The effectiveness of a 3D virtual tooth identification test as an assessment tool for a dental anatomy course

INTRODUCTION

There has been a recent demand in dental education for distance learning and the use of virtual assessment tools that can leverage technology to potentially replace physical testing facilities. However, virtual tools that evaluate student learning should be validated prior to adoption. The aim of this study was to investigate the effectiveness, efficiency and user satisfaction of a 3D tooth identification test for a dental anatomy course that can be given remotely.

MATERIALS AND METHODS

First-year dental students (n = 41) enrolled in a dental anatomy course took both traditional in-person practical and virtual 3D tooth identification tests consisting of 25 test items. The test scores, average test durations, faculty time commitment and user perception were collected and analysed. Pearson product-moment correlation coefficients (p < .05) were determined for the criterion measures including real tooth identification test scores, comprehensive written examination and overall grade for the course.

RESULTS

The average number of correct answers for the real and 3D virtual tooth identification examination was 21.3 ± 2.65 and 20.7 ± 2.56, respectively. The average test duration for the real and 3D virtual tooth identification test was 25:00 and 21:16 min, respectively. There was a positive correlation (p < .05) of the 3D virtual tooth identification test with the real tooth identification test (0.368), comprehensive written examination (0.334) and the overall course grade (0.646). The total faculty time commitment for the real and 3D virtual tooth identification test was 96 and 65 min, respectively. The students cited difficulty in manipulating the 3D models.

CONCLUSION

This study presents evidence that the 3D virtual tooth identification test can be used to assess dental students' understanding of dental anatomy effectively and efficiently.

Systematic Review of the Effect of Technology-Mediated Education Intervention on Maternal Outcomes in the First Year After Birth

OBJECTIVE

To synthesize the findings on the effect of technology-mediated education intervention in the first year after birth on maternal health outcomes and to evaluate interventions for participant perspectives and health equity.

DATA SOURCES

We conducted a systematic review of the literature using the electronic databases PubMed, Embase, and CINAHL for articles published between 2010 and 2020. The search strategy was developed by a health sciences librarian.

STUDY SELECTION

We included articles if the following criteria were met: they reported studies conducted in the United States or a resource-similar nation on the evaluation of a technology-mediated education intervention within the first year after birth and they included the assessment of at least one maternal health outcome.

DATA EXTRACTION

The lead author extracted data from the full-text articles and entered them into Microsoft Excel. We assessed the quality and risk of bias using the Cochrane Collaboration's tool for examining the potential risk of bias.

DATA SYNTHESIS

We identified 21 articles that met the inclusion criteria. Videos were the most commonly reported technology-mediated education intervention, followed by text messages, phone calls, and websites. Maternal health outcomes addressed in the included articles were mental health, weight loss, breastfeeding, general postpartum education, perineal care, and substance use. Technology-mediated education interventions positively affected mental health, weight loss, and breastfeeding outcomes.

CONCLUSION

The current evidence suggests that technology-mediated education intervention is beneficial for the physical and mental health outcomes of women during the first year after birth. Future work may benefit from more attention to health equity and design in collaboration with women to gain a better understanding of the information needs and desired technology features.

Toward Technology-Based Education and English as a Foreign Language Motivation: A Review of Literature

This review examined the studies on the role of technology-based English as a foreign language (EFL) academic motivation. A significant positive correlation between academic motivation and educational technology use has been approved in related studies. However, there is a dire need for studying the effect of Mobile-Assisted Language Learning (MALL) and Computer-Assisted Language Learning (CALL) on learners' motivation. The literature showed that purposeful attractiveness, effectiveness, and usefulness of digital instruments can positively affect learner motivation. There are also some reasons for increasing learner motivation in educational technology contexts, such as learners' integration with the community, familiarising with different societies and cultures, input flooding opportunities, engagement in academic contexts, and interaction with native speakers. In the end, the paedagogical implications are expounded to promote the learners' grit and diminish anxiety for better performance. This review also provides suggestions for further research to clarify our perspective on emotional variables like motivation.

Amigos de Fibro (Fibro Friends): Validation of an Educational Program to Promote Health in Fibromyalgia

Health education is one of the main items to enable the promotion of health for individuals with fibromyalgia (FM) in Primary Health Care (PHC) in Brazil. The purpose of this study was to validate a multidisciplinary educational health promotion program called Amigos de Fibro (Fibro Friends) for individuals with FM. Methodological research involving 23 health professionals (expert judges) and 45 individuals with FM (target audience) used an instrument to assess the objectives, proposed themes and initiatives, relevance, writing style, and structure of the program through the Delphi technique. The content validity index (CVI) ≥ 0.78 and coefficient kappa ≥ 0.61 were used for data analysis. All 25 items evaluated in both groups presented considerable minimum CVI by CVI and the kappa coefficient. In the global evaluation of Amigos de Fibro, the CVI of the specialist judges was 0.90, while the values of the target audience judges were 0.95. The kappa coefficient of the expert judges was 0.90 and that of the target audience judges was 0.85. Amigos de Fibro, a light technology in health, was considered with adequate content validity and internal consistency and is, therefore, valid in the use by health professionals with the target audience in PHC, making it possible for them to act as health-promoting agents.

Development and Assessment of an Integrated Anatomy Mobile App

INTRODUCTION

Curricular hours for anatomical sub-disciplines (gross anatomy, embryology, histology, and neuroanatomy) continue to decline, while medical schools are simultaneously transitioning to systems-based, vertically integrated curricula. This requires students to learn and integrate all basic science content for a learning block prior to the summative assessment. Currently, no educational technology resource exists that integrates the four anatomical sub-disciplines into a single resource to supplement integrated curricula. The objective of this study was to assess a novel integrated anatomical sciences mobile app for medical students.

MATERIALS AND METHODS

The 4natomy mobile app was developed to integrate the four sub-disciplines for a single topic, the spinal cord. The app was distributed to first-year medical students during the neurological disorders learning. Following the learning block, assessment of the student acceptance and experience with the app was conducted through a technology acceptance model (TAM) framework survey.

RESULTS

The results indicated that students found the app to be useful (p < 0.001) and easy to use (p < 0.05), predicting continued future usage of the app. Students requested expanded anatomy content for the entire learning block, as well as more clinical correlations, videos, and animations.

CONCLUSIONS

The integrated anatomy mobile app developed in this study was useful and easy to use, indicating continued use within an integrated medical curriculum. This was the first study to utilize the TAM as a conceptual framework for technology assessment in medical education, suggesting that future studies that develop new technologies should adapt the TAM for user testing. This article is protected by copyright. All rights reserved.

Virtual VM4 Clinical Rotations: A COVID-19 Pandemic Response at Iowa State University College of Veterinary Medicine

Policy changes in response to the coronavirus disease 2019 (COVID-19) pandemic at Iowa State University College of Veterinary Medicine (ISU-CVM) included the administrative directive that fourth-year (VM4) clinical rotations immediately transition from in-person to virtual format. This article summarizes the efforts, successes, and challenges experienced by ISU-CVM clinical faculty during this transition. Numerous data sources were reviewed, including college records and announcements, faculty survey results, and student rotation evaluations. Data were explored using quantitative and qualitative methods. Between March and July 2020, 36 faculty from 15 different clinical services invested approximately 5,000 hours in delivering virtual content to 165 VM4 students from ISU-CVM and Caribbean veterinary schools. With departmental, college, and university assistance, faculty effectively used educational technologies (Zoom, Canvas, Echo360) and developed adaptive and innovative methods for virtual content delivery. Virtual VM4 rotations were collectively well received and appreciated by students, and student evaluation scores for virtual rotations were statistically equivalent to or higher than those for the corresponding in-person rotations in the preceding year. Although certain hands-on skills could not be adequately acquired in a virtual environment, students gained theoretical knowledge and case-based problem-solving skills in the online format. Faculty reported satisfaction with their adaptability and resilience in these challenging circumstances. These findings demonstrate that ISU-CVM clinical faculty invested substantial time and effort to transition in-person clinical rotations to virtual format during the early COVID-19 pandemic. This is particularly noteworthy given that many of these same faculty simultaneously served as essential personnel managing clinical cases in the university's teaching hospital.

Assessment of learning outcomes of first year dental students using an interactive Nearpod educational platform

PURPOSE

The impact of COVID-19 required revisions in curricula, especially among professional programs that have traditionally required hands-on learning of content. This study endeavored to assess the level of effectiveness of the online presentation of material both qualitatively and quantitatively in a 5-week module on cariology for first-year dental students. Quantitative analysis of the assessment data was required to determine if an interactive engagement platform increased student outcomes. Quantitative survey and qualitative student comments were analyzed to determine the students' preferences for supplemental learning opportunities and utilization trends. The purpose of this study was to measure the learning outcomes of online course delivery with the use of an interactive education platform.

METHODS

The dental class of 2023 received the cariology material in a live, in-person lecture format. The class of 2024 received the same material in a combination of synchronous Zoom lectures and asynchronous interactive presentations utilizing the interactive education platform (Nearpod). The identical midterm examination on cariology was administered to both cohorts at the completion of the 5-week module.

RESULTS

Quantitatively, the class of 2024 had a significantly higher mean score than the class of 2023 on the midterm examination, collectively and in both female and male cohorts. Qualitatively, the dental students overwhelmingly expressed support for the ease of use and educational value of the Nearpod platform.

CONCLUSIONS

This study found that student performance on the identical exam was improved through the use of synchronous Zoom lectures and asynchronous Nearpod review sessions. The application of technology to enhance remote learning can be effective in supporting student mastery of core concepts in dental education.

A Serious Game (Immunitates) About Immunization: Development and Validation Study

Background

Vaccination is a fundamental part of all levels—local to worldwide—of public health, and it can be considered one of humanity's greatest achievements in the control and elimination of infectious diseases. Teaching immunization and vaccination can be monotonous and tiring. It is necessary to develop new approaches for teaching these themes in nursing school.

Objective

We aimed to develop and validate a serious game about immunization and vaccination for Brazilian nursing students.

Methods

We developed a quiz-type game, Immunitates, using design and educational theoretical models and Brazilian National Health Guidelines. The game’s heuristics and content were evaluated with 2 different instruments by a team of experts. A sample of nursing students evaluated the validity of the game’s heuristics only. We calculated the content validity index (CVI) for each evaluation.

Results

The study included 49 experts and 15 nursing students. All evaluations demonstrated high internal consistency (Cronbach α≥.86). The game’s heuristics (experts: CVI 0.75-1.0; students: CVI 0.67-1.0) and the game’s contents demonstrated validity (experts: CVI 0.73-1.0). Participants identified some specific areas for improvement in the next version.

Conclusions

The serious game appears to be valid. It is intended as a support tool for nursing students in the teaching–learning process and as a tool for continuing education for nurses.

The soap carving versus the digital sculpting: Evaluation of students' preferences and performance in dental anatomy course: Pilot study

PURPOSE/OBJECTIVES

The aim of this study was to evaluate the change in students' preferences between soap carving (SC) and digital sculpting (DS) methods after obtaining tooth with both methods, their opinions about the methods and their performance in the dental anatomy course.

MATERIALS AND METHODS

The SC and DS methods were demonstrated. Students were asked to obtain a maxillary central incisor by both methods and to record time. Students' preferences were asked both before and after applying both methods. The level of significance for statistical analysis was set at p ≤ .05.

RESULTS

Forty first year preclinical students (24 female, 16 male) participated in this study. Their mean age was 19.38 years ±1.00 year. There was a statistically significant difference between the mean time of the DS method according to gender (p = .004) and the mean time of DS and SC methods for females (p = .015). There was also a statistically significant difference between preferences of students for "In the future while treating the patient in the clinic, I learned with ………… method in the preclinic will be more useful for me." statement, before and after applying both methods (p = .034).

CONCLUSIONS

The obtaining the tooth of the students with DS method were longer than with SC method (especially in the females). After applying both methods, the students changed their minds that learning the information about the SC and DS methods would have a similar effect when treating patients in the clinic.

Development of an electronic learning progression dashboard to monitor student clinical experiences

INTRODUCTION

Clinical experience tracking mechanisms for students at dental schools provide patient assignment, student experience, and learning progression feedback. The purpose of this study was to evaluate dental students' clinical experiences following the implementation of a learning progression dashboard (LPD).

METHODS

After developing and deploying an electronic LPD using PHP, secondary data analysis on dental students' clinical experiences from 2017-2019 was conducted. Student experience differences were compared between the year before continuous use of the LPD and the first year using it. LPD data contained the required clinical procedures dentistry students must perform across all disciplines and the number of planned, in progress, and completed tasks each student has accomplished. Using two time points, the students' experiences were compared. Univariate statistics and independent t-tests were conducted in R for detecting the differences in the number and categories of codes.

RESULTS

The number and category of codes showed significant differences between the academic year 2017-2018 and 2018-2019 for both third- and fourth-year dental students after one and two terms. Overall, students recorded a 26% greater number of treatment codes and experienced a 26% greater number of code categories compared to the previous year.

CONCLUSION

Applying information management methods such as dashboards can better inform educators on student clinical experiences and improve clinical learning outcomes for students.

Technology enhanced learning environments and the potential for enhancing spatial reasoning: a mixed methods study

Spatial reasoning has been shown to be an important, trainable cognitive skillset for developing successful engagement in science, technology, engineering and mathematics (STEM), but little empirical work has been conducted in the context of digitally mediated pedagogies. This paper reports on a study into the effectiveness of a technologically enhanced STEM program on the spatial reasoning of a cohort of year 7 students (n = 107). The students undertook five digitally based activities over the period of a week and were assessed on their spatial reasoning development and attitudes towards STEM prior and subsequent to the intervention. Results indicate that the week of learning activities had an impact on attitudes towards STEM and had a positive impact on overall spatial skills. However, no statistically significant improvements were found within the spatial sub-skills or in relation to specific activities.

Exploring predoctoral dental student use of YouTube as a learning tool for clinical endodontic procedures

PURPOSE/OBJECTIVES

The goal of the present study was to examine perceived barriers to achieving clinical competence in endodontics and explain how YouTube is used to supplement formal education in this discipline.

METHODS

Postgraduate endodontic students conducted focus groups with fourth-year dental students at NYU College of Dentistry. The discussion was facilitated by a semistructured interview guide. Open-ended questions about participants' perceived barriers to clinical competency in endodontics, experiences using YouTube to learn about clinical endodontics, and preferences for video format learning were asked. Demographic information was gathered. Thematic analysis of data was conducted and data collection was terminated once saturation was achieved.

RESULTS

Thirty fourth-year dental students were enrolled in the study. The majority, 96.7%, reported using YouTube as a learning tool for dental procedures and 83.3% to learn about endodontics, specifically. The following domains were explored during data analysis: barriers to clinical competency, YouTube uses/experiences, and content preferences. The following themes within barriers to clinical competency were identified: psychological, educational, and clinical. Within the YouTube domain, the following themes were examined: goals of use, timing and frequency of use, search strategies, benefit/ shortcomings of YouTube, and validity of content. Students primarily used YouTube to enhance confidence and understand procedural flow.

CONCLUSION

YouTube videos were primarily used to help students overcome perceived educational and psychological barriers that resulted in gaps in confidence and knowledge of performing endodontic procedures. Dental students placed high value on easily accessible video content of limited duration, where clinical procedures were performed on live patients.

Developing a Conversational Agent's Capability to Identify Structural Wrongness in Arguments Based on Toulmin's Model of Arguments

This article discusses the usefulness of Toulmin's model of arguments as structuring an assessment of different types of wrongness in an argument. We discuss the usability of the model within a conversational agent that aims to support users to develop a good argument. Within the article, we present a study and the development of classifiers that identify the existence of structural components in a good argument, namely a claim, a warrant (underlying understanding), and evidence. Based on a dataset (three sub-datasets with 100, 1,026, 211 responses in each) in which users argue about the intelligence or non-intelligence of entities, we have developed classifiers for these components: The existence and direction (positive/negative) of claims can be detected a weighted average F1 score over all classes (positive/negative/unknown) of 0.91. The existence of a warrant (with warrant/without warrant) can be detected with a weighted F1 score over all classes of 0.88. The existence of evidence (with evidence/without evidence) can be detected with a weighted average F1 score of 0.80. We argue that these scores are high enough to be of use within a conditional dialogue structure based on Bloom's taxonomy of learning; and show by argument an example conditional dialogue structure that allows us to conduct coherent learning conversations. While in our described experiments, we show how Toulmin's model of arguments can be used to identify structural problems with argumentation, we also discuss how Toulmin's model of arguments could be used in conjunction with content-wise assessment of the correctness especially of the evidence component to identify more complex types of wrongness in arguments, where argument components are not well aligned. Owing to having progress in argument mining and conversational agents, the next challenges could be the developing agents that support learning argumentation. These agents could identify more complex type of wrongness in arguments that result from wrong connections between argumentation components.

Teaching evidence-based medicine with electronic databases for preclinical education

To evaluate the efficacy of an educational module on evidence-based medicine (EBM) assisted with electronic medical databases (EMDs) for preclinical education, medical students (n = 111) were matriculated in a program consisted of 16 2-h sessions on EBM plus hands-on experience on EMDs in a problem-based learning-type format. Students were required to make an oral presentation on designated clinical scenarios before and after the sessions, without prior notice, as an indicator of performance. In addition, questionnaires focusing on behavioral changes, awareness, and confidence of mastering EBM were administered before and after the sessions to assess the attitudinal and behavioral impact of the intervention on the participants. We found evidence of better postprogram performance in utilizing EBM-relevant concepts and resources when the enrolled medical students were giving oral presentations. Moreover, the participants reported increased awareness of EBM and, behaviorally, increased utilization of EBM-relevant resources provided by libraries. Also, they reported improvement on appropriately using EBM-relevant resources, and 99% of the participants reported strong confidence in practicing EBM. In conclusion, modules on EBM implemented with EMDs benefitted medical students in scenario-oriented PBL tutorials. Improvements in awareness, behavior, confidence, and performance in mastering EBM were noted.

Dental EHR-infused Persona Ontologies to Enrich Dental Dialogue Interaction of Agents

The quality of patient-provider communication can predict the healthcare outcomes in patients, and therefore, training dental providers to handle the communication effort with patients is crucial. In our previous work, we developed an ontology model that can standardize and represent patient-provider communication, which can later be integrated in conversational agents as tools for dental communication training. In this study, we embark on enriching our previous model with an ontology of patient personas to portray and express types of dental patient archetypes. The Ontology of Patient Personas that we developed was rooted in terminologies from an OBO Foundry ontology and dental electronic health record data elements. We discuss how this ontology aims to enhance the aforementioned dialogue ontology and future direction in executing our model in software agents to train dental students.

Distance learning strategies in medical education during COVID-19: A systematic review

The current outbreak of coronavirus disease 2019 (COVID-19) across the world forced universities to suspend learning to limit the spread of the virus. Many medical schools have shifted to online education as an information delivery mechanism where the educator and learner are separated in space and potentially also in time. This systematic review aims to explore and understand the variety of distance learning strategies in medical students in the contexts of COVID-19. A systematic review was conducted in Web of Sciences, PubMed, Educational Resources and Information Center, and Scopus from December 2019 to July 2020. Eight sets of terminology were used, combining "Distance learning" AND "Medical education" AND "Pandemic." Studies were reviewed independently by two reviewers. Data were extracted and quality appraised using QualSyst tools, and synthesized by performing thematic analysis. A total of 473 articles were identified after removing duplicates and 314 records were screened, of which 125 were included in this study. The primary articles were 52 primarily qualitative articles. Five learning strategies consisted of technology-enhanced learning (TEL), simulation-based learning, technology-based clinical education, mobile learning, and blended learning. Tools, methods, and learning resources associated with these five learning strategies were extracted from the articles. Our review highlights that TEL and simulation-based learning were more commonly used than others in distance learning in medical education during the COVID-19 pandemic. These strategies have the potential to improve learners' level of knowledge and performance through making online learning resources such as Massive Open Online Courses, virtual clinical cases, and blended sources accessible.

Effectiveness of enhanced video-based learning on removable partial denture module

INTRODUCTION

The application of video-based learning in dentistry has been widely investigated; however, the nature of on-screen video enhancements of the video has been minimally explored in the literature. This study investigated the effectiveness of an in-class and on-demand enhanced video to support learning on removable partial dentures in terms of knowledge acquisition, perception and clinical skill performance.

METHODS

Fifty-four dental students enrolled in 2018 were recruited as participants and assigned to two groups. Both groups were given the same lecture and asked to watch the same video in either the enhanced or non-enhanced version. The enhanced video was modified with the contemporaneous subtitle of the presenters' dialogue, text bullet points and summary text pages. The knowledge acquisition from the two types of video was subjected to pre- and post-tests one month after the students watched the video. A questionnaire was used to evaluate the students' perceptions of the learning experience and a performance test on practical skills was performed after six weeks. All the students responded to the test (100%).

RESULTS

The enhanced video demonstration improved the students' short-term knowledge acquisition after they watched the video, with an average score of 1.59 points higher in the enhanced group than in the non-enhanced group (p < .05). The practical performance did not differ between the two groups. The students were more likely accepted the enhanced video as a replacement of the existing teaching method rather than a teaching supplement (70.3%).

CONCLUSION

The application of the enhanced video demonstration resulted in a better theoretical knowledge retention but not practical performance. Students also preferred watching video to using conventional learning methods.

Best Practices for the Implementation and Sustainment of Virtual Health Information System Training: Qualitative Study

BACKGROUND

The COVID-19 pandemic has necessitated the adoption and implementation of digital technologies to help transform the educational ecosystem and the delivery of care.

OBJECTIVE

We sought to understand instructors' and learners' perceptions of the challenges and opportunities faced in implementing health information system virtual training amid the COVID-19 pandemic.

METHODS

Semistructured interviews were conducted with education specialists and health care staff who provided or had taken part in a virtual instructor-led training at a large Canadian academic health sciences center. Guided by the Technology Acceptance Model and the Community of Inquiry framework, we analyzed interview transcript themes deductively and inductively.

RESULTS

Of the 18 individuals participating in the study, 9 were education specialists, 5 were learners, 3 were program coordinators, and 1 was a senior manager at the Centre for Learning, Innovation, and Simulation. We found 3 predominant themes: adopting a learner-centered approach for a meaningful learning experience, embracing the advances in educational technologies to maximize the transfer of learning, and enhancing the virtual user experience.

CONCLUSIONS

This study adds to the literature on designing and implementing virtual training in health care organizations by highlighting the importance of recognizing learners' needs and maximizing the transfer of learning. Findings from this study can be used to help inform the design and development of training strategies to support learners across an organization during the current climate and to ensure changes are sustainable.

Leveraging Technology to Overcome the "Scalability Problem" in Communication Skills Training Courses

Although multiple consensus statements have called for large-scale efforts to improve clinicians’ communication skills regarding a variety of difficult conversations in medicine, this goal will be difficult to attain because there are no readily scalable, validated communication skills training programs for clinicians. However, novel applications of existing technologies and approaches grounded in learning science can overcome the scalability barriers. Moreover, future advances in virtual reality and artificial intelligence are likely to greatly enhance the possibilities for communication skills training programs. The purpose of this paper is to propose a scalable, theoretically grounded method to train clinicians in advanced communication skills in medicine. First, we summarize four key principles of adult learning relevant to communication skills training in medicine. Second, we discuss recommended practices to design effective technology-enhanced educational interventions, with an emphasis on achieving high amounts of user engagement. Third, we synthesize these principles into a framework for a web- and videoconference-based platform for teaching advanced communication skills in medicine. Once developed, this low-cost, scalable training platform has the potential to allow thousands of clinicians to acquire the advanced communication skills needed for difficult conversations in medicine.

A Mobile App (AMOR Mama) for Women With Breast Cancer Undergoing Radiation Therapy: Functionality and Usability Study

Background

Mobile apps targeting women with breast cancer can facilitate access to information, improve well-being, and record reports of treatment-related symptoms. However, it is important to confirm the benefits of these apps before they are used as a tool in clinical care.

Objective

The aim of this study was to evaluate the functionality and the usability of a mobile app created to guide and monitor patients with breast cancer undergoing radiation therapy.

Methods

The evaluation process of the mobile app was performed in 2 steps with 8 professionals, including nurses, physician, medical physicists, and communication networks engineer. The first step was the focus group, which allowed obtaining suggestions proposed by the participants regarding the improvement of the mobile app. The second step was the individual filling in of an evaluation tool to obtain objective measures about the mobile app. A minimum concordance index of 80% was considered to ensure the adequacy of the material.

Results

After the mobile app was evaluated by 8 professionals, only 1 item of the evaluation tool, that is, concerning the potentiality of the app to be used by users of different educational levels, obtained a concordance index <80%.

Conclusions

The mobile app titled “AMOR Mama” was considered suitable, which suggests its contribution to an educational health technology to guide and monitor patients with breast cancer undergoing radiation therapy. More studies with this target population should be carried out to assess the performance and quality of the mobile app during its use.

Clinician-Created Educational Video Resources for Shared Decision-making in the Outpatient Management of Chronic Disease: Development and Evaluation Study

Background

The provision of reliable patient education is essential for shared decision-making. However, many clinicians are reluctant to use commonly available resources, as they are generic and may contain information of insufficient quality. Clinician-created educational materials, accessed during the waiting time prior to consultation, can potentially benefit clinical practice if developed in a time- and resource-efficient manner.

Objective

The aim of this study is to evaluate the utility of educational videos in improving patient decision-making, as well as consultation satisfaction and anxiety, within the outpatient management of chronic disease (represented by atrial fibrillation). The approach involves clinicians creating audiovisual patient education in a time- and resource-efficient manner for opportunistic delivery, using mobile smart devices with internet access, during waiting time before consultation.

Methods

We implemented this educational approach in outpatient clinics and collected patient responses through an electronic survey. The educational module was a web-based combination of 4 short videos viewed sequentially, followed by a patient experience survey using 5-point Likert scales and 0-100 visual analogue scales. The clinician developed the audiovisual module over a 2-day span while performing usual clinical tasks, using existing hardware and software resources (laptop and tablet). Patients presenting for the outpatient management of atrial fibrillation accessed the module during waiting time before their consultation using either a URL or Quick Response (QR) code on a provided tablet or their own mobile smart devices. The primary outcome of the study was the module’s utility in improving patient decision-making ability, as measured on a 0-100 visual analogue scale. Secondary outcomes were the level of patient satisfaction with the videos, measured with 5-point Likert scales, in addition to the patient’s value for clinician narration and the module’s utility in improving anxiety and long-term treatment adherence, as represented on 0-100 visual analogue scales.

Results

This study enrolled 116 patients presenting for the outpatient management of atrial fibrillation. The proportion of responses that were “very satisfied” with the educational video content across the 4 videos ranged from 93% (86/92) to 96.3% (104/108) and this was between 98% (90/92) and 99.1% (107/108) for “satisfied” or “very satisfied.” There were no reports of dissatisfaction for the first 3 videos, and only 1% (1/92) of responders reported dissatisfaction for the fourth video. The median reported scores (on 0-100 visual analogue scales) were 90 (IQR 82.5-97) for improving patient decision-making, 89 (IQR 81-95) for reducing consultation anxiety, 90 (IQR 81-97) for improving treatment adherence, and 82 (IQR 70-90) for the clinician’s narration adding benefit to the patient experience.

Conclusions

Clinician-created educational videos for chronic disease management resulted in improvements in patient-reported informed decision-making ability and expected long-term treatment adherence, as well as anxiety reduction. This form of patient education was also time efficient as it used the sunk time cost of waiting time to provide education without requiring additional clinician input.

Impact of blended learning on manual defibrillator's use: A simulation-based randomized trial

Background

Blended learning, defined as the combination of traditional face‐to‐face instructor‐led learning and e‐learning course, has never been validated as a teaching method for the effective use of manual defibrillators in cardiopulmonary resuscitation.

Aim

To evaluate whether paediatric emergency and critical care providers exposed to a blended learning session performed better and recalled more defibrillator skills than those exposed to face‐to‐face learning only.

Study design

A two‐period prospective, stratified, single‐centre, simulation‐based, randomized, controlled trial.

Methods

Registered nurses and postgraduate residents from either a paediatric emergency department or an intensive care unit were randomly assigned to a blended learning or face‐to‐face learning sessions on the recommended use of a manual defibrillator. Participants' adherence to recommendations was assessed by testing defibrillator skills in three consecutive paediatric cardiopulmonary scenarios performed on the day of the training and once again 2 months later. The primary endpoint was the number of errors observed during defibrillation, cardioversion, and transcutaneous pacing at the time of the initial intervention.

Results

Fifty participants were randomized to receive the intervention and 51 to the control group. When pooling all three procedures, the median total errors per participant was lower (2 [IQR: 1‐4]) in providers exposed to blended learning than in those exposed to face‐to‐face learning only (3 [IQR: 2‐5]; P = .06). The median of total errors per procedure was also lower. However, both training methods appeared insufficient to maintain appropriate skill retention over time as a repetition of procedures 2 months later without any refresher learning session yielded more errors in both groups.

Conclusions

Learners exposed to blended learning showed a reduced number in the total amount of errors compared with those exposed to face‐to‐face learning alone, with waning of skills over time.

Relevance to clinical practice

Proficiently teaching the use of a manual defibrillator can be performed through blended learning.

Teaching and Learning Modalities in Higher Education During the Pandemic: Responses to Coronavirus Disease 2019 From Spain

The effects of the pandemic have affected and continue to affect education methods every day. The education methods are not immune to the pandemic periods we are facing, so teachers must know how to adapt their methods in such a way that teaching, and its quality, is not negatively affected. This study provides an overview of different types of teaching methodology before, during, and after the coronavirus disease 2019 (COVID-19) pandemic. This study describes the different types of teaching (e.g., presence learning, blended learning, and distance education) used in two Spanish Universities (i.e., one private and one public) during the pandemic. A new teaching methodology is proposed. The purpose of this study report is to share what we learned about the response to COVID-19. Results provide a basis for reflection about the pros and cons of teaching and learning modalities in higher education. The current situation demands that we continue to rethink what is the best methodology for teaching so that the education of students is not affected in any way. This study is useful for learning about different teaching methods that exist and which ones may suit us best depending on the context, situation, and needs of our students.

Evaluating Classification Consistency of Oral Lesion Images for Use in an Image Classification Teaching Tool

A web-based image classification tool (DiLearn) was developed to facilitate active learning in the oral health profession. Students engage with oral lesion images using swipe gestures to classify each image into pre-determined categories (e.g., left for refer and right for no intervention). To assemble the training modules and to provide feedback to students, DiLearn requires each oral lesion image to be classified, with various features displayed in the image. The collection of accurate meta-information is a crucial step for enabling the self-directed active learning approach taken in DiLearn. The purpose of this study is to evaluate the classification consistency of features in oral lesion images by experts and students for use in the learning tool. Twenty oral lesion images from DiLearn's image bank were classified by three oral lesion experts and two senior dental hygiene students using the same rubric containing eight features. Classification agreement among and between raters were evaluated using Fleiss' and Cohen's Kappa. Classification agreement among the three experts ranged from identical (Fleiss' Kappa = 1) for "clinical action", to slight agreement for "border regularity" (Fleiss' Kappa = 0.136), with the majority of categories having fair to moderate agreement (Fleiss' Kappa = 0.332-0.545). Inclusion of the two student raters with the experts yielded fair to moderate overall classification agreement (Fleiss' Kappa = 0.224-0.554), with the exception of "morphology". The feature of clinical action could be accurately classified, while other anatomical features indirectly related to diagnosis had a lower classification consistency. The findings suggest that one oral lesion expert or two student raters can provide fairly consistent meta-information for selected categories of features implicated in the creation of image classification tasks in DiLearn.

Evaluation of Participant Success in Gamified Drone Training Simulator Using Brain Signals and Key Logs

The risk of accidents while operating a drone is quite high. The most important solution is training for drone pilots. Drone pilot training can be done in both physical and virtual environments, but the probability of an accident is higher for pilot trainees, so the first method is to train in a virtual environment. The purpose of this study is to develop a new system to collect data on students’ educational development performance of students during the use of Gamified Drone Training Simulator and objectively analyze students’ development. A multimodal recording system that can collect simulator, keystroke, and brain activity data has been developed to analyze the cognitive and physical activities of participants trained in the gamified drone simulator. It was found that as the number of trials increased, participants became accustomed to the cognitive load of visual/auditory tasks and therefore the power in the alpha and beta bands decreased. It was observed that participants’ meditation and attention scores increased with the number of repetitions of the educational game. It can be concluded that the number of repetitions lowers stress and anxiety levels, increases attention, and thus enhances game performance.