluation implied room for game design improvement. The general QRA confirmed a well-adapted level of difficulty for the target sample. Moreover, despite the overall attrition rate of 39\% (32/82), 90\% (74/82) of the participants still completed 80\% of the game, albeit with a large variation in training days. Higher initial QRA significantly increased game exposure ($\beta$=.35; P<.001), and lower initial story ratings significantly slackened the training duration ($\beta$=?0.16; P=.003). In-game QRA was positively predicted by game phase ($\beta$=1.44; P=.004), baseline listening comprehension ($\beta$=1.56; P=.002), and vocabulary ($\beta$=.16; P=.01), with larger QRA growth over game phases in children with lower baseline listening comprehension skills ($\beta$=?0.08; P=.04). Conclusions: Generally, the story game seemed enjoyable and feasible. However, the GameFlow model evaluation and predictive relationships imply room for further game design improvements. Furthermore, our results cautiously suggest the potential of the game to foster language comprehension; however, future randomized controlled trials should further elucidate the impact on language comprehension. ",
doi="10.2196/34698",
url="https://games.jmir.org/2022/1/e34698",
url="http://www.ncbi.nlm.nih.gov/pubmed/35319480"
}


@Article{info:doi/10.2196/25715,
author="{\"O}eren, Mariliis
and Jordan, Iain
and Coughlin, Deborah
and Turnbull, Sophie",
title="Improving Access to Behavioral Strategies to Improve Mental Well-being With an Entertaining Breakfast Show App: Feasibility Evaluation Study",
journal="JMIR Form Res",
year="2022",
month="Mar",
day="23",
volume="6",
number="3",
pages="e25715",
keywords="mental well-being",
keywords="mental health",
keywords="smartphone",
keywords="mobile app",
keywords="education",
keywords="entertainment",
keywords="psychotherapy",
keywords="feasibility",
keywords="mobile phone",
abstract="Background: Although mental ill-health is more prevalent among people from lower socioeconomic groups, digital mental well-being innovations are often developed for people from higher socioeconomic groups, who already have resources to maintain good mental and physical health. To decrease health inequalities and ensure that available solutions are appealing and accessible to people with fewer resources, new approaches should be explored. We developed the app Wakey!, which focused on creating engaging mental health content that is accessible, particularly among lower socioeconomic groups in the United Kingdom. Objective: The aim of this study is to assess engagement with the app, investigate initial effectiveness data for 6 well-being outcomes, and explore participants' subjective experiences of using Wakey! Methods: The app Wakey! was publicly launched on January 20, 2020, and was free to download from Apple Store and Google Play. The app provided its users with entertaining and educational content related to mental well-being. Concurrently, a single-arm mixed methods feasibility trial was carried out from January to April 2020 among people who had downloaded the app and created an account. The primary outcome was engagement, which was collected passively from data logs. Secondary outcome measures were 6 well-being outcomes collected from self-report questionnaires. Individual interviews with 19 app users were carried out in April 2020. Results: In total, 5413 people fit the inclusion criteria and were included in the final sample---65.62\% (3520/5364) women, 61.07\% (3286/5381) aged between 25 and 44 years, 61.61\% (2902/4710) in employment, 8.92\% (420/4710) belonging to the lower socioeconomic group, and 8.09\% (438/5413) were engaged users. There was no evidence of a difference in engagement regarding sociodemographic and socioeconomic characteristics. There was evidence that users with a higher average daily sleep score, who joined the study more recently, who had higher baseline self-report of sleep quality, and who found episodes more entertaining were more likely to be engaged users. Among 230 users who provided follow-up data, there was evidence of improvements on four of the six well-being outcomes: life satisfaction (P<.001), feeling that life is worthwhile (P=.01), ease of getting up in the morning (P<.001), and self-efficacy (P=.04). The app and its content were well received by those who were interviewed, and several people perceived a positive change in their mental well-being. Conclusions: This study shows that the app Wakey! could potentially be engaging across different socioeconomic groups, and there is an indication that it could positively impact the mental well-being of those engaged with the app. However, this study was a pragmatic trial with a limited sample, and the selection bias was present in the qualitative and quantitative study. Further work is needed to make any generalizable conclusions. Trial Registration: ClinicalTrials.gov NCT04287296; https://clinicaltrials.gov/ct2/show/NCT04287296 ",
doi="10.2196/25715",
url="https://formative.jmir.org/2022/3/e25715",
url="http://www.ncbi.nlm.nih.gov/pubmed/35319468"
}


@Article{info:doi/10.2196/31820,
author="Man, Alice
and van Ballegooie, Courtney",
title="Assessment of the Readability of Web-Based Patient Education Material From Major Canadian Pediatric Associations: Cross-sectional Study",
journal="JMIR Pediatr Parent",
year="2022",
month="Mar",
day="16",
volume="5",
number="1",
pages="e31820",
keywords="health literacy",
keywords="accessibility",
keywords="online health information",
keywords="pediatrics",
keywords="patient education",
abstract="Background: Web-based patient education materials (PEMs) are frequently written above the recommended reading level in North America. Poor PEM readability limits the accessibility of medical information for individuals with average literacy levels or lower. Pediatric hospital and association websites have not only been shown to be a preferred source of information among caregivers but have also become a necessity during the COVID-19 pandemic. The readability of Canadian pediatric association websites has not yet been assessed. Objective: The aim of this study is to determine if the content of PEMs from Canadian pediatric associations is written at a reading level that the majority of Canadians can understand. Methods: A total of 258 PEMs were extracted from 10 Canadian pediatric associations and evaluated for their reading level using 10 validated readability scales. The PEMs underwent a difficult word analysis and comparisons between PEMs from different associations were conducted. Results: Web-based PEMs were identified from 3 pediatric association websites, where the reading level (calculated as a grade level) was found to be an average of 8.8 (SD 1.8) for the Caring for Kids website, 9.5 (SD 2.2) for the Pediatric Endocrine Group website, and 13.1 (SD 2.1) for the Atlantic Pediatric Society website. The difficult word analysis identified that 19.9\% (SD 6.6\%) of words were unfamiliar, with 13.3\% (SD 5.3\%) and 31.9\% (SD 6.1\%) of words being considered complex (?3 syllables) and long (?6 letters), respectively. Conclusions: The web-based PEMs were found to be written above the recommended seventh-grade reading level for Canadians. Consideration should be made to create PEMs at an appropriate reading level for both patients and their caregivers to encourage health literacy and ultimately promote preventative health behaviors and improve child health outcomes. ",
doi="10.2196/31820",
url="https://pediatrics.jmir.org/2022/1/e31820",
url="http://www.ncbi.nlm.nih.gov/pubmed/35293875"
}


@Article{info:doi/10.2196/30778,
author="{\vS}orgo, Andrej
and Crnkovi{\v c}, Nu{\vs}a
and Gabrovec, Branko
and Cesar, Katarina
and Selak, {\vS}pela",
title="Influence of Forced Online Distance Education During the COVID-19 Pandemic on the Perceived Stress of Postsecondary Students: Cross-sectional Study",
journal="J Med Internet Res",
year="2022",
month="Mar",
day="15",
volume="24",
number="3",
pages="e30778",
keywords="online study",
keywords="stress",
keywords="COVID-19",
keywords="postsecondary students",
keywords="pandemic",
keywords="epidemiology",
keywords="educational institutions",
keywords="online education",
keywords="pedagogy",
keywords="mental health",
abstract="Background: One of the most significant changes in the majority of postsecondary educational institutions was the closure of those institutions and the shift of educational activities to online distance learning formats as a result of the COVID-19 pandemic. Closure combined with forced online distance education (FODE) was a cure with many side effects, 1 of them being the effect on students' mental health and, more specifically, levels of stress. Due to the novelty of the situation, there have been no studies so far designed to link satisfaction with online study, feelings toward the study obligations, and stress among students. Objective: The aim of the study is to assess the perceived stress of Slovenian postsecondary students in order to identify the online study--related factors affecting or acting as a covariate during the COVID-19 lockdown. Methods: Data collection was conducted through a self-reported survey as part of a large cross-sectional study based on data collected from postsecondary students from a number of higher educational institutions. The random sample consisted of 4455 individuals. The Perceived Stress Scale (PSS-4), Satisfaction with Online Study Scale (SAT-5), and Feelings Towards Study Obligations Scale (FETSOS) were used to assess the constructs and the relations observed within the study. Results: The results indicate that more than half of all respondents reported high levels of stress. The difference in the reported levels of perceived stress between genders were statistically significant (N=4454, F2=56.719, P<.001, Cohen d=0.35). Overall, the results suggest that a decline in the motivation to study, the quality of internet and mobile connections, and the presence of distracting factors in the study space were the 3 main factors related to the students' negative emotions as associated with the timeliness, performance, and quality of the study obligations. Furthermore, the results show that the level of satisfaction with online study affected stress such that the higher the satisfaction, the lower the stress. Moreover, the more positive feelings connected with the timeliness, performance, and quality of the study obligations that the students felt, the more satisfaction they reported with online study and, thus indirectly, lower stress and less negative feelings. Conclusions: The findings of this study call for implementing structures and measures targeted at stress reduction, working conditions, and pedagogy with regard to FODE. ",
doi="10.2196/30778",
url="https://www.jmir.org/2022/3/e30778",
url="http://www.ncbi.nlm.nih.gov/pubmed/35171098"
}


@Article{info:doi/10.2196/33282,
author="Tan, Wen Jun
and Ng, Bee Kian
and Mogali, Reddy Sreenivasulu",
title="An Exploratory Digital Board Game Approach to the Review and Reinforcement of Complex Medical Subjects Like Anatomical Education: Cross-sectional and Mixed Methods Study",
journal="JMIR Serious Games",
year="2022",
month="Jan",
day="10",
volume="10",
number="1",
pages="e33282",
keywords="serious games",
keywords="board games",
keywords="anatomy",
keywords="flow",
abstract="Background: Serious games have the potential to resolve educational problems faced by medical students, such as insufficient rehearsal due to boredom and lack of motivation. However, serious games' relatively novel concepts in science and many genres of games that are common in recreation remain underresearched in the literature. Board games are one such genre that, despite their potential, affordability, and flexibility, are rarely designed for medical students, and little is known about student perceptions of them and their compatibility with rehearsal. Objective: In this cross-sectional study, we sought to elicit, via an exploratory mixed methods approach, student perceptions of a digital serious board game specifically designed for the gamified rehearsal of complex medical subjects, with the chosen topic of anatomy. Methods: A digital serious board game, based on self-determination theory (SDT), was first designed and developed to facilitate the rehearsal of anatomy information. Students were then voluntarily recruited to partake in the intervention and were randomly split into three teams of 2 players per game session, after which they were administered the Flow Short Scale (FSS), which is a 13-item measure where items were rated on a 7-point Likert scale ranging from 1 (``not at all'') to 7 (``very much''). Students then participated in a focus group discussion to elicit their perceptions of the game. Findings from the FSS were subject to descriptive analysis, and the focus group discussion was subject to inductive thematic analysis. Results: A total of 12 undergraduate, second-year medical students from the Lee Kong Chian School of Medicine in Singapore participated in the study. FSS results indicated a moderate level of overall flow (mean score 4.94, SD 1.07) via the subdomains of fluency (mean score 4.77, SD 1.13) and absorption (mean score 5.21, SD 1.1). Students perceived the game as fun, enjoyable, engaging, and appropriate as a rehearsal tool that alleviated the monotony of traditional methods of rehearsal. Conclusions: Our digital board game--based rehearsal tool, when based on SDT, appeared to be suitable for gamified rehearsal in a fun and enjoyable environment due to its facilitation of intrinsic motivation in its players. ",
doi="10.2196/33282",
url="https://games.jmir.org/2022/1/e33282",
url="http://www.ncbi.nlm.nih.gov/pubmed/35006080"
}


@Article{info:doi/10.2196/26252,
author="Pant, Ichhya
and Rimal, Rajiv
and Yilma, Hagere
and Bingenheimer, Jeffrey
and Sedlander, Erica
and Behera, Sibabrata",
title="mHealth for Anemia Reduction: Protocol for an Entertainment Education--Based Dual Intervention",
journal="JMIR Res Protoc",
year="2021",
month="Nov",
day="22",
volume="10",
number="11",
pages="e26252",
keywords="mHealth",
keywords="interactive",
keywords="voice response",
keywords="entertainment",
keywords="education",
keywords="rural",
keywords="anemia",
keywords="bystander",
keywords="violence against women",
abstract="Background: More than half of the women of reproductive age (aged 15-49 years) are anemic in India. The uptake of and adherence to iron folic acid (IFA) supplements remain low despite sustained efforts to increase their use. With India's burgeoning digital environment, mobile phones offer a potential medium for increasing their uptake, especially when combined with interactive voice messages that deliver entertaining stories infused with norms-based educational messages. Objective: This study aims to investigate whether a norms-based entertainment education mobile health intervention can increase self-efficacy for IFA adherence among women of reproductive age in Odisha, India. Methods: Mobile reduction in anemia through normative innovations (mRANI) is a randomized 2-arm study that includes assessments before and after the intervention. All study participants will be recruited from the intervention arm of the parent reduction in anemia through normative innovations trial only. Although the usual practice is to randomize participants either to a treatment arm or a usual care control arm, we will assign the mRANI control group to another entertainment education--based treatment group that is designed to improve bystander intervention to reduce violence against women. Data collection for the mRANI study is embedded in the parent trial and will include baseline and end line assessments. The primary outcomes are self-efficacy for IFA adherence and violence against women--related bystander intervention. The inclusion criteria for the mRANI study are participation in the parent trial and phone ownership. Women (approximately n=400) who meet the mRANI inclusion criteria will be randomly assigned to the IFA arm or the bystander arm. Ordinary least squares regression with robust SEs will be conducted to assess between-group comparisons at the end line. A mediation analysis will be conducted to examine whether social norms and interactivity mediate the relationship between intervention exposure and primary outcomes in both arms. Real-time monitoring data will offer insights into intervention receptivity and audience engagement. Results: Data collection for the mRANI study is integrated within the parent trial. Household surveys were conducted between February and March of 2021. Responses on the mRANI study's primary and secondary outcomes were collected from 381 participants. The data analysis is expected to be completed by October 2021. Conclusions: This study will provide evidence on whether a mobile health norms--based entertainment education intervention can increase self-efficacy for IFA adherence and violence against women--related bystander intervention. International Registered Report Identifier (IRRID): PRR1-10.2196/26252 ",
doi="10.2196/26252",
url="https://www.researchprotocols.org/2021/11/e26252",
url="http://www.ncbi.nlm.nih.gov/pubmed/34812735"
}


@Article{info:doi/10.2196/30533,
author="Stunden, Chelsea
and Zakani, Sima
and Martin, Avery
and Moodley, Shreya
and Jacob, John",
title="Replicating Anatomical Teaching Specimens Using 3D Modeling Embedded Within a Multimodal e-Learning Course: Pre-Post Study Exploring the Impact on Medical Education During COVID-19",
journal="JMIR Med Educ",
year="2021",
month="Nov",
day="17",
volume="7",
number="4",
pages="e30533",
keywords="congenital heart disease",
keywords="cardiac anatomy, pathologic anatomy",
keywords="education",
keywords="learning aids",
keywords="3D models",
abstract="Background: The COVID-19 pandemic has had significant effects on anatomy education. During the pandemic, students have had no access to cadavers, which has been the principal method of learning anatomy. We created and tested a customized congenital heart disease e-learning course for medical students that contained interactive 3D models of anonymized pediatric congenital heart defects. Objective: The aim of this study is to assess whether a multimodal e-learning course contributed to learning outcomes in a cohort of first-year undergraduate medical students studying congenital heart diseases. The secondary aim is to assess student attitudes and experiences associated with multimodal e-learning. Methods: The pre-post study design involved 290 first-year undergraduate medical students. Recruitment was conducted by course instructors. Data were collected before and after using the course. The primary outcome was knowledge acquisition (test scores). The secondary outcomes included attitudes and experiences, time to complete the modules, and browser metadata. Results: A total of 141 students were included in the final analysis. Students' knowledge significantly improved by an average of 44.6\% (63/141) when using the course (SD 1.7\%; Z=?10.287; P<.001). Most students (108/122, 88.3\%) were highly motivated to learn with the course, and most (114/122, 93.5\%) reported positive experiences with the course. There was a strong correlation between attitudes and experiences, which was statistically significant (rs=0.687; P<.001; n=122). No relationships were found between the change in test scores and attitudes (P=.70) or experiences (P=.47). Students most frequently completed the e-learning course with Chrome (109/141, 77.3\%) and on Apple macOS (86/141, 61\%) or Windows 10 (52/141, 36.9\%). Most students (117/141, 83\%) had devices with high-definition screens. Most students (83/141, 58.9\%) completed the course in <3 hours. Conclusions: Multimodal e-learning could be a viable solution in improving learning outcomes and experiences for undergraduate medical students who do not have access to cadavers. Future research should focus on validating long-term learning outcomes. ",
doi="10.2196/30533",
url="https://mededu.jmir.org/2021/4/e30533",
url="http://www.ncbi.nlm.nih.gov/pubmed/34787589"
}


@Article{info:doi/10.2196/30607,
author="Koenig, Leni Julia Felicitas
and Buentzel, Judith
and Jung, Wolfram
and Truemper, Lorenz
and Wurm-Kuczera, Isabel Rebecca",
title="Using Instagram to Enhance a Hematology and Oncology Teaching Module During the COVID-19 Pandemic: Cross-sectional Study",
journal="JMIR Med Educ",
year="2021",
month="Nov",
day="15",
volume="7",
number="4",
pages="e30607",
keywords="COVID-19",
keywords="medical education",
keywords="distance learning",
keywords="undergraduate medical education",
keywords="digital medical education",
keywords="Instagram",
keywords="hematology and medical oncology",
abstract="Background: The COVID-19 pandemic necessitated the rapid expansion of novel tools for digital medical education. At our university medical center, an Instagram account was developed as a tool for medical education and used for the first time as a supplement to the hematology and medical oncology teaching module of 2020/2021. Objective: We aimed to evaluate the acceptance and role of Instagram as a novel teaching format in the education of medical students in hematology and medical oncology in the German medical curriculum. Methods: To investigate the role of Instagram in student education of hematology and medical oncology, an Instagram account was developed as a tie-in for the teaching module of 2020/21. The account was launched at the beginning of the teaching module, and 43 posts were added over the 47 days of the teaching module (at least 1 post per day). Five categories for the post content were established: (1) engagement, (2) self-awareness, (3) everyday clinical life combined with teaching aids, (4) teaching aids, and (5) scientific resources. Student interaction with the posts was measured based on overall subscription, ``likes,'' comments, and polls. Approval to conduct this retrospective study was obtained from the local ethics commission of the University Medical Center Goettingen. Results: Of 164 medical students, 119 (72.6\%) subscribed to the Instagram account, showing high acceptance and interest in the use of Instagram for medical education. The 43 posts generated 325 interactions. The highest number of interactions was observed for the category of engagement (mean 15.17 interactions, SD 5.01), followed by self-awareness (mean 14 interactions, SD 7.79). With an average of 7.3 likes per post, overall interaction was relatively low. However, although the category of scientific resources garnered the fewest likes (mean 1.86, SD 1.81), 66\% (27/41) of the student participants who answered the related Instagram poll question were interested in studies and reviews, suggesting that although likes aid the estimation of a general trend of interest, there are facets to interest that cannot be represented by likes. Interaction significantly differed between posting categories (P<.001, Welch analysis of variance). Comparing the first category (engagement) with categories 3 to 5 showed a significant difference (Student t test with the Welch correction; category 1 vs 3, P=.01; category 1 vs 4, P=.01; category 1 vs 5, P=.001). Conclusions: Instagram showed high acceptance among medical students participating in the hematology and oncology teaching curriculum. Students were most interested in posts on routine clinical life, self-care topics, and memory aids. More studies need to be conducted to comprehend the use of Instagram in medical education and to define the role Instagram will play in the future. Furthermore, evaluation guidelines and tools need to be developed. ",
doi="10.2196/30607",
url="https://mededu.jmir.org/2021/4/e30607",
url="http://www.ncbi.nlm.nih.gov/pubmed/34779777"
}


@Article{info:doi/10.2196/25110,
author="Xie, Wenxiu
and Ji, Christine
and Hao, Tianyong
and Chow, Chi-Yin",
title="Predicting the Easiness and Complexity of English Health Materials for International Tertiary Students With Linguistically Enhanced Machine Learning Algorithms: Development and Validation Study",
journal="JMIR Med Inform",
year="2021",
month="Oct",
day="26",
volume="9",
number="10",
pages="e25110",
keywords="feature selection",
keywords="logistic regression",
keywords="online health resources",
abstract="Background: There is an increasing body of research on the development of machine learning algorithms in the evaluation of online health educational resources for specific readerships. Machine learning algorithms are known for their lack of interpretability compared with statistics. Given their high predictive precision, improving the interpretability of these algorithms can help increase their applicability and replicability in health educational research and applied linguistics, as well as in the development and review of new health education resources for effective and accessible health education. Objective: Our study aimed to develop a linguistically enriched machine learning model to predict binary outcomes of online English health educational resources in terms of their easiness and complexity for international tertiary students. Methods: Logistic regression emerged as the best performing algorithm compared with support vector machine (SVM) (linear), SVM (radial basis function), random forest, and extreme gradient boosting on the transformed data set using L2 normalization. We applied recursive feature elimination with SVM to perform automatic feature selection. The automatically selected features (n=67) were then further streamlined through expert review. The finalized feature set of 22 semantic features achieved a similar area under the curve, sensitivity, specificity, and accuracy compared with the initial (n=115) and automatically selected feature sets (n=67). Logistic regression with the linguistically enhanced feature set (n=22) exhibited important stability and robustness on the training data of different sizes (20\%, 40\%, 60\%, and 80\%), and showed consistently high performance when compared with the other 4 algorithms (SVM [linear], SVM [radial basis function], random forest, and extreme gradient boosting). Results: We identified semantic features (with positive regression coefficients) contributing to the prediction of easy-to-understand online health texts and semantic features (with negative regression coefficients) contributing to the prediction of hard-to-understand health materials for readers with nonnative English backgrounds. Language complexity was explained by lexical difficulty (rarity and medical terminology), verbs typical of medical discourse, and syntactic complexity. Language easiness of online health materials was associated with features such as common speech act verbs, personal pronouns, and familiar reasoning verbs. Successive permutation of features illustrated the interaction between these features and their impact on key performance indicators of the machine learning algorithms. Conclusions: The new logistic regression model developed exhibited consistency, scalability, and, more importantly, interpretability based on existing health and linguistic research. It was found that low and high linguistic accessibilities of online health materials were explained by 2 sets of distinct semantic features. This revealed the inherent complexity of effective health communication beyond current readability analyses, which were limited to syntactic complexity and lexical difficulty. ",
doi="10.2196/25110",
url="https://medinform.jmir.org/2021/10/e25110",
url="http://www.ncbi.nlm.nih.gov/pubmed/34698644"
}


@Article{info:doi/10.2196/27441,
author="Tackett, Sean
and Green, David
and Dyal, Michael
and O'Keefe, Erin
and Thomas, Emmanuelle Tanya
and Nguyen, Tiffany
and Vo, Duyen
and Patel, Mausam
and Murdock, J. Christopher
and Wolfe, M. Erin
and Shehadeh, A. Lina",
title="Use of Commercially Produced Medical Education Videos in a Cardiovascular Curriculum: Multiple Cohort Study",
journal="JMIR Med Educ",
year="2021",
month="Oct",
day="7",
volume="7",
number="4",
pages="e27441",
keywords="commercial videos",
keywords="flipped classroom",
keywords="organ-systems courses",
keywords="medical education",
keywords="medical students",
keywords="teaching",
keywords="education",
keywords="health science education",
keywords="e-Learning",
abstract="Background: Short instructional videos can make learning more efficient through the application of multimedia principles, and video animations can illustrate the complex concepts and dynamic processes that are common in health sciences education. Commercially produced videos are commonly used by medical students but are rarely integrated into curricula. Objective: Our goal was to examine student engagement with medical education videos incorporated into a preclinical Cardiovascular Systems course. Methods: Students who took the first-year 8-week Cardiovascular Systems course in 2019 and 2020 were included in the study. Videos from Osmosis were recommended to be watched before live sessions throughout the course. Video use was monitored through dashboards, and course credit was given for watching videos. All students were emailed electronic surveys after the final exam asking about the course's blended learning experience and use of videos. Osmosis usage data for number of video views, multiple choice questions, and flashcards were extracted from Osmosis dashboards. Results: Overall, 232/359 (64.6\%) students completed surveys, with rates by class of 81/154 (52.6\%) for MD Class of 2022, 39/50 (78\%) for MD/MPH Class of 2022, and 112/155 (72.3\%) for MD Class of 2023. Osmosis dashboard data were available for all 359 students. All students received the full credit offered for Osmosis engagement, and learning analytics demonstrated regular usage of videos and other digital platform features. Survey responses indicated that most students found Osmosis videos to be helpful for learning (204/232, 87.9\%; P=.001) and preferred Osmosis videos to the traditional lecture format (134/232, 57.8\%; P<.001). Conclusions: Commercial medical education videos may enhance curriculum with low faculty effort and improve students' learning experiences. Findings from our experience at one medical school can guide the effective use of supplemental digital resources for learning, and related evaluation and research. ",
doi="10.2196/27441",
url="https://mededu.jmir.org/2021/4/e27441",
url="http://www.ncbi.nlm.nih.gov/pubmed/34617911"
}


@Article{info:doi/10.2196/28739,
author="Emwodew, Delelegn
and Melese, Tesfahun
and Takele, Adamu
and Mesfin, Nebiyu
and Tariku, Binyam",
title="Knowledge and Attitude Toward Evidence-Based Medicine and Associated Factors Among Medical Interns in Amhara Regional State Teaching Hospitals, Northwest Ethiopia: Cross-sectional Study",
journal="JMIR Med Educ",
year="2021",
month="Jun",
day="24",
volume="7",
number="2",
pages="e28739",
keywords="knowledge",
keywords="attitude",
keywords="evidence-based medicine",
keywords="teaching hospitals",
abstract="Background: Evidence-based medicine (EBM) is widely accepted in medicine. It is necessary to improve the knowledge and attitudes of medical students in the use of evidence. In Ethiopia, little is known about medical students' knowledge and attitudes toward EBM. Objective: This study aimed to assess the knowledge and attitudes toward EBM and its associated factors among medical interns in teaching hospitals. Methods: A cross-sectional survey was conducted using a random sample of medical interns in teaching hospitals in Ethiopia. Multivariable logistic regression analyses were used to identify the factors associated with the knowledge and attitudes toward EBM. Adjusted odds ratio (AOR) with 95\% confidence interval and P?.05 was used to quantify strength of association between variables. Results: Out of a sample of 423 medical interns, 403 completed the questionnaire (95.3\% response rate). Overall, 68.0\% (274/403 of respondents had a favorable attitude toward EBM and 57.1\% (230/403) had good knowledge of EBM. The majority (355/403, 88.1\%) of participants had internet access. Only 19.6\% (79/403) of respondents had received EBM-related training. Respondents' knowledge of EBM was associated with previous EBM training (AOR 2.947, 95\% CI 1.648-5.268, P<.001), understanding of sensitivity (AOR 2.836, 95\% CI 1.824-4.408, P=.003), and internet access (AOR 2.914, 95\% CI 1.494-5.685, P=.002). The use of an electronic database as a source of information (AOR 1.808, 95\% CI 1.143-2.861, P=.01) and understanding of absolute risk reduction (AOR 2.750, 95\% CI 1.105-6.841, P=.03) were predictors of positive attitudes. Conclusions: This study demonstrates a lack of formal EBM training and awareness of basic concepts of EBM among medical interns. Medical intern attitudes toward EBM are relatively good. To enhance EBM knowledge and skills, formal teaching of EBM should be integrated into medical education. ",
doi="10.2196/28739",
url="https://mededu.jmir.org/2021/2/e28739/",
url="http://www.ncbi.nlm.nih.gov/pubmed/34185012"
}


@Article{info:doi/10.2196/24496,
author="Cui, Shu
and Zhang, Chao
and Wang, Shijiang
and Zhang, Xingong
and Wang, Lei
and Zhang, Ling
and Yuan, Qiuyu
and Huang, Cui
and Cheng, Fangshuo
and Zhang, Kai
and Zhou, Xiaoqin",
title="Experiences and Attitudes of Elementary School Students and Their Parents Toward Online Learning in China During the COVID-19 Pandemic: Questionnaire Study",
journal="J Med Internet Res",
year="2021",
month="May",
day="19",
volume="23",
number="5",
pages="e24496",
keywords="attitude",
keywords="elementary school students",
keywords="parents",
keywords="online learning",
keywords="COVID-19",
abstract="Background: Due to widespread SARS-CoV-2 infection, an emergency homeschooling plan was rigorously implemented throughout China. Objective: This study aimed to investigate the experiences and attitudes of elementary school students and their parents (two generations from the same family) toward online learning in China during the pandemic. Methods: A 16-item questionnaire was distributed at the 10-day and 40-day marks after the start of the first online course to 867 parent-child pairs and 141 parent-child pairs, respectively. The questionnaire was comprised of questions pertaining to course and homework completeness, effectiveness, reliability, and abundance as well as the students' enthusiasm for taking part in online classes and their satisfaction with the courses. Results: Our findings indicate that 90.7\% (786/867) of students exhibited high or moderate enthusiasm for participating in online classes. However, most students performed poorly in online learning classes and after-school homework. With regard to satisfaction, parents' and students' average scores were 7.35 and 7.25, respectively (10-point scoring system). During the second stage of this study, parents' positive evaluations for online learning declined, including those for the effectiveness and reliability of the courses. Furthermore, the proportion of students who completed the courses and homework on time decreased; this difference proved statistically significant (P=.047). The parents' and students' overall satisfaction with online learning also declined during the second stage (parents: 7.21; students: 7.23); however, the difference in overall satisfaction between the two stages was not statistically significant (parents: P=.53; students: P=.60). Several of the parents (315/867, 36.2\%) indicated that assisting with and supervising the students' online learning resulted in increased stress. Further, 36\% of parents expressed dissatisfaction with or provided suggestions for online learning; most parents and students hoped to return to face-to-face classes (parents: 823/867, 94.9\%; students: 811/867, 93.5\%). Finally, our results presented the following six main issues that parents were the most concerned about: (1) disappointment regarding timely interaction in courses; (2) apprehensiveness about students' understanding of the course; (3) the increased burden of annoying adult responsibilities; (4) concern about children's eyesight; (5) the idea that teachers' explanations were not detailed enough; and (6) concerns about the decline of students' interest in and attention toward online courses. Conclusions: Online learning can prevent the spread of infectious diseases while still allowing elementary school students to attain knowledge. However, in our study, children's completion of the courses and homework were not satisfactory. Furthermore, their parents often experienced stress and had many concerns and complaints. Measures such as increasing the interactivity of the courses and prohibiting teachers from assigning tasks to parents could improve the effectiveness of these courses and the mental health of parents and students. ",
doi="10.2196/24496",
url="https://www.jmir.org/2021/5/e24496",
url="http://www.ncbi.nlm.nih.gov/pubmed/33878022"
}


@Article{info:doi/10.2196/26927,
author="Stuby, Loric
and Currat, Ludivine
and Gartner, Birgit
and Mayoraz, Mathieu
and Harbarth, Stephan
and Suppan, Laurent
and Suppan, M{\'e}lanie",
title="Impact of Face-to-Face Teaching in Addition to Electronic Learning on Personal Protective Equipment Doffing Proficiency in Student Paramedics: Protocol for a Randomized Controlled Trial",
journal="JMIR Res Protoc",
year="2021",
month="Apr",
day="30",
volume="10",
number="4",
pages="e26927",
keywords="personal protective equipment",
keywords="electronic learning",
keywords="prehospital",
keywords="student paramedics",
keywords="infection prevention",
keywords="face-to-face learning",
keywords="protection",
keywords="student",
keywords="online learning",
keywords="online education",
keywords="protocol",
keywords="randomized controlled trial",
keywords="gamification",
abstract="Background: The COVID-19 pandemic has brought attention to the importance of correctly using personal protective equipment (PPE). Doffing is a critical phase that increases the risk of contamination of health care workers. Although a gamified electronic learning (e-learning) module has been shown to increase the adequate choice of PPE among prehospital personnel, it failed to enhance knowledge regarding donning and doffing sequences. Adding other training modalities such as face-to-face training to these e-learning tools is therefore necessary to increase prehospital staff proficiency and thus help reduce the risk of contamination. Objective: The aim of this study is to assess the impact of the Peyton 4-step approach in addition to a gamified e-learning module for teaching the PPE doffing sequence to first-year paramedic students. Methods: Participants will first follow a gamified e-learning module before being randomized into one of two groups. In the control group, participants will be asked to perform a PPE doffing sequence, which will be video-recorded to allow for subsequent assessment. In the experimental group, participants will first undergo face-to-face training performed by third-year students using the Peyton 4-step approach before performing the doffing sequence themselves, which will also be video-recorded. All participants will then be asked to reconstruct the doffing sequence on an online platform. The recorded sequences will be assessed independently by two investigators: a prehospital emergency medicine expert and an infection prevention and control specialist. The assessors will be blinded to group allocation. Four to eight weeks after this first intervention, all participants will be asked to record the doffing sequence once again for a subsequent skill retention assessment and to reconstruct the sequence on the same online platform to assess knowledge retention. Finally, participants belonging to the control group will follow face-to-face training. Results: The study protocol has been presented to the regional ethics committee (Req-2020-01340), which issued a declaration of no objection as such projects do not fall within the scope of the Swiss federal law on human research. Study sessions were performed in January and February 2021 in Geneva, and will be performed in April and June 2021 in Bern. Conclusions: This study should help to determine whether face-to-face training using the Peyton 4-step approach improves the application and knowledge retention of a complex procedure when combined with an e-learning module. International Registered Report Identifier (IRRID): PRR1-10.2196/26927 ",
doi="10.2196/26927",
url="https://www.researchprotocols.org/2021/4/e26927",
url="http://www.ncbi.nlm.nih.gov/pubmed/33929334"
}


@Article{info:doi/10.2196/21988,
author="Zhang, Cevin
and Baalsrud Hauge, Jannicke
and H{\"a}renstam, Pukk Karin
and Meijer, Sebastiaan",
title="Game Experience and Learning Effects of a Scoring-Based Mechanic for Logistical Aspects of Pediatric Emergency Medicine: Development and Feasibility Study",
journal="JMIR Serious Games",
year="2021",
month="Mar",
day="11",
volume="9",
number="1",
pages="e21988",
keywords="serious game",
keywords="emergency department",
keywords="experience",
keywords="learning engagement",
keywords="learning behavior transition",
keywords="logistical performance",
abstract="Background: Using serious games for learning in operations management is well established. However, especially for logistics skills in health care operations, there is little work on the design of game mechanics for learning engagement and the achievement of the desired learning goals. Objective: This contribution presents a serious game design representing patient flow characteristics, systemic resource configurations, and the roles of the players based on a real Swedish emergency ward. The game was tested in a set of game-based learning practices in the modalities of a physical board game and an online multiplayer serious game that implemented the same game structure. Methods: First, survey scores were collected using the Game Experience Questionnaire Core and Social Presence Modules to evaluate the experience and acceptance of the proposed design to gamify real processes in emergency care. Second, lag sequential analysis was applied to analyze the impact of the game mechanics on learning behavior transitions. Lastly, regression analysis was used to understand whether learning engagement attributes could potentially serve as significant predicting variables for logistical performance in a simulated learning environment. Results: A total of 36 students from courses in engineering and management at KTH Royal Institute of Technology participated in both game-based learning practices during the autumn and spring semesters of 2019 and 2020. For the Core Module, significant differences were found for the scores for negative affect and tension compared with the rest of the module. For the Social Presence Module, significant differences were found in the scores for the psychological involvement -- negative feelings dimension compared with the rest of the module. During the process of content generation, the participant had access to circulating management resources and could edit profiles. The standard regression analysis output yielded a $\Delta$R2 of 0.796 (F14,31=2725.49, P<.001) for the board version and 0.702 (F24,31=2635.31, P<.001) for the multiplayer online version after the learning engagement attributes. Conclusions: The high scores of positive affect and immersion compared to the low scores of negative feelings demonstrated the motivating and cognitive involvement impact of the game. The proposed game mechanics have visible effects on significant correlation parameters between the majority of scoring features and changes in learning engagement attributes. Therefore, we conclude that for enhancing learning in logistical aspects of health care, serious games that are steered by well-designed scoring mechanisms can be used. ",
doi="10.2196/21988",
url="https://games.jmir.org/2021/1/e21988",
url="http://www.ncbi.nlm.nih.gov/pubmed/33704081"
}


@Article{info:doi/10.2196/14666,
author="Abduljabbar, H. Ahmed
and Alnajjar, F. Sara
and Alshamrani, Hussein
and Bashamakh, F. Lujain
and Alshehri, Z. Hisham
and Alqulayti, M. Waleed
and Wazzan, A. Mohammad",
title="The Influence of Gender on the Choice of Radiology as a Specialty Among Medical Students in Saudi Arabia: Cross-Sectional Study",
journal="Interact J Med Res",
year="2020",
month="Apr",
day="28",
volume="9",
number="2",
pages="e14666",
keywords="gender",
keywords="radiology",
keywords="specialty choice",
abstract="Background: Medical undergraduates are the future doctors of the country. Therefore, determining how medical students choose their areas of specialty is essential to obtain a balanced distribution of physicians among all specialties. Although gender is a significant factor that affects specialty choice, the factors underlying gender differences in radiology are not fully elucidated. Objective: This study examined the factors that attracted medical students to and discouraged them from selecting diagnostic radiology and analyzed whether these factors differed between female and male medical students. Methods: This cross-sectional study conducted at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, used an electronic questionnaire sent to medical students from all medical years during February 2018. Subgroup analyses for gender and radiology interest were performed using the chi-square test and Cram{\'e}r's V test. Results: In total, 539 students (276 women; 263 men) responded. The most common factor preventing students from choosing radiology as a career was the lack of direct patient contact, which deterred approximately 47\% who decided against considering this specialty. Negative perceptions by other physicians (P<.001), lack of acknowledgment by patients (P=.004), and lack of structured radiology rotations (P=.007) dissuaded significantly more male students than female students. Among those interested in radiology, more female students were attracted by job flexibility (P=.01), while more male students were attracted by focused patient interactions with minimal paperwork (P<.001). Conclusions: No significant difference was found between the genders in terms of considering radiology as a specialty. Misconception plays a central role in students' judgment regarding radiology. Hence, early exposure to radiology, assuming a new teaching method, and using a curriculum that supports the active participation of students in a radiology rotation are needed to overcome this misconception. ",
doi="10.2196/14666",
url="http://www.i-jmr.org/2020/2/e14666/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32141832"
}


@Article{info:doi/10.2196/12176,
author="Ntalindwa, Theoneste
and Soron, Rashid Tanjir
and Nduwingoma, Mathias
and Karangwa, Evariste
and White, Rebecca",
title="The Use of Information Communication Technologies Among Children With Autism Spectrum Disorders: Descriptive Qualitative Study",
journal="JMIR Pediatr Parent",
year="2019",
month="Sep",
day="27",
volume="2",
number="2",
pages="e12176",
keywords="autism spectrum disorders",
keywords="information communication technologies",
keywords="inclusive education",
abstract="Background: The prevalence of Autism Spectrum Disorder (ASD) appears to be increasing globally due to the complex interaction of multiple biopsychosocial and environmental factors. Mobile phones, tablets, and other electronic gadgets have transformed our means of communication, and have also changed both healthcare and how we learn. These technological enhancements may have a positive impact on the lives of children, but there is currently a global scarcity of information on how information technology influences the education of children with ASD. Objective: This study was conducted in Rwandan schools and communities, and aimed to understand the perceptions of students with ASD, their parents, and their teachers, on the use of Information and Communication Technology (ICT) in the education of those with ASD. Methods: This qualitative descriptive study was conducted from December 2017 to July 2018. Researchers conducted four focus group discussions (FGDs) with 54 participants from different backgrounds: teachers, parents, and students with ASD. Each of the FGDs took approximately two and a half hours. A predefined set of open-ended questions were selected to discover people's perceptions regarding assistive technologies used in ASD, their effectiveness, the scope of using them in their context, and upcoming challenges during implementation. The interviews were recorded, transcribed, and analyzed. Results: The findings of the study revealed seven key themes: (1) the use of ICT for the education of children with ASD; (2) existing augmentative facilities for learning; (3) current patterns of use of ICT in education; (4) preferred areas of learning for ASD students; (5) integration of ICT into educational programs; (6) areas of interest outside the classroom; and (7) future opportunities and challenges in Rwanda. We found most of the study participants assumed that appropriate technology and related innovations might solve the challenges faced by learners with ASD in classrooms. Moreover, they thought that children with ASD more so enjoyed watching television, playing digital games, and drawing objects using gadgets than interacting with people or playing with other children. Conclusions: The use of various low-cost technical devices can aid with teaching and the education of children with autism in Rwanda. However, this area requires further research to discover the impact ICT can have on the education of children with ASD, so this study may become a starting point for further research in the area. ",
doi="10.2196/12176",
url="http://pediatrics.jmir.org/2019/2/e12176/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31573940"
}


@Article{info:doi/10.2196/ijmr.4749,
author="Xesfingi, Sofia
and Vozikis, Athanassios",
title="eHealth Literacy: In the Quest of the Contributing Factors",
journal="Interact J Med Res",
year="2016",
month="May",
day="25",
volume="5",
number="2",
pages="e16",
keywords="eHealth literacy",
keywords="health information",
keywords="Internet",
keywords="demographic factors",
keywords="life-style habits",
abstract="Background: Understanding the factors that influence eHealth in a country is particularly important for health policy decision makers and the health care market, as it provides critical information to develop targeted and tailored interventions for relevant patient--consumer segments, and further suggests appropriate strategies for training the health illiterate part of the population. Objective: The objective of the study is to assess the eHealth literacy level of Greek citizens, using the eHealth Literacy Scale (eHEALS), and further explore the factors that shape it and are associated with it. Methods: This empirical study relies on a unique sample of 1064 citizens in Greece in the year 2013. The participants were requested to answer various questions about their ability to solve health-related issues using the Internet, and to provide information about their demographic characteristics and life-style habits. Ordered logit models were used to describe a certain citizen's likelihood of being eHealth literate. Results: The demographic factors show that the probability of an individual being eHealth literate decreases by 23\% (P=.001) when the individual ages and increases by 53\% (P<.001) when he or she acquires higher level of education. Among the life-style variables, physical exercise appears to be strongly and positively associated with the level of eHealth literacy (P=.001). Additionally, other types of technology literacies, such as computer literacy and information literacy, further enhance the eHealth performance of citizens and have the greatest impact among all factors. Conclusions: The factors influencing eHealth literacy are complex and interdependent. However, the Internet is a disruptive factor in the relationship between health provider and health consumer. Further research is needed to examine how several factors associate with eHealth literacy, since, the latter is not only related to health care outcomes but also can be a tool for disseminating social inequalities. ",
doi="10.2196/ijmr.4749",
url="http://www.i-jmr.org/2016/2/e16/",
url="http://www.ncbi.nlm.nih.gov/pubmed/27226146"
}


@Article{info:doi/10.2196/ijmr.4937,
author="Liyanagunawardena, Rekha Tharindu
and Williams, Ann Shirley",
title="Elderly Learners and Massive Open Online Courses: A Review",
journal="Interact J Med Res",
year="2016",
month="Jan",
day="07",
volume="5",
number="1",
pages="e1",
keywords="massive open online courses",
keywords="loneliness",
keywords="older adults",
keywords="elderly",
keywords="eLearning",
keywords="education",
keywords="continuing education",
keywords="computer-assisted instruction",
abstract="Background: Massive open online courses (MOOCs) have become commonplace in the e-learning landscape. Thousands of elderly learners are participating in courses offered by various institutions on a multitude of platforms in many different languages. However, there is very little research into understanding elderly learners in MOOCs. Objective: We aim to show that a considerable proportion of elderly learners are participating in MOOCs and that there is a lack of research in this area. We hope this assertion of the wide gap in research on elderly learners in MOOCs will pave the way for more research in this area. Methods: Pre-course survey data for 10 University of Reading courses on the FutureLearn platform were analyzed to show the level of participation of elderly learners in MOOCs. Two MOOC aggregator sites (Class Central and MOOC List) were consulted to gather data on MOOC offerings that include topics relating to aging. In parallel, a selected set of MOOC platform catalogues, along with a recently published review on health and medicine-related MOOCs, were searched to find courses relating to aging. A systematic literature search was then employed to identify research articles on elderly learners in MOOCs. Results: The 10 courses reviewed had a considerable proportion of elderly learners participating in them. For the over-66 age group, this varied from 0.5\% (on the course ``Managing people'') to 16.3\% (on the course ``Our changing climate''), while for the over-56 age group it ranged from 3.0\% (on ``A beginners guide to writing in English'') to 39.5\% (on ``Heart health''). Only six MOOCs were found to include topics related to aging: three were on the Coursera platform, two on the FutureLearn platform, and one on the Open2Study platform. Just three scholarly articles relating to MOOCs and elderly learners were retrieved from the literature search. Conclusions: This review presents evidence to suggest that elderly learners are already participating in MOOCs. Despite this, there has been very little research into their engagement with MOOCs. Similarly, there has been little research into exploiting the scope of MOOCs for delivering topics that would be of interest to elderly learners. We believe there is potential to use MOOCs as a way of tackling the issue of loneliness among older adults by engaging them as either resource personnel or learners. ",
doi="10.2196/ijmr.4937",
url="http://www.i-jmr.org/2016/1/e1/",
url="http://www.ncbi.nlm.nih.gov/pubmed/26742809"
}