Evaluation of a medication calculation mobile app using a cognitive load instructional design

Understanding The Role of Cognitive Load In Paramedical Contexts: A Systematic Review

Objectives: Cognitive load refers to the working memory resources required during a task. When the load is too high or too low this has implications for an individual's task performance. In the context of paramedicine and emergency medical services (EMS) broadly, high cognitive load could potentially put patient and personnel safety at risk. This systematic review aimed to determine the current understanding of the role of cognitive load in paramedical contexts.Methods: To do this, five databases were searched (Elsevier Embase, ProQuest Psychology, CINAHL, Ovid Medline, and Ovid PsychINFO) using synonyms of cognitive load and paramedical contexts. Included articles were full text, peer reviewed empirical research, with a focus on cognitive load and EMS work. Two reviewers screened titles, abstracts, and full text using a traffic light system against the inclusion and exclusion criteria. The quality of evidence was assessed using the GRADE framework. This study was registered on PROSPERO (CRD42022384246). No funding was received for this research.Results: The searches identified 73 unique articles and after title/abstract and full text screening, 25 articles were included in the final review. Synthesis of the research revealed 10 categories of findings in the area. These are clinical performance, cognitive processes, emotional responses, physical expenditure, physiological responses, equipment and ergonomics, expertise and experience, multiple loads, cognitive load measures, and task complexity.Conclusions: From these findings it was determined that there is agreement in terms of what factors influence cognitive load in paramedical contexts, such as cognitive processes, task complexity, physical expenditure, level of experience, multiple types of loads, and the use of equipment. Cognitive load influences clinical task performance and has a bi-directional relationship with emotion. However, the literature is mixed regarding physiological responses to cognitive load, and how they are best measured. These findings highlight potential intervention points where cognitive load can be managed or reduced to improve working conditions for EMS clinicians and safety for their patients.

Numeracy Education for Health Care Providers: A Scoping Review

INTRODUCTION

Health numeracy (numerical literacy) refers to an individual's ability to use numerical information to make effective health decisions. Numeracy is fundamental in the role of a health care provider, forming the basis of evidence-based medicine and effective patient-provider communication. Despite a high level of education, many health care providers struggle with numeracy. Numeracy is often integrated into training curricula; however, teaching modality, competencies covered, learner satisfaction, and effectiveness of these educational interventions varies.

METHOD

A scoping review was conducted to explore and summarize what is known about numeracy skills education programs for health care providers. A comprehensive literature search was conducted from January 2010 to April 2021 in 10 databases. Controlled vocabulary terms and text words were used. The search was restricted to human studies, adults, and the English language. Articles were included if they were related to numeracy education for health care providers or trainees and provided details regarding methods, evaluation, and results.

RESULTS

The literature search retrieved 31,611 results and 71 met the inclusion criteria. Most interventions were conducted in a university setting, and targeted nursing students, medical students, resident physicians, and pharmacy students. Common numeracy concepts included statistics/biostatistics, medication calculations, evidence-based medicine, research methodology, and epidemiology. A variety of teaching modalities were used, which most often combined active approaches (eg, workshops, laboratories, small-group exercises, and discussion boards) with passive approaches (eg, traditional lectures and didactic teaching). Measured outcomes included knowledge and skills, self-efficacy, attitudes, and engagement.

DISCUSSION

Although efforts have been made to incorporate numeracy into training curricula, greater emphasis should be placed on developing strong numeracy skills in health care providers, particularly given the role numerical information plays in clinical decision making, evidence-based practices, and patient-provider communication.

The use of mobile technology to support work integrated learning in undergraduate nursing programs: An integrative review

OBJECTIVES

Investigate the use of mobile technology to support Work Integrated Learning in undergraduate nursing programs.

DESIGN

Integrative review with narrative synthesis.

DATA SOURCES

Electronic databases searched in February 2021 included CINAHL, ERIC, MEDLINE and APA PsychInfo.

REVIEW METHODS

The methodological framework described by Whittemore and Knafl (2005) guided this integrative review. A total of five (5) studies published between 2017 and 2020 were analysed and synthesised.

RESULTS

Data was categorised into two themes: 1) Accessibility of Learning Resources, and 2) Effective and Timely Communication. Convenient and easy access to Learning Resources at the point of care improved students' confidence and competence to perform clinical skills, thereby reducing student's anxiety and increasing satisfaction rates. The accessibility to educational and skills-based resources also promoted patient safety at the point of care. Effective and Timely Communication improved engagement and collaboration between students, clinical facilitators and academics, enabling a more supportive environment that improved student autonomy and motivation for self-directed learning. The Effective and Timely Communication of student progression and assessment strategies was found to improve student engagement and motivation to be independent learners.

CONCLUSION

This review contributes important knowledge because internationally there is a need to increase knowledge and understanding of how to best support Work Integrated Learning experiences of student nurses. Mobile technology has been recognised as an innovative tool in education, further research investigating its use to support Work Integrated Learning in undergraduate nursing programs is required.

Usability Methods and Attributes Reported in Usability Studies of Mobile Apps for Health Care Education: Scoping Review

BACKGROUND

Mobile devices can provide extendable learning environments in higher education and motivate students to engage in adaptive and collaborative learning. Developers must design mobile apps that are practical, effective, and easy to use, and usability testing is essential for understanding how mobile apps meet users' needs. No previous reviews have investigated the usability of mobile apps developed for health care education.

OBJECTIVE

The aim of this scoping review is to identify usability methods and attributes in usability studies of mobile apps for health care education.

METHODS

A comprehensive search was carried out in 10 databases, reference lists, and gray literature. Studies were included if they dealt with health care students and usability of mobile apps for learning. Frequencies and percentages were used to present the nominal data, together with tables and graphical illustrations. Examples include a figure of the study selection process, an illustration of the frequency of inquiry usability evaluation and data collection methods, and an overview of the distribution of the identified usability attributes. We followed the Arksey and O'Malley framework for scoping reviews.

RESULTS

Our scoping review collated 88 articles involving 98 studies, mainly related to medical and nursing students. The studies were conducted from 22 countries and were published between 2008 and 2021. Field testing was the main usability experiment used, and the usability evaluation methods were either inquiry-based or based on user testing. Inquiry methods were predominantly used: 1-group design (46/98, 47%), control group design (12/98, 12%), randomized controlled trials (12/98, 12%), mixed methods (12/98, 12%), and qualitative methods (11/98, 11%). User testing methods applied were all think aloud (5/98, 5%). A total of 17 usability attributes were identified; of these, satisfaction, usefulness, ease of use, learning performance, and learnability were reported most frequently. The most frequently used data collection method was questionnaires (83/98, 85%), but only 19% (19/98) of studies used a psychometrically tested usability questionnaire. Other data collection methods included focus group interviews, knowledge and task performance testing, and user data collected from apps, interviews, written qualitative reflections, and observations. Most of the included studies used more than one data collection method.

CONCLUSIONS

Experimental designs were the most commonly used methods for evaluating usability, and most studies used field testing. Questionnaires were frequently used for data collection, although few studies used psychometrically tested questionnaires. The usability attributes identified most often were satisfaction, usefulness, and ease of use. The results indicate that combining different usability evaluation methods, incorporating both subjective and objective usability measures, and specifying which usability attributes to test seem advantageous. The results can support the planning and conduct of future usability studies for the advancement of mobile learning apps in health care education.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/19072.

Mobile applications in medical education: A systematic review and meta-analysis

Objective

This review evaluates the effectiveness of smartphone applications in improving academic performance and clinical practice among healthcare professionals and students.

Methods

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were retrieved from PubMed, Scopus, and Cochrane library through a comprehensive search strategy. Studies that included medical, dental, nursing, allied healthcare professional, undergraduates, postgraduates, and interns from the same disciplines who used mobile applications for their academic learning and/or daily clinical practice were considered.

Results

52 studies with a total of 4057 learner participants were included in this review. 33 studies (15 RCTs, 1 cluster RCT, 7 quasi-experimental studies, 9 interventional cohort studies and 1 cross-sectional study) reported that mobile applications were an effective tool that contributed to a significant improvement in the knowledge level of the participants. The pooled effect of 15 studies with 962 participants showed that the knowledge score improved significantly in the group using mobile applications when compared to the group who did not use mobile applications (SMD = 0.94, 95% CI = 0.57 to1.31, P<0.00001). 19 studies (11 RCTs, 3 quasi-experimental studies and 5 interventional cohort studies) reported that mobile applications were effective in significantly improving skills among the participants.

Conclusion

Mobile applications are effective tools in enhancing knowledge and skills. They can be considered as effective adjunct tools in medical education by considering their low expense, high versatility, reduced dependency on regional or site boundaries, online and offline, simulation, and flexible learning features of mobile apps.

Utilization of Nursing Education Progressive Web Application (NEPWA) Media in an Education and Health Promotion Course Using Gagne's Model of Instructional Design on Nursing Students: Quantitative Research and Development Study

Background

Previous studies have proven that web-based learning media that offer interesting features with the learning management system concept could support the learning processes of nursing students. Nonetheless, it is still necessary to conduct further research on its potential as an information media that supports learning using 1 of the mobile learning methods.

Objective

This study aims to develop and use the Nursing Education Progressive Web Application (NEPWA) media in an education and health promotion course for nursing students.

Methods

This is a research and development study aimed at developing the NEPWA media using the Analyze, Design, Develop, Implement, and Evaluate approach and a quantitative research with descriptive and pre-experimental 1-group pretest-posttest design conducted in the Study Program of Nursing Sciences, Faculty of Health Sciences, Muhammadiyah University of Surakarta. A total of 39 nursing students in their second year of undergraduate studies participated in this study. A pretest-posttest design was used to measure any changes in the dependent variable, whereas a posttest design was used to measure any changes in the independent variables.

Results

After using the NEPWA media, there was a significant increase in the student knowledge variable (N=39; knowledge: P<.001; 95% CI 23.88-33.14). In terms of student satisfaction with the learning process using Gagne’s model of instructional design, most of the students were satisfied, with a mean score of ≥3. In addition, the results of the measurement using the System Usability Scale on the NEPWA media showed that NEPWA has good usability and it is acceptable by users, with a mean score of 72.24 (SD 8.54).

Conclusions

The NEPWA media can be accepted by users and has good usability, and this media is designed to enhance student knowledge.

Mobile applications in oncology: A systematic review of health science databases

INTRODUCTION

In recent years there has been an exponential growth in the number of mobile applications (apps) relating to the early diagnosis of cancer and prevention of side effects during cancer treatment. For health care professionals and users, it can thus be difficult to determine the most appropriate app for given needs and assess the level of scientific evidence supporting their use. Therefore, this review aims to examine the research studies that deal with this issue and determine the characteristics of the apps involved.

METHODOLOGY

This study involved a systematic review of the scientific literature on randomized clinical trials that use apps to improve cancer management among patients, using the Pubmed (Medline), Latin America and the Caribbean in Health Sciences (LILACS), and Cochrane databases. The search was limited to articles written in English and Spanish published in the last 10 years. A search of the App Store for iOS devices and Google Play for Android devices was performed to find the apps identified in the included research articles.

RESULTS

In total, 54 articles were found to analyze the development of an application in the field of oncology. These articles were most frequently related to the use of apps for the early detection of cancer (n = 28), particularly melanoma (n = 9). In total, 21 studies reflected the application used. The apps featured in nine articles were located using the App Store and Google Play (n = 9), of which five were created to manage cancer-related issues. The rest of the apps were designed for use in the general population (n = 4).

CONCLUSIONS

There is an increasing number of research articles that study the use of apps in the field of oncology; however, these mobile applications tend to disappear from app stores after the studies are completed.