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Using Project Extension for Community Healthcare Outcomes to Enhance Substance Use Disorder Care in Primary Care: Mixed Methods Study. 利用 "社区医疗保健成果推广项目 "加强初级医疗中的药物使用障碍护理:混合方法研究。
IF 3.6 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-04-01 DOI: 10.2196/48135
MacKenzie Koester, Rosemary Motz, Ariel Porto, Nikita Reyes Nieves, Karen Ashley
<p><strong>Background: </strong>Substance use and overdose deaths make up a substantial portion of injury-related deaths in the United States, with the state of Ohio leading the nation in rates of diagnosed substance use disorder (SUD). Ohio's growing epidemic has indicated a need to improve SUD care in a primary care setting through the engagement of multidisciplinary providers and the use of a comprehensive approach to care.</p><p><strong>Objective: </strong>The purpose of this study was to assess the ability of the Weitzman Extension for Community Healthcare Outcomes (ECHO): Comprehensive Substance Use Disorder Care program to both address and meet 7 series learning objectives and address substances by analyzing (1) the frequency of exposure to the learning objective topics and substance types during case discussions and (2) participants' change in knowledge, self-efficacy, attitudes, and skills related to the treatment of SUDs pre- to postseries. The 7 series learning objective themes included harm reduction, team-based care, behavioral techniques, medication-assisted treatment, trauma-informed care, co-occurring conditions, and social determinants of health.</p><p><strong>Methods: </strong>We used a mixed methods approach using a conceptual content analysis based on series learning objectives and substances and a 2-tailed paired-samples t test of participants' self-reported learner outcomes. The content analysis gauged the frequency and dose of learning objective themes and illicit and nonillicit substances mentioned in participant case presentations and discussions, and the paired-samples t test compared participants' knowledge, self-efficacy, attitudes, and skills associated with learning objectives and medication management of substances from pre- to postseries.</p><p><strong>Results: </strong>The results of the content analysis indicated that 3 learning objective themes-team-based care, harm reduction, and social determinants of health-resulted in the highest frequencies and dose, appearing in 100% (n=22) of case presentations and discussions. Alcohol had the highest frequency and dose among the illicit and nonillicit substances, appearing in 81% (n=18) of case presentations and discussions. The results of the paired-samples t test indicated statistically significant increases in knowledge domain statements related to polysubstance use (P=.02), understanding the approach other disciplines use in SUD care (P=.02), and medication management strategies for nicotine (P=.03) and opioid use disorder (P=.003). Statistically significant increases were observed for 2 self-efficacy domain statements regarding medication management for nicotine (P=.002) and alcohol use disorder (P=.02). Further, 1 statistically significant increase in the skill domain was observed regarding using the stages of change theory in interventions (P=.03).</p><p><strong>Conclusions: </strong>These findings indicate that the ECHO program's content aligned with its stated l
背景:在美国,药物使用和用药过量导致的死亡在与伤害相关的死亡中占很大比例,俄亥俄州的药物使用障碍(SUD)诊断率居全国之首。俄亥俄州日益严重的疫情表明,有必要通过多学科医疗服务提供者的参与以及采用综合护理方法来改善初级医疗环境中的药物滥用障碍护理:本研究旨在评估魏茨曼社区医疗保健成果扩展项目(ECHO)的能力:目的:本研究旨在评估 "威茨曼社区医疗保健成果推广计划(ECHO):药物使用障碍综合护理 "项目在处理和实现 7 个系列学习目标以及处理物质方面的能力,具体方法是分析(1)在病例讨论中接触学习目标主题和物质类型的频率,以及(2)参与者在治疗药物使用障碍前与治疗药物使用障碍后在知识、自我效能、态度和技能方面的变化。7 个系列的学习目标主题包括减少伤害、团队护理、行为技术、药物辅助治疗、创伤知情护理、共患疾病和健康的社会决定因素:我们采用了混合方法,根据系列学习目标和物质进行了概念内容分析,并对参与者自我报告的学习成果进行了双尾配对样本 t 检验。内容分析测试了学习目标主题以及学员案例陈述和讨论中提到的非法和非非法药物的频率和剂量,配对样本 t 检验比较了学员从系列学习前到系列学习后与学习目标和药物管理相关的知识、自我效能、态度和技能:内容分析结果表明,3 个学习目标主题--基于团队的护理、减少伤害和健康的社会决定因素--出现的频率和剂量最高,在 100%(n=22)的病例介绍和讨论中都有出现。在非法和非非法物质中,酒精出现的频率和剂量最高,出现在 81% (n=18)的病例陈述和讨论中。配对样本 t 检验的结果表明,与多种物质使用(P=.02)、了解其他学科在 SUD 护理中使用的方法(P=.02)以及尼古丁(P=.03)和阿片类药物使用障碍(P=.003)的药物管理策略相关的知识领域陈述在统计学上有显著增加。在尼古丁(P=.002)和酒精使用障碍(P=.02)的药物管理方面,2 项自我效能领域陈述有统计学意义的增长。此外,在技能领域,关于在干预中使用变化阶段理论(P=.03),观察到 1 项统计学意义上的显著提高:这些研究结果表明,ECHO 项目的内容符合其既定的学习目标;在 3 个主题上达到了学习目标,并取得了显著的进步;在案例介绍和讨论中达到了解决多种物质问题的目的。这些结果表明,"ECHO 项目 "是教育多学科医疗服务提供者采用综合方法治疗 SUD 的潜在工具。
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引用次数: 0
Measuring the Digital Competence of Health Professionals: Scoping Review. 衡量卫生专业人员的数字化能力:范围审查。
IF 3.2 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-03-29 DOI: 10.2196/55737
Anne Mainz, Julia Nitsche, Vera Weirauch, Sven Meister

Background: Digital competence is listed as one of the key competences for lifelong learning and is increasing in importance not only in private life but also in professional life. There is consensus within the health care sector that digital competence (or digital literacy) is needed in various professional fields. However, it is still unclear what exactly the digital competence of health professionals should include and how it can be measured.

Objective: This scoping review aims to provide an overview of the common definitions of digital literacy in scientific literature in the field of health care and the existing measurement instruments.

Methods: Peer-reviewed scientific papers from the last 10 years (2013-2023) in English or German that deal with the digital competence of health care workers in both outpatient and inpatient care were included. The databases ScienceDirect, Scopus, PubMed, EBSCOhost, MEDLINE, OpenAIRE, ERIC, OAIster, Cochrane Library, CAMbase, APA PsycNet, and Psyndex were searched for literature. The review follows the JBI methodology for scoping reviews, and the description of the results is based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist.

Results: The initial search identified 1682 papers, of which 46 (2.73%) were included in the synthesis. The review results show that there is a strong focus on technical skills and knowledge with regard to both the definitions of digital competence and the measurement tools. A wide range of competences were identified within the analyzed works and integrated into a validated competence model in the areas of technical, methodological, social, and personal competences. The measurement instruments mainly used self-assessment of skills and knowledge as an indicator of competence and differed greatly in their statistical quality.

Conclusions: The identified multitude of subcompetences illustrates the complexity of digital competence in health care, and existing measuring instruments are not yet able to reflect this complexity.

背景:数字能力被列为终身学习的关键能力之一,不仅在私人生活中,而且在职业生活中的重要性也与日俱增。医疗保健领域已达成共识,各专业领域都需要数字化能力(或数字化素养)。然而,卫生专业人员的数字化能力究竟应包括哪些内容以及如何衡量这些能力,目前仍不清楚:本综述旨在概述医疗保健领域科学文献中对数字素养的常见定义以及现有的测量工具:方法:纳入过去 10 年(2013-2023 年)中涉及门诊和住院医护人员数字能力的英文或德文同行评审科学论文。检索了 ScienceDirect、Scopus、PubMed、EBSCOhost、MEDLINE、OpenAIRE、ERIC、OAIster、Cochrane Library、CAMbase、APA PsycNet 和 Psyndex 等数据库中的文献。本综述采用了 JBI 的范围界定综述方法,对结果的描述基于 PRISMA-ScR(系统综述和 Meta 分析的首选报告项目,范围界定综述的扩展)核对表:初步检索发现了 1682 篇论文,其中 46 篇(2.73%)被纳入综述。综述结果表明,在数字能力的定义和测量工具方面,技术技能和知识都是重点。在所分析的作品中,我们发现了一系列能力,并将其整合到一个经过验证的能力模型中,包括技术能力、方法能力、社会能力和个人能力。测量工具主要使用技能和知识的自我评估作为能力指标,在统计质量方面存在很大差异:结论:已确定的众多子能力说明了医疗保健领域数字化能力的复杂性,而现有的测量工具还无法反映这种复杂性。
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引用次数: 0
Performance of GPT-4V in Answering the Japanese Otolaryngology Board Certification Examination Questions: Evaluation Study. GPT-4V 在回答日本耳鼻喉科医师资格考试问题时的表现:评估研究。
IF 3.6 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-03-28 DOI: 10.2196/57054
Masao Noda, Takayoshi Ueno, Ryota Koshu, Yuji Takaso, Mari Dias Shimada, Chizu Saito, Hisashi Sugimoto, Hiroaki Fushiki, Makoto Ito, Akihiro Nomura, Tomokazu Yoshizaki

Background: Artificial intelligence models can learn from medical literature and clinical cases and generate answers that rival human experts. However, challenges remain in the analysis of complex data containing images and diagrams.

Objective: This study aims to assess the answering capabilities and accuracy of ChatGPT-4 Vision (GPT-4V) for a set of 100 questions, including image-based questions, from the 2023 otolaryngology board certification examination.

Methods: Answers to 100 questions from the 2023 otolaryngology board certification examination, including image-based questions, were generated using GPT-4V. The accuracy rate was evaluated using different prompts, and the presence of images, clinical area of the questions, and variations in the answer content were examined.

Results: The accuracy rate for text-only input was, on average, 24.7% but improved to 47.3% with the addition of English translation and prompts (P<.001). The average nonresponse rate for text-only input was 46.3%; this decreased to 2.7% with the addition of English translation and prompts (P<.001). The accuracy rate was lower for image-based questions than for text-only questions across all types of input, with a relatively high nonresponse rate. General questions and questions from the fields of head and neck allergies and nasal allergies had relatively high accuracy rates, which increased with the addition of translation and prompts. In terms of content, questions related to anatomy had the highest accuracy rate. For all content types, the addition of translation and prompts increased the accuracy rate. As for the performance based on image-based questions, the average of correct answer rate with text-only input was 30.4%, and that with text-plus-image input was 41.3% (P=.02).

Conclusions: Examination of artificial intelligence's answering capabilities for the otolaryngology board certification examination improves our understanding of its potential and limitations in this field. Although the improvement was noted with the addition of translation and prompts, the accuracy rate for image-based questions was lower than that for text-based questions, suggesting room for improvement in GPT-4V at this stage. Furthermore, text-plus-image input answers a higher rate in image-based questions. Our findings imply the usefulness and potential of GPT-4V in medicine; however, future consideration of safe use methods is needed.

背景:人工智能模型可以从医学文献和临床病例中学习,并生成可与人类专家相媲美的答案。然而,在分析包含图像和图表的复杂数据方面仍存在挑战:本研究旨在评估 ChatGPT-4 Vision(GPT-4V)对 2023 年耳鼻喉科医师资格认证考试中 100 道题目(包括基于图像的题目)的回答能力和准确性:方法:使用 GPT-4V 生成 2023 年耳鼻喉科医师资格认证考试中 100 道问题的答案,其中包括基于图像的问题。结果:纯文本输入的准确率为0.5%,而纯文字输入的准确率为0.5%,纯文本输入的准确率为0.5%,而纯文字输入的准确率为0.5%:结果:纯文本输入的准确率平均为 24.7%,但在增加了英文翻译和提示后,准确率提高到 47.3%(结论:对人工智能回答能力的研究表明,人工智能在回答临床问题方面具有很高的准确率:对人工智能在耳鼻喉科医师资格认证考试中的答题能力进行研究,有助于我们更好地了解人工智能在这一领域的潜力和局限性。虽然增加翻译和提示后,答题准确率有所提高,但图像题的答题准确率低于文本题,这表明 GPT-4V 在现阶段仍有改进的余地。此外,在基于图像的问题中,文字加图像输入的答案正确率更高。我们的研究结果表明,GPT-4V 在医学领域具有实用性和潜力;但是,未来还需要考虑安全使用方法。
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引用次数: 0
Telehealth Education in Allied Health Care and Nursing: Web-Based Cross-Sectional Survey of Students' Perceived Knowledge, Skills, Attitudes, and Experience. 专职医疗保健和护理中的远程保健教育:基于网络的学生认知、技能、态度和经验横断面调查。
IF 3.6 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-03-21 DOI: 10.2196/51112
Lena Rettinger, Peter Putz, Lea Aichinger, Susanne Maria Javorszky, Klaus Widhalm, Veronika Ertelt-Bach, Andreas Huber, Sevan Sargis, Lukas Maul, Oliver Radinger, Franz Werner, Sebastian Kuhn

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.

背景:COVID-19 大流行凸显了远程保健在医疗保健中日益重要的作用。评估医疗保健和护理专业学生的远程保健能力对其成功融入教育和实践至关重要:我们旨在评估学生对远程保健知识、技能、态度和经验的感知。此外,我们还旨在研究学生对其课程中远程保健内容和教学方法的偏好:我们于 2022 年 5 月开展了一项基于网络的横断面研究。通过迭代反馈和面效测试开发和改进的项目特定问卷涉及人口统计学、个人看法和远程保健专业经验等主题,并征求对潜在远程保健课程内容的意见。对完成率至少达到 50%的调查问卷进行了统计分析,包括分类变量的描述性统计、结果的图表表示以及分组分析中中心倾向的 Kruskal Wallis 检验:共有来自 7 个本科和 4 个硕士医疗保健和护理专业的 261 名学生参与了研究。大多数学生表示对远程医疗感兴趣(180/261,69% 非常感兴趣或比较感兴趣),并认识到远程医疗在其教育中的重要性(215/261,82.4% 非常重要或比较重要)。然而,大多数参与者表示对与其专业相关的远程保健应用了解有限(仅有 7/261 人,2.7% 表示非常了解),并且对各种远程保健应用的积极远程保健经验有限(介于 18/261 人,6.9% 和 63/261 人,24.1% 之间)。研究项目之间在远程保健兴趣(P=.005)、知识(P=.005)和应用(P=.005)方面存在明显的统计学差异:这项研究强调了将远程保健纳入医疗保健教育课程的必要性,因为学生对远程保健持积极态度,但似乎没有为其实施做好充分准备。为了让未来的卫生专业人员为远程保健在实践中发挥越来越大的作用做好最佳准备,在设计远程保健课程时可以考虑本研究的结果。
{"title":"Telehealth Education in Allied Health Care and Nursing: Web-Based Cross-Sectional Survey of Students' Perceived Knowledge, Skills, Attitudes, and Experience.","authors":"Lena Rettinger, Peter Putz, Lea Aichinger, Susanne Maria Javorszky, Klaus Widhalm, Veronika Ertelt-Bach, Andreas Huber, Sevan Sargis, Lukas Maul, Oliver Radinger, Franz Werner, Sebastian Kuhn","doi":"10.2196/51112","DOIUrl":"10.2196/51112","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":36236,"journal":{"name":"JMIR Medical Education","volume":"10 ","pages":"e51112"},"PeriodicalIF":3.6,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10995793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Capability of GPT-4V(ision) in the Japanese National Medical Licensing Examination: Evaluation Study. 日本国家医师资格考试中 GPT-4V(ision)的能力:评估研究。
IF 3.6 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-03-12 DOI: 10.2196/54393
Takahiro Nakao, Soichiro Miki, Yuta Nakamura, Tomohiro Kikuchi, Yukihiro Nomura, Shouhei Hanaoka, Takeharu Yoshikawa, Osamu Abe

Background: Previous research applying large language models (LLMs) to medicine was focused on text-based information. Recently, multimodal variants of LLMs acquired the capability of recognizing images.

Objective: We aim to evaluate the image recognition capability of generative pretrained transformer (GPT)-4V, a recent multimodal LLM developed by OpenAI, in the medical field by testing how visual information affects its performance to answer questions in the 117th Japanese National Medical Licensing Examination.

Methods: We focused on 108 questions that had 1 or more images as part of a question and presented GPT-4V with the same questions under two conditions: (1) with both the question text and associated images and (2) with the question text only. We then compared the difference in accuracy between the 2 conditions using the exact McNemar test.

Results: Among the 108 questions with images, GPT-4V's accuracy was 68% (73/108) when presented with images and 72% (78/108) when presented without images (P=.36). For the 2 question categories, clinical and general, the accuracies with and those without images were 71% (70/98) versus 78% (76/98; P=.21) and 30% (3/10) versus 20% (2/10; P≥.99), respectively.

Conclusions: The additional information from the images did not significantly improve the performance of GPT-4V in the Japanese National Medical Licensing Examination.

背景:以往将大型语言模型(LLMs)应用于医学的研究主要集中在基于文本的信息上。最近,大型语言模型的多模态变体获得了识别图像的能力:我们旨在评估生成预训练变换器(GPT)-4V(OpenAI 最近开发的一种多模态 LLM)在医学领域的图像识别能力,测试视觉信息如何影响其在回答第 117 届日本国家医师资格考试中的问题时的表现:我们重点研究了 108 道包含 1 张或 1 张以上图片的试题,并在两种条件下向 GPT-4V 展示了相同的试题:(1) 同时包含试题文本和相关图片;(2) 仅包含试题文本。然后,我们使用精确的 McNemar 检验比较了两种条件下的准确率差异:在 108 个有图像的问题中,GPT-4V 在有图像时的准确率为 68%(73/108),在无图像时的准确率为 72%(78/108)(P=.36)。对于临床和一般两个问题类别,有图像和无图像的准确率分别为 71% (70/98) 对 78% (76/98; P=.21) 和 30% (3/10) 对 20% (2/10; P≥.99):结论:在日本国家医师资格考试中,来自图像的额外信息并未显著提高 GPT-4V 的成绩。
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引用次数: 0
Sharing Digital Health Educational Resources in a One-Stop Shop Portal: Tutorial on the Catalog and Index of Digital Health Teaching Resources (CIDHR) Semantic Search Engine. 在一站式门户网站中共享数字健康教育资源:数字健康教学资源目录和索引(CIDHR)语义搜索引擎教程。
IF 3.6 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-03-04 DOI: 10.2196/48393
Julien Grosjean, Arriel Benis, Jean-Charles Dufour, Émeline Lejeune, Flavien Disson, Badisse Dahamna, Hélène Cieslik, Romain Léguillon, Matthieu Faure, Frank Dufour, Pascal Staccini, Stéfan Jacques Darmoni
<p><strong>Background: </strong>Access to reliable and accurate digital health web-based resources is crucial. However, the lack of dedicated search engines for non-English languages, such as French, is a significant obstacle in this field. Thus, we developed and implemented a multilingual, multiterminology semantic search engine called Catalog and Index of Digital Health Teaching Resources (CIDHR). CIDHR is freely accessible to everyone, with a focus on French-speaking resources. CIDHR has been initiated to provide validated, high-quality content tailored to the specific needs of each user profile, be it students or professionals.</p><p><strong>Objective: </strong>This study's primary aim in developing and implementing the CIDHR is to improve knowledge sharing and spreading in digital health and health informatics and expand the health-related educational community, primarily French speaking but also in other languages. We intend to support the continuous development of initial (ie, bachelor level), advanced (ie, master and doctoral levels), and continuing training (ie, professionals and postgraduate levels) in digital health for health and social work fields. The main objective is to describe the development and implementation of CIDHR. The hypothesis guiding this research is that controlled vocabularies dedicated to medical informatics and digital health, such as the Medical Informatics Multilingual Ontology (MIMO) and the concepts structuring the French National Referential on Digital Health (FNRDH), to index digital health teaching and learning resources, are effectively increasing the availability and accessibility of these resources to medical students and other health care professionals.</p><p><strong>Methods: </strong>First, resource identification is processed by medical librarians from websites and scientific sources preselected and validated by domain experts and surveyed every week. Then, based on MIMO and FNRDH, the educational resources are indexed for each related knowledge domain. The same resources are also tagged with relevant academic and professional experience levels. Afterward, the indexed resources are shared with the digital health teaching and learning community. The last step consists of assessing CIDHR by obtaining informal feedback from users.</p><p><strong>Results: </strong>Resource identification and evaluation processes were executed by a dedicated team of medical librarians, aiming to collect and curate an extensive collection of digital health teaching and learning resources. The resources that successfully passed the evaluation process were promptly included in CIDHR. These resources were diligently indexed (with MIMO and FNRDH) and tagged for the study field and degree level. By October 2023, a total of 371 indexed resources were available on a dedicated portal.</p><p><strong>Conclusions: </strong>CIDHR is a multilingual digital health education semantic search engine and platform that aims to increase the acce
背景:获取可靠、准确的数字健康网络资源至关重要。然而,缺乏针对法语等非英语语言的专用搜索引擎是这一领域的一大障碍。因此,我们开发并实施了一个多语言、多术语的语义搜索引擎,名为 "数字健康教学资源目录和索引"(CIDHR)。CIDHR 向所有人免费开放,重点关注法语资源。CIDHR 的启动旨在提供经过验证的高质量内容,以满足每个用户(无论是学生还是专业人士)的特定需求:本研究开发和实施 CIDHR 的主要目的是改善数字健康和健康信息学方面的知识共享和传播,扩大健康相关教育社区(主要是法语社区,也包括其他语言社区)。我们打算为卫生和社会工作领域的数字卫生初级(即学士水平)、高级(即硕士和博士水平)和继续培训(即专业人员和研究生水平)的持续发展提供支持。主要目的是描述 CIDHR 的发展和实施情况。这项研究的假设是,医学信息学多语言本体(MIMO)和法国国家数字健康参考资料(FNRDH)的概念结构等医学信息学和数字健康专用的受控词汇表,为数字健康教学和学习资源编制索引,能有效提高这些资源对医科学生和其他医疗保健专业人员的可用性和可及性:首先,由医学图书馆员从网站和科学资源中进行资源识别,这些资源由领域专家预选和验证,每周进行一次调查。然后,根据 MIMO 和 FNRDH,为每个相关知识领域的教育资源编制索引。同样的资源也被标记为相关的学术和专业经验级别。之后,索引资源将与数字健康教学社区共享。最后一步是通过获取用户的非正式反馈来评估 CIDHR:资源识别和评估过程由一个专门的医学图书馆员团队完成,旨在收集和整理大量的数字健康教学资源。成功通过评估程序的资源被迅速纳入 CIDHR。这些资源被认真地编入索引(与 MIMO 和 FNRDH 合作),并根据学习领域和学位水平进行标记。到 2023 年 10 月,专门门户网站上共有 371 种编入索引的资源:CIDHR 是一个多语言数字健康教育语义搜索引擎和平台,旨在提高教育资源对更广泛的医疗保健相关社区的可访问性。它的重点是通过使用一站式门户方法,使资源 "可查找"、"可访问"、"可互操作 "和 "可重复使用"。CIDHR 已经并将继续在提高数字卫生知识普及率方面发挥重要作用。
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引用次数: 0
Development of a Clinical Simulation Video to Evaluate Multiple Domains of Clinical Competence: Cross-Sectional Study. 开发临床模拟视频以评估临床能力的多个领域:横断面研究。
IF 3.6 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-02-29 DOI: 10.2196/54401
Kiyoshi Shikino, Yuji Nishizaki, Sho Fukui, Daiki Yokokawa, Yu Yamamoto, Hiroyuki Kobayashi, Taro Shimizu, Yasuharu Tokuda

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.

背景:日本的医科学生需要接受为期 2 年的研究生住院医师培训课程,以掌握临床知识和全科医学技能。全科医学培训考试(GM-ITE)可评估住院医师研究生的临床知识。临床模拟视频(CSV)可评估学习者的人际交往能力:本研究旨在通过让住院医师观看 CSV 来评估 GM-ITE 分数与住院医师诊断技能之间的关系,并探讨住院医师对 CSV 的真实性、教育价值以及对其学习动机的影响的看法:参与者包括 56 名医学研究生住院医师,他们在 2021 年 1 月 21 日至 1 月 28 日期间参加了 GM-ITE;观看了 CSV;然后提供了诊断结果。我们比较了 CSV 和 GM-ITE 的得分,并使用判别指数检验了模拟的有效性,其中≥0.20 表示判别能力强,>0.40 表示能很好地衡量受试者的资质。此外,我们还发放了一份匿名问卷,以了解参与者对 CSV 的真实性、教育价值及其对学习动机的影响的看法:在 56 名参与者中,有 6 人(11%)提供了正确的诊断,他们都来自研究生二年级。所有领域都显示出较高的辨别力。匿名)跟踪调查结果表明,CSV 格式比传统的 GM-ITE 更适合用于评估临床能力。匿名调查显示,12 名参与者(52%)认为 CSV 形式比 GM-ITE 更适合评估临床能力,18 名参与者(78%)肯定了视频模拟的真实性,17 名参与者(74%)表示这种体验提高了他们的学习动力:研究结果表明,模拟真实世界临床考试的 CSV 模块成功地评估了受试者在多个领域的临床能力。研究表明,CSV 不仅增强了对诊断技能的评估,还对学习者的学习动机产生了积极影响,这表明模拟在医学教育中发挥着多方面的作用。
{"title":"Development of a Clinical Simulation Video to Evaluate Multiple Domains of Clinical Competence: Cross-Sectional Study.","authors":"Kiyoshi Shikino, Yuji Nishizaki, Sho Fukui, Daiki Yokokawa, Yu Yamamoto, Hiroyuki Kobayashi, Taro Shimizu, Yasuharu Tokuda","doi":"10.2196/54401","DOIUrl":"10.2196/54401","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":36236,"journal":{"name":"JMIR Medical Education","volume":"10 ","pages":"e54401"},"PeriodicalIF":3.6,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10940988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the Feasibility of Using ChatGPT to Create Just-in-Time Adaptive Physical Activity mHealth Intervention Content: Case Study. 探索使用 ChatGPT 创建适时适应性体育活动 mHealth 干预内容的可行性:案例研究。
IF 3.6 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-02-29 DOI: 10.2196/51426
Amanda Willms, Sam Liu
<p><strong>Background: </strong>Achieving physical activity (PA) guidelines' recommendation of 150 minutes of moderate-to-vigorous PA per week has been shown to reduce the risk of many chronic conditions. Despite the overwhelming evidence in this field, PA levels remain low globally. By creating engaging mobile health (mHealth) interventions through strategies such as just-in-time adaptive interventions (JITAIs) that are tailored to an individual's dynamic state, there is potential to increase PA levels. However, generating personalized content can take a long time due to various versions of content required for the personalization algorithms. ChatGPT presents an incredible opportunity to rapidly produce tailored content; however, there is a lack of studies exploring its feasibility.</p><p><strong>Objective: </strong>This study aimed to (1) explore the feasibility of using ChatGPT to create content for a PA JITAI mobile app and (2) describe lessons learned and future recommendations for using ChatGPT in the development of mHealth JITAI content.</p><p><strong>Methods: </strong>During phase 1, we used Pathverse, a no-code app builder, and ChatGPT to develop a JITAI app to help parents support their child's PA levels. The intervention was developed based on the Multi-Process Action Control (M-PAC) framework, and the necessary behavior change techniques targeting the M-PAC constructs were implemented in the app design to help parents support their child's PA. The acceptability of using ChatGPT for this purpose was discussed to determine its feasibility. In phase 2, we summarized the lessons we learned during the JITAI content development process using ChatGPT and generated recommendations to inform future similar use cases.</p><p><strong>Results: </strong>In phase 1, by using specific prompts, we efficiently generated content for 13 lessons relating to increasing parental support for their child's PA following the M-PAC framework. It was determined that using ChatGPT for this case study to develop PA content for a JITAI was acceptable. In phase 2, we summarized our recommendations into the following six steps when using ChatGPT to create content for mHealth behavior interventions: (1) determine target behavior, (2) ground the intervention in behavior change theory, (3) design the intervention structure, (4) input intervention structure and behavior change constructs into ChatGPT, (5) revise the ChatGPT response, and (6) customize the response to be used in the intervention.</p><p><strong>Conclusions: </strong>ChatGPT offers a remarkable opportunity for rapid content creation in the context of an mHealth JITAI. Although our case study demonstrated that ChatGPT was acceptable, it is essential to approach its use, along with other language models, with caution. Before delivering content to population groups, expert review is crucial to ensure accuracy and relevancy. Future research and application of these guidelines are imperative as we deepen our unde
背景:实践证明,达到体育锻炼(PA)指南建议的每周 150 分钟中等强度至剧烈强度的体育锻炼,可以降低许多慢性疾病的患病风险。尽管在这一领域有大量证据,但全球的体育锻炼水平仍然很低。通过及时适应性干预(JITAIs)等针对个人动态状态量身定制的策略,创建引人入胜的移动医疗(mHealth)干预措施,有可能提高 PA 水平。然而,由于个性化算法需要各种版本的内容,因此生成个性化内容可能需要很长时间。ChatGPT 提供了一个快速生成定制内容的绝佳机会;然而,目前还缺乏对其可行性的研究:本研究旨在:(1)探索使用 ChatGPT 为 PA JITAI 移动应用程序创建内容的可行性;(2)描述在移动医疗 JITAI 内容开发中使用 ChatGPT 的经验教训和未来建议:在第一阶段,我们使用无代码应用程序生成器 Pathverse 和 ChatGPT 开发了一款 JITAI 应用程序,以帮助家长支持孩子的 PA 水平。该干预措施是基于多过程行动控制(M-PAC)框架开发的,并在应用程序设计中采用了针对 M-PAC 构建的必要行为改变技术,以帮助家长支持孩子的 PA。我们讨论了将 ChatGPT 用于此目的的可接受性,以确定其可行性。在第 2 阶段,我们总结了在 JITAI 内容开发过程中使用 ChatGPT 所获得的经验教训,并提出了建议,为今后类似的使用案例提供参考:在第 1 阶段,通过使用特定的提示,我们按照 M-PAC 框架高效地生成了 13 节课程的内容,这些内容与增加父母对子女 PA 的支持有关。我们认为,在本案例研究中使用 ChatGPT 为 JITAI 开发 PA 内容是可以接受的。在第二阶段,我们将使用 ChatGPT 创建移动健康行为干预内容的建议总结为以下六个步骤:(1)确定目标行为;(2)将干预建立在行为改变理论的基础上;(3)设计干预结构;(4)将干预结构和行为改变结构输入 ChatGPT;(5)修改 ChatGPT 响应;以及(6)定制将在干预中使用的响应:结论:ChatGPT 为在移动医疗联合ITAI 的背景下快速创建内容提供了难得的机会。虽然我们的案例研究表明 ChatGPT 是可以接受的,但在使用它和其他语言模型时必须谨慎。在向人群提供内容之前,专家审查对于确保准确性和相关性至关重要。随着我们对 ChatGPT 及其与人类输入互动的理解不断加深,未来的研究和这些指导方针的应用势在必行。
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引用次数: 0
Using ChatGPT-Like Solutions to Bridge the Communication Gap Between Patients With Rheumatoid Arthritis and Health Care Professionals. 使用类似 ChatGPT 的解决方案弥合类风湿关节炎患者与医护人员之间的沟通鸿沟。
IF 3.6 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-02-27 DOI: 10.2196/48989
Chih-Wei Chen, Paul Walter, James Cheng-Chung Wei

The communication gap between patients and health care professionals has led to increased disputes and resource waste in the medical domain. The development of artificial intelligence and other technologies brings new possibilities to solve this problem. This viewpoint paper proposes a new relationship between patients and health care professionals-"shared decision-making"-allowing both sides to obtain a deeper understanding of the disease and reach a consensus during diagnosis and treatment. Then, this paper discusses the important impact of ChatGPT-like solutions in treating rheumatoid arthritis using methotrexate from clinical and patient perspectives. For clinical professionals, ChatGPT-like solutions could provide support in disease diagnosis, treatment, and clinical trials, but attention should be paid to privacy, confidentiality, and regulatory norms. For patients, ChatGPT-like solutions allow easy access to massive amounts of information; however, the information should be carefully managed to ensure safe and effective care. To ensure the effective application of ChatGPT-like solutions in improving the relationship between patients and health care professionals, it is essential to establish a comprehensive database and provide legal, ethical, and other support. Above all, ChatGPT-like solutions could benefit patients and health care professionals if they ensure evidence-based solutions and data protection and collaborate with regulatory authorities and regulatory evolution.

患者与医护人员之间的沟通鸿沟导致医疗领域的纠纷增多和资源浪费。人工智能等技术的发展为解决这一问题带来了新的可能。本文提出了患者与医护人员之间的新型关系--"共同决策",让双方在诊断和治疗过程中对疾病有更深入的了解并达成共识。然后,本文从临床和患者的角度讨论了类似 ChatGPT 的解决方案在使用甲氨蝶呤治疗类风湿性关节炎中的重要影响。对于临床专业人员来说,类似 ChatGPT 的解决方案可以为疾病诊断、治疗和临床试验提供支持,但应注意隐私、保密和监管规范。对于患者来说,类似 ChatGPT 的解决方案可以让他们轻松获取海量信息;但这些信息应得到谨慎管理,以确保安全有效的护理。为确保类似 ChatGPT 的解决方案能有效改善患者与医护人员之间的关系,必须建立一个全面的数据库,并提供法律、道德和其他方面的支持。最重要的是,如果类似 ChatGPT 的解决方案能确保基于证据的解决方案和数据保护,并与监管机构和监管演进合作,就能使患者和医护专业人员受益。
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引用次数: 0
Correction: How Does ChatGPT Perform on the United States Medical Licensing Examination (USMLE)? The Implications of Large Language Models for Medical Education and Knowledge Assessment. 更正:ChatGPT 在美国医学执业资格考试 (USMLE) 中的表现如何?大语言模型对医学教育和知识评估的意义。
IF 3.6 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-02-27 DOI: 10.2196/57594
Aidan Gilson, Conrad W Safranek, Thomas Huang, Vimig Socrates, Ling Chi, Richard Andrew Taylor, David Chartash

[This corrects the article DOI: 10.2196/45312.].

[此处更正了文章 DOI:10.2196/45312]。
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引用次数: 0
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JMIR Medical Education
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