JMIR Medical Education最新文献

Background: Digital technologies (DTs) have profoundly impacted health care delivery globally and are increasingly used in clinical practice. Despite this, there is a scarcity of guidelines for implementing training in digital health competencies (DHC) in medical schools, especially for clinical practice. A lack of sustained integration of DHC risks creating knowledge gaps due to a limited understanding of how DT should be used in health care. Furthermore, few studies have explored reasons for this lag, both within and beyond the medical school curriculum. Current frameworks to address these barriers are often specific to individual countries or schools and focus primarily on curriculum design and delivery. A comprehensive framework is therefore required to ensure consistent implementation of DHC across various contexts and times.

Objective: This study aims to use Singapore as a case study and examine the perspectives of doctors in organizational leadership positions to identify and analyze the barriers to DHC implementation in the undergraduate curriculum of Singapore's medical schools. It also seeks to apply the Normalization Process Theory (NPT) to address these barriers and bridge the gap between health care systems and digital health education (DHE) training.

Methods: Individual semistructured interviews were conducted with doctors in executive and organizational leadership roles. Participants were recruited through purposive sampling, and the data were interpreted using qualitative thematic analysis.

Results: A total of 33 doctors participated, 26 of whom are currently in organizational leadership roles and 7 of whom have previously held such positions. A total of 6 barriers were identified: bureaucratic inertia, lack of opportunities to pursue nontraditional career pathways, limited protective mechanisms for experiential learning and experimentation, lack of clear policy guidelines for clinical practice, insufficient integration between medical school education and clinical experience, and poor IT integration within the health care industry.

Conclusions: These barriers are also present in other high-income countries experiencing health care digitalization, highlighting the need for a theoretical framework that broadens the generalizability of existing recommendations. Applying the NPT underscores the importance of addressing these barriers to effectively integrate DHC into the curriculum. The active involvement of multiple stakeholders and the incorporation of continuous feedback mechanisms are essential. Our proposed framework provides concrete, evidence-based, and step-by-step recommendations for implementation practice, supporting the introduction of DHC in undergraduate medical education.

Background: Health care professionals often face challenges in providing affirming and culturally competent care to transgender, nonbinary, and intersex (TNBI) patients due to a lack of understanding and training in TNBI health care. This gap highlights the opportunity for tailored educational resources to enhance health care professionals' interactions with TNBI individuals.

Objective: This study aimed to explore health care professionals' perspectives on education and awareness of health issues related to TNBI individuals. Specifically, it aimed to identify their needs, challenges, and preferences in accessing and using digital educational resources to enhance their knowledge and competence in providing inclusive and effective care for this population.

Methods: A qualitative research approach was used in this study. In total, 15 health care professionals were recruited via convenience sampling to participate in semistructured interviews. Thematic analysis was applied to identify recurring codes and themes.

Results: The study identified several themes and subthemes related to gender diversity awareness, inclusive communication and understanding the needs of TNBI individuals, societal and structural challenges, regulatory gaps in training and support infrastructure, education and training needs for health care professionals on TNBI care, educational resources and training tools for TNBI care, challenges and design considerations for eHealth tools integrations, and evaluating eHealth impact. Participants identified communication barriers, the need for health care providers to use inclusive language, and gaps in both health care system infrastructure and specialized training for gender-affirming care. In addition, participants expressed a need for comprehensive education on transgender and nonbinary health issues, resources for mental health professionals, user-friendly design, and accessibility features in eHealth tools.

Conclusions: The study revealed substantial deficiencies in health care professionals' knowledge of gender diversity, cultural competency, and the importance of inclusive communication. Addressing the identified barriers and challenges through targeted interventions, such as providing training and support for health care professionals, investing in user-friendly design and data security, and promoting cultural competence in TNBI health care, is essential. Despite integration challenges, eHealth tools have the potential to improve patient-health care professional relationships and access to care.

Background: Advancements in ChatGPT are transforming medical education by providing new tools for assessment and learning, potentially enhancing evaluations for doctors and improving instructional effectiveness.

Objective: This study evaluates the performance and consistency of ChatGPT-3.5 Turbo and ChatGPT-4o mini in solving European Portuguese medical examination questions (2023 National Examination for Access to Specialized Training; Prova Nacional de Acesso à Formação Especializada [PNA]) and compares their performance to human candidates.

Methods: ChatGPT-3.5 Turbo was tested on the first part of the examination (74 questions) on July 18, 2024, and ChatGPT-4o mini on the second part (74 questions) on July 19, 2024. Each model generated an answer using its natural language processing capabilities. To test consistency, each model was asked, "Are you sure?" after providing an answer. Differences between the first and second responses of each model were analyzed using the McNemar test with continuity correction. A single-parameter t test compared the models' performance to human candidates. Frequencies and percentages were used for categorical variables, and means and CIs for numerical variables. Statistical significance was set at P<.05.

Results: ChatGPT-4o mini achieved an accuracy rate of 65% (48/74) on the 2023 PNA examination, surpassing ChatGPT-3.5 Turbo. ChatGPT-4o mini outperformed medical candidates, while ChatGPT-3.5 Turbo had a more moderate performance.

Conclusions: This study highlights the advancements and potential of ChatGPT models in medical education, emphasizing the need for careful implementation with teacher oversight and further research.

Background: The COVID-19 pandemic challenged medical educators due to social distancing. Podcasts and asynchronous learning platforms help distill medical education in a socially distanced environment. Medical educators interested in providing asynchronous teaching should know how these methods performed during the pandemic.

Objective: The purpose of this study was to assess the level of engagement for an emergency medicine (EM) board review podcast and website platform, before and during the COVID-19 pandemic. We measured engagement via website traffic, including such metrics as visits, bounce rate, unique visitors, and page views. We also evaluated podcast analytics, which included total listeners, engaged listeners, and number of plays.

Methods: Content was designed after the American Board of EM Model, covering only 1 review question per episode. Website traffic and podcast analytics were studied monthly from 2 time periods of 20 months each, before the pandemic (July 11, 2018, to February 31, 2020) and during the pandemic (May 1, 2020, to December 31, 2021). March and April 2020 data were omitted from the analysis due to variations in closure at various domestic and international locations. Results underwent statistical analysis in March 2022.

Results: A total of 132 podcast episodes and 93 handouts were released from July 11, 2018, to December 31, 2021. The mean number of listeners per podcast increased significantly from 2.11 (SD 1.19) to 3.77 (SD 0.76; t test, P<.001), the mean number engaged per podcast increased from 1.72 (SD 1.00) to 3.09 (SD 0.62; t test, P<.001), and the mean number of plays per podcast increased from 42.54 (SD 40.66) to 69.23 (SD 17.54; t test, P=.012). Similarly, the mean number of visits per posting increased from 5.85 (SD 3.28) to 15.39 (SD 3.06; t test, P<.001), the mean number of unique visitors per posting increased from 3.74 (SD 1.83) to 10.41 (SD 2.33; t test, P<.001), and the mean number of page views per posting increased from 17.13 (SD 10.63) to 33.32 (SD 7.01; t test, P<.001). Note that, all measures showed a decrease from November 2021 to December 2021.

Conclusions: During the COVID-19 pandemic, there was an increased engagement for our EM board review podcast and website platform over a long-term period, specifically through website visitors and the number of podcast plays. Medical educators should be aware of the increasing usage of web-based education tools, and that asynchronous learning is favorably viewed by learners. Limitations include the inability to view Spotify (Spotify Technology S.A.) analytics during the study period, and confounding factors like increased popularity of social media inadvertently promoting the podcast.

Background: Since the COVID-19 pandemic, residency candidates have moved from attending traditional in-person interviews to virtual interviews with residency training programs. This transition spurred increased social media engagement by residency candidates, in an effort to learn about prospective programs, and by residency programs, to improve recruitment efforts. There is a paucity of literature on the effectiveness of social media outreach and its impact on candidates' perceptions of residency programs.

Objective: We aimed to determine patterns of social media platform usage among prospective residency candidates and social media's influence on students' perceptions of residency programs.

Methods: A cross-sectional survey was administered anonymously to fourth-year medical students who successfully matched to a residency training program at a single institution in 2023. These data were analyzed using descriptive statistics, as well as thematic analysis for open-ended questions.

Results: Of the 148 eligible participants, 69 (46.6%) responded to the survey, of whom 45 (65.2%) used social media. Widely used social media platforms were Instagram (19/40, 47.5%) and Reddit (18/40, 45%). Social media influenced 47.6% (20/42) of respondents' opinions of programs and had a moderate or major effect on 26.2% (11/42) of respondents' decisions on program ranking. Resident-faculty relations and social events showcasing camaraderie and wellness were the most desired content.

Conclusions: Social media is used by the majority of residency candidates during the residency application process and influences residency program ranking. This highlights the importance of residency programs in leveraging social media usage to recruit applicants and provide information that allows the candidate to better understand the program.

Background: With the rapid development of artificial intelligence technologies, there is a growing interest in the potential use of artificial intelligence-based tools like ChatGPT in medical education. However, there is limited research on the initial perceptions and experiences of faculty and students with ChatGPT, particularly in Saudi Arabia.

Objective: This study aimed to explore the earliest knowledge, perceived benefits, concerns, and limitations of using ChatGPT in medical education among faculty and students at a leading Saudi Arabian university.

Methods: A qualitative exploratory study was conducted in April 2023, involving focused meetings with medical faculty and students with varying levels of ChatGPT experience. A thematic analysis was used to identify key themes and subthemes emerging from the discussions.

Results: Participants demonstrated good knowledge of ChatGPT and its functions. The main themes were perceptions of ChatGPT use, potential benefits, and concerns about ChatGPT in research and medical education. The perceived benefits included collecting and summarizing information and saving time and effort. However, concerns and limitations centered around the potential lack of critical thinking in the information provided, the ambiguity of references, limitations of access, trust in the output of ChatGPT, and ethical concerns.

Conclusions: This study provides valuable insights into the perceptions and experiences of medical faculty and students regarding the use of newly introduced large language models like ChatGPT in medical education. While the benefits of ChatGPT were recognized, participants also expressed concerns and limitations requiring further studies for effective integration into medical education, exploring the impact of ChatGPT on learning outcomes, student and faculty satisfaction, and the development of critical thinking skills.

Background: Student development is currently taking place in an environment governed by new technologies and social media. Some platforms, such as Instagram or X (previously known as "Twitter"), have been incorporated as additional tools for teaching and learning processes in higher education, especially in the framework of image-based applied disciplines, including radiology and pathology. Nevertheless, the role of social media in the teaching of core subjects such as histology has hardly been studied, and there are very few reports on this issue.

Objective: The aim of this work was to investigate the impact of implementing social media on the ability to learn human histology. For this purpose, a set of voluntary e-learning activities was shared on Instagram as a complement to traditional face-to-face teaching.

Methods: The proposal included questionnaires based on multiple-choice questions, descriptions of histological images, and schematic diagrams about the subject content. These activities were posted on an Instagram account only accessible by second-year medical students from the University of Malaga. In addition, students could share their own images taken during the laboratory practice and interact with their peers.

Results: Of the students enrolled in Human Histology 2, 85.6% (143/167) agreed to participate in the platform. Most of the students valued the initiative positively and considered it an adequate instrument to improve their final marks. Specifically, 68.5% (98/143) of the student body regarded the multiple-choice questions and image-based questions as the most useful activities. Interestingly, there were statistically significant differences between the marks on the final exam (without considering other evaluation activities) for students who participated in the activity compared with those who did not or barely participated in the activity (P<.001). There were no significant differences by degree of participation between the more active groups.

Conclusions: These results provide evidence that incorporating social media may be considered a useful, easy, and accessible tool to improve the learning of human histology in the context of medical degrees.

Background: Mobile apps designed for teaching human anatomy offer a flexible, interactive, and personalized learning platform, enriching the educational experience for both students and health care professionals.

Objective: This study aimed to conduct a systematic review of the human anatomy mobile apps available on Google Play, evaluate their quality, highlight the highest scoring apps, and determine the relationship between objective quality ratings and subjective star ratings.

Methods: The Mobile App Rating Scale (MARS) was used to evaluate the apps. The intraclass correlation coefficient was calculated using a consistency-type 2-factor random model to measure the reliability of the evaluations made by the experts. In addition, Pearson correlations were used to analyze the relationship between MARS quality scores and subjective evaluations of MARS quality item 23.

Results: The mobile apps with the highest overall quality scores according to the MARS (ie, sections A, B, C, and D) were Organos internos 3D (anatomía) (version 4.34), Sistema óseo en 3D (Anatomía) (version 4.32), and VOKA Anatomy Pro (version 4.29). To measure the reliability of the MARS quality evaluations (sections A, B, C, and D), the intraclass correlation coefficient was used, and the result was "excellent." Finally, Pearson correlation results revealed a significant relationship (r=0.989; P<.001) between the quality assessments conducted by health care professionals and the subjective evaluations of item 23.

Conclusions: The average evaluation results of the selected apps indicated a "good" level of quality, and those with the highest ratings could be recommended. However, the lack of scientific backing for these technological tools is evident. It is crucial that research centers and higher education institutions commit to the active development of new mobile health apps, ensuring their accessibility and validation for the general public.

Background: Improved long-term learning retention leads to higher exam scores and overall course grades, which is crucial for success in preclinical coursework in any podiatric medicine curriculum. Audiovisual mnemonics, in conjunction with text-based materials and an interactive user interface, have been shown to increase memory retention and higher order thinking.

Objective: This pilot study aims to evaluate the effectiveness of integrating web-based multimedia learning resources for improving student engagement and increasing learning retention.

Methods: A quasi-experimental study was conducted with 2 cohorts totaling 158 second-year podiatric medical students. The treatment group had access to Picmonic's audiovisual resources, while the control group followed traditional instruction methods. Exam scores, final course grades, and user interactions with Picmonic were analyzed. Logistic regression and correlation analyses were conducted to examine the relationships between Picmonic access, performance outcomes, and student engagement.

Results: The treatment group (n=91) had significantly higher average exam scores (P<.001) and final course grades (P<.001) than the control group (n=67). Effect size for the average final grades (d=0.96) indicated the practical significance of these differences. Logistic regression analysis revealed a positive association between Picmonic access with an odds ratio of 2.72 with a 95% confidence interval, indicating that it is positively associated with the likelihood of achieving high final grades. Correlation analysis revealed a positive relationship (r=0.25, P=.02) between the number of in-video questions answered and students' final grades. Survey responses reflected increased student engagement, comprehension, and higher user satisfaction (3.71 out of 5 average rating) with the multimedia-based resources compared to traditional instructional resources.

Conclusions: This pilot study underscores the positive impact of animation-supported web-based instruction on preclinical medical education. The treatment group, equipped with Picmonic, exhibited improved learning outcomes, enhanced engagement, and high satisfaction. These results contribute to the discourse on innovative educational methods and highlight the potential of multimedia-based learning resources to enrich medical curricula. Despite certain limitations, this research suggests that animation-supported audiovisual instruction offers a valuable avenue for enhancing student learning experiences in medical education.