Reinvigorating Continuing Medical Education: Meeting the Challenges of the Digital Age

Bridging the digital divide: Promoting equal access to online learning for health professions in an unequal world

Online learning has the potential to enhance open and equitable access to medical education resources globally. Conversely, there are also concerns that it can perpetuate and exacerbate digital inequalities between developed (global North) and developing (global South) countries. In this article, we describe the historical lack of representation of the global South in the design of online medical education, as well as the resulting consequences and potential solutions. We compare the Northern and Southern views of online learning in medical education and identify the different types of barriers to its adoption. We describe how socioeconomic disparities and the historical dominance of the global North over the global South have led to systemic digital inequalities in the design and implementation of online learning in education generally, and in medical education particularly. The lack of representation of global South voices hinders the development of digital learning solutions relevant to local contexts, therefore limiting their effectiveness and sustainability. Thus, we propose approaches to build more equitable partnerships by soliciting local input and local expertise. Further, we discuss the need to maintain local relevance while setting global standards. Overall, we hope to inform and guide the development of more equitable and accessible online education training for a diverse global population.

Experiences of patient education among people affected by cardiovascular disease: a qualitative study based on Andragogy model

BACKGROUND

Patient education is a key component of patient care, positively affecting health promotion and self-care ability. In this regard, an extensive body of research supports the use of the andragogy model in patient education. The study aimed to explore the experiences of people with cardiovascular disease in patient education.

METHODS

This qualitative study involved 30 adult patients with cardiovascular disease who were hospitalized or had a history of hospitalization. They were purposively recruited with maximum variation from two large hospitals in Tehran, Iran. Data were gathered by conducting semi-structured interviews. Data collection was done by conducting semi-structured interviews. Then, the data were analyzed using directed content analysis and a preliminary framework based on six constructs of the andragogy model.

RESULTS

Data analysis resulted in the development of 850 primary codes, which were reduced to 660 during data reduction. These codes were grouped into nineteen subcategories under the six primary constructs of the andragogy model, i.e., need-to-know, self-concept, prior experience, readiness for learning, orientation to learning, and motivation for learning. The most common problems in patient education were associated with self-concept, previous experience, and readiness for learning components.

CONCLUSION

This study provides valuable information about the problems of patient education for adults with cardiovascular disease. Correction of the issues identified can improve care quality and patient outcomes.

Teaching Medical Students About Kawasaki Disease: The Development and Evaluation of a Digital Educational Resource

Introduction

The use of digital educational resources has gained widespread popularity across all disciplines in medical education; pediatrics being no exception. In this paper, we report how instructional design and multimedia principles were used to develop and evaluate an e-learning resource on Kawasaki Disease, which was primarily created as a revision aid for undergraduate medical students.

Methods

The design and development of the resource was based upon the Analysis, Design, Development, Implementation and Evaluation (ADDIE) instructional model. A "People, Activities, Contexts and Technologies" (PACT) analysis was initially undertaken to identify learners' needs, and the 12 Principles of Multimedia Design informed the development of the resource. The evaluation strategy was informed by the Usability Evaluation Method for e-Learning Applications and focused on the instructional design parameters of navigation, visual design and intrinsic motivation to learn.

Results and Conclusion

Feedback from the seven medical students who completed and evaluated the resource showed high levels of satisfaction. Students perceived it to be beneficial to their learning and indicated a preference for an interactive digital resource over traditional modes of learning, such as textbooks. However, as this was a small-scale evaluation, suggestions for further evaluation and how this may inform ongoing development of the resource are considered in this paper.

@MondayNightIBD and the expanding gastroenterology Twitterverse: A study on continuing medical education on #GITwitter

OBJECTIVES

@MondayNightIBD provides weekly continuing medical education (CME) activities focused on inflammatory bowel diseases to clinicians on Twitter. Given its novelty, we assessed whether @MondayNightIBD improves learner knowledge and leads to practice change. We also examined whether inflammatory bowel disease topics addressed in @MondayNightIBD are aligned with entrustable professional activities (EPAs) set forth by national gastroenterology societies.

METHODS

@MondayNightIBD CME sessions from February 2020 (date the handle was accredited to provide CME) to May 2021 were analyzed. Pre- and post-activity knowledge was assessed for average score improvement using student's T-tests and Cohen's D effect size. Post-activity surveys examined for learners' perceptions of whether activities met educational goals and affected willingness to change clinical practice using descriptive percentages. In addition, activities from April 2019 (date of @MondayNightIBD inception) to May 2021 were assessed for whether they address EPAs set forth by national gastroenterology societies.

RESULTS

Learners' knowledge improved after @MondayNightIBD activities with average pre-activity correct answers of 58% to a post-activity average of 79% (p < 0.001). Greater than 95% of learners found that activities met learning objectives and enhanced knowledge. A total of 92% of learners were committed to practice change because of their @MondayNightIBD participation. Finally, 78% of EPAs set forth by a national gastroenterology society have been covered by @MondayNightIBD since its inception.

CONCLUSIONS

@MondayNightIBD is a Twitter-based CME activities platform for gastroenterologists and other clinicians that is embraced by learners, improves knowledge, and encourages practice change. Topics covered during @MondayNightIBD are aligned with EPAs set forth by national gastroenterology societies. @MondayNightIBD is a successful model of social media medical education, and a novel approach to effectively provide evidence-based CME.

Application of the electronic book to promote self-directed learning in medical technologist continuing education: a cross-sectional study

BACKGROUND

Continuing education (CE) is essential for health professionals to improve competence in clinical practice, yet many medical technologists still experience barriers to learning in complex clinical settings. To better manage CE and address medical technologists' learning needs, we developed a learner-centred electronic book (e-book) to promote self-directed learning for medical technologists.

METHODS

A cross-sectional study was conducted to explore the acceptability and learning impacts of the e-book as CE material for medical technologists in two medical centres in Taiwan. We designed the learner-centred context in the e-book based on medical technologists' practice requirements and learning needs. Moreover, we adopted The New World Kirkpatrick Model with four levels (reactions, learning, behaviours and results) to evaluate the e-book's learning impacts on medical technologists. A total of 280 medical technologists were invited to complete a questionnaire and a post-test, providing learning patterns as well as their satisfaction with the e-book and their learning outcomes after using it.

RESULTS

Most readers had positive learning experiences and better learning outcomes, including knowledge acquisition and behavioural change, after reading the e-book. The e-book became a new CE activity and reached medical technologists in various types of laboratories.

CONCLUSIONS

The low-cost and learner-centred e-book effectively overcame CE learning barriers for medical technologists. The interactivity and flexibility of e-learning particularly helped learners to engage in clinical scenarios in laboratory medicine. This study could pave the way for medical educators to build a high-quality e-learning model in CE.

Surveying and Modelling 21st Century Online Learning Patterns of Medical Students

Medical education in the 21st century is shifting more toward online learning because of extensive application of information and communication technology (ICT). We surveyed medical students' 21st century online learning experiences and modeled the interrelations among relevant dimensions of 21st century online learning. Based on the general themes proposed by multiple 21st century learning frameworks and current medical education emphases, a seven-factor instrument was developed for surveying 364 medical students' learning process, thinking process, and basic science-related clinical ability. The associations among the seven factors and the structural relationships of how online learning practices and thinking processes affected basic science-related clinical ability were explored. The developed instrument was validated and possessed good reliability. The seven dimensions were interrelated. Specifically, meaningful learning with ICT was positively associated with other learning practices. The learning practices were positively associated with the thinking processes and the thinking processes were positively associated with students' basic science-related clinical ability. Our findings suggested that students engaged in active and collaborative learning with technology would employ higher-order thinking and perceived better basic science-related clinical ability. The findings support engaging medical students with 21st century learning practices to strengthen students' self-perception of clinical ability.

Digitalisation as the Indicator of the Evidence of Sustainability in the European Union

Digitalisation provides access to an integrated network of information that can benefit society and businesses. However, the evidence of sustainability in business is less researched. In our paper, by building up the research approach, we address the relevant gap by investigating how sustainable development goals represent the interrelationship between digitalisation and sustainability. Such research is particularly important because understandings of digitalisation and sustainability determine how different actors, including business managers and policymakers, act in response to those imperatives to develop future employees skills starting from school age. Following a multi-method approach, we have combined our analysis into two steps examining the relationship between digitalisation and sustainability. Building digital networks, business managers and policy makers using digital means can create some unique opportunities to strategically address sustainable development challenges for the United Nations Targets (SDG) to ensure higher productivity, education, and an equality-oriented society. This point of view describes the potential of digitalisation for society and businesses of the future. The authors revise the links between digitalisation and sustainability in the European Union countries by using data available in Eurostat and UNECE public databases. The two-stage methodology for the identification of the relationship between ICT and sustainability is used in the paper and a linear regression model is applied. The results showed tiers with five SDGs, focusing on business, and all these tiers are fixed in the constructed equations for each SDG. The recommended solution is statistically valid and proves the novelty of this research. Among digitalisation indicators, only mobile-cellular subscriptions and fixed-broadband sub-basket prices in part do not affect researched sustainable development indicators.

Effectiveness of Educational Interventions for Health Workers on Antibiotic Prescribing in Outpatient Settings in China: A Systematic Review and Meta-Analysis

Educational interventions are considered an important component of antibiotic stewardship, but their effect has not been systematically evaluated in outpatient settings in China. This research aims to evaluate the effectiveness of educational interventions for health workers on antibiotic prescribing rates in Chinese outpatient settings. Eight databases were searched for relevant randomized clinical trials, non-randomized trials, controlled before–after studies and interrupted time-series studies from January 2001 to July 2021. A total of 16 studies were included in the systematic review and 12 in the meta-analysis. The results showed that educational interventions overall reduced the antibiotic prescription rate significantly (relative risk, RR 0.72, 95% confidence interval, CI 0.61 to 0.84). Subgroup analysis demonstrated that certain features of education interventions had a significant effect on antibiotic prescription rate reduction: (1) combined with compulsory administrative regulations (RR With: 0.65 vs. Without: 0.78); (2) combined with financial incentives (RR With: 0.51 vs. Without: 0.77). Educational interventions can also significantly reduce antibiotic injection rates (RR 0.83, 95% CI 0.74 to 0.94) and the inappropriate use of antibiotics (RR 0.61, 95% CI 0.51 to 0.73). The limited number of high-quality studies limits the validity and reliability of the results. More high-quality educational interventions targeting the reduction of antibiotic prescribing rates are needed.

Pilot Testing a Series of Value-Based Care Training Courses

PURPOSE

The US healthcare system currently emphasizes volume of services over value. To facilitate changing to a value-based care model, one managed care organization developed a series of online courses designed to teach clinicians value-based care principles and practices. A pilot test was conducted to obtain feedback regarding course content and design, so the courses could be revised prior to their launch.

PATIENTS AND METHODS

A representative cross section of the courses' target audience (n = 50) was recruited to participate in the pilot test, and data were collected through an online survey. Descriptive statistics were calculated for responses to close-ended survey questions, and affinity analysis was performed on responses to open-ended survey questions. Issues identified were then categorized as urgent/not urgent with respect to course revision.

RESULTS

Nearly a quarter (24%) of respondents indicated that the course contained incorrect or misleading information. Other responses noted inconsistencies in course content, eg, misspelled or mispronounced words, slides that were hard to read, etc.

CONCLUSION

This study demonstrates how a pilot test was used as part of a formative assessment to improve course content and design. During a pilot test, attention should be paid to making it easy for participants to provide feedback.

Concordance of the cardiovascular patient education with the principles of Andragogy model

Background

Patient education is a critical aspect of patient care and is considered a vital part of self-care (especially in patients with cardiovascular disease (CVD)) and health promotion. The literature supports incorporating the principles of the andragogy model (adult learning) into patient education. This study aimed to determine the concordance of the CVD patient education with the principles of the andragogy model.

Methods

This cross-sectional survey was conducted on 384 adult CVD patients from 2 selected hospitals of Tehran. The sampling method was convenient, and the data collection tool was a researcher-made questionnaire based on the principles of the andragogy model. Data were analyzed using SPSS16 statistical software.

Results

The mean age of the patients was 55.69 ± 13.01 years old. Frequency of distribution of the patients who, in total, selected the items of 4 or 5 for respecting the principles of andragogy model was as follows: 68.16% for the motivation, 66.29% for the need, 66.03% for the orientation, 54.16% for the experiences, 51.55% for the self-concept, and 44.65% for the readiness principle.

Also, three principles of motivation (77.37) need (74.97), and orientation (74.78) had the highest mean, respectively, in terms of adhering to this model. But the most common problems in patient education were related to the principles of readiness (64.35), self-concept (68.19), and experiences (77.71) with the lowest mean.

Conclusions

The findings of this study provided valuable information on the flaws in patient education, including ignoring and disrespecting the principles of adult education. Correcting these detected defects and providing feedback to health professionals can improve the quality of patient education programs and patient satisfaction. Also, it empowers healthcare providers, patients, and families through effective education strategies.

Evaluating knowledge retention and perceived benefits of medical webinar for professional development among Indonesian physicians

PURPOSE

To assess knowledge retention of physicians after participating in a webinar series and its perceived benefits on daily practice and career development.

METHODS

The webinar series comprised six separate webinars about daily practice. Online questionnaires were sent to all participating physicians via email 3 months after the webinars. The questionnaire assessed knowledge retention through the difference between initial and follow-up post-test as well as the webinar series' benefits on daily practice and career development. Participants' demographic information, including their age, gender, education, year of graduation, and work details, were collected to compare outcomes between demographic groups.

RESULTS

A total of 689 responses were gathered, and 622 were analyzed. At follow-up, the median knowledge score was significantly lower than the initial median knowledge score (Z=-6.973, p<0.001). Participants' perception of the webinar series' benefits on daily practice and career development was very positive. A significant weak negative correlation was found between age and knowledge score at follow-up (rs=-0.157, p<0.001). Physicians who graduated more recently and worked for less than 3 years scored significantly higher on knowledge tests at follow-up. Meanwhile, perception score towards webinar series' benefits on daily practice was significantly higher among physicians with more extended work history. Male physicians scored significantly higher on perception score towards webinar series' benefits on career development.

CONCLUSION

Online continuing medical education programs like webinars can encourage physicians to maintain their competence, but further research on improving knowledge retention over time is necessary. Overall, physicians perceived webinars to be beneficial for their professional development.

Assessment of pharmacists' perception toward continuing education

Continuing education (CE) is a structured educational activity. Pharmacists must actively participate in CE and is an important part of developing the professional competency of pharmacists. This research focuses on measuring Saudi pharmacists' perception in CE, its impact on professional performance, and the barriers in CE. This was a cross-sectional study, conducted in 2020, using random sample of Saudi pharmacists working in all workplaces from different cities in Saudi Arabia using a questionnaire. The questionnaire consists of 15 questions that assess the perception of Saudi pharmacists toward CE and barriers that prevent them from CE. A total of 409 pharmacists participated in the study. Majority of pharmacists were working in government hospitals (48.4%) and have <2 years of practice experience (44.5%). More than 70% of respondents acknowledged that CE helps to increase their knowledge. The pharmacists mentioned that getting a certificate (23.37%) was the major reason for attending a CE event. The reasons that prevent respondents from attending live CE were cost and work responsibilities (23.59% and 24.57%, respectively). This study reported a subjective assessment of pharmacists' perception toward CE, their lifelong learning experience. Saudi pharmacists showed a great desire for CE because they believed that it greatly affects their professional performance.

Assessment of Entrustable Professional Activities Using a Web-Based Simulation Platform During Transition to Emergency Medicine Residency: Mixed Methods Pilot Study

BACKGROUND

The 13 core entrustable professional activities (EPAs) are key competency-based learning outcomes in the transition from undergraduate to graduate medical education in the United States. Five of these EPAs (EPA2: prioritizing differentials, EPA3: recommending and interpreting tests, EPA4: entering orders and prescriptions, EPA5: documenting clinical encounters, and EPA10: recognizing urgent and emergent conditions) are uniquely suited for web-based assessment.

OBJECTIVE

In this pilot study, we created cases on a web-based simulation platform for the diagnostic assessment of these EPAs and examined the feasibility and acceptability of the platform.

METHODS

Four simulation cases underwent 3 rounds of consensus panels and pilot testing. Incoming emergency medicine interns (N=15) completed all cases. A maximum of 4 "look for" statements, which encompassed specific EPAs, were generated for each participant: (1) performing harmful or missing actions, (2) narrowing differential or wrong final diagnosis, (3) errors in documentation, and (4) lack of recognition and stabilization of urgent diagnoses. Finally, we interviewed a sample of interns (n=5) and residency leadership (n=5) and analyzed the responses using thematic analysis.

RESULTS

All participants had at least one missing critical action, and 40% (6/15) of the participants performed at least one harmful action across all 4 cases. The final diagnosis was not included in the differential diagnosis in more than half of the assessments (8/15, 54%). Other errors included selecting incorrect documentation passages (6/15, 40%) and indiscriminately applying oxygen (9/15, 60%). The interview themes included psychological safety of the interface, ability to assess learning, and fidelity of cases. The most valuable feature cited was the ability to place orders in a realistic electronic medical record interface.

CONCLUSIONS

This study demonstrates the feasibility and acceptability of a web-based platform for diagnostic assessment of specific EPAs. The approach rapidly identifies potential areas of concern for incoming interns using an asynchronous format, provides feedback in a manner appreciated by residency leadership, and informs individualized learning plans.

Flipping a Single Lecture in a Survey Course to Active Learning: Do the Benefits Justify the Costs?

Health education has seen a surge of interest in active learning strategies like the flipped classroom. In response to the need for physical distancing in the age of COVID-19, schools are rapidly shifting to web-based and video technology, sometimes without being able to predict the outcomes of this change. The objectives of this pilot experiment were to (1) compare active learning (AL) methods versus traditional lecture for transmitting and retaining knowledge in the introductory pre-clinical medical school curriculum and (2) weigh whether the costs required to flip instruction were justified by learning gains. The authors took a 2 h lecture for first-year medical students and converted half of it into an AL format. In-person lecture and active learning groups were compared in terms of student knowledge at pre-intervention, immediately post-intervention, and 6 months post-intervention. Costs for first-time delivery and anticipated costs for repeat delivery of each format were calculated. Students’ gains in knowledge increased in both groups, though more by lecture (control) than via AL. Delivering a single hour of new AL costs 3.4 times that of a new lecture. Repeat offerings of the AL intervention were estimated to cost 5.4 times that of the repeat lecture. The 1 h AL session was less effective than the 1 h lecture for knowledge acquisition and retention at 6-month follow-up. The AL was more expensive to produce and to repeat. Future research needs to evaluate the impact of AL with a larger N, control group, structured faculty/resident procedures, and assessment of gaining and applying attitudes and skills in addition to knowledge.

Management of Dyslipidaemia in Real-world Clinical Practice: Rationale and Design of the VIPFARMA ISCP Project

Dyslipidaemia plays a major role in the pathogenesis of atherosclerosis. Every year, scientific institutions publish cardiovascular prevention guidelines with updated goals and recommendations based on new evidence. However, medical barriers exist that make achieving these goals difficult and gaps between guidelines and best daily clinical practice still persist. The International Society of Cardiovascular Pharmacotherapy designed the Surveillance of Prescription Drugs in the Real World Project (VIPFARMA ISCP), a survey for physicians who manage lipid disorders in high-risk patients. Seven clusters of questions will be analysed comprising demographics, institution profile, access to continuing medical education, clinical practice profile, attitude regarding use of statins, knowledge regarding proprotein convertase subtilisin/kexin type 9 inhibitors and attitudes regarding medical decisions about triglycerides. The present study will be the first part of a larger programme and aims to shed light on barriers between lipid-lowering drug therapy recommendations in the 2019 European Society of Cardiology guidelines and clinical practice in different countries.

Structure-based virtual screening of bioactive compounds from Indonesian medical plants against severe acute respiratory syndrome coronavirus-2

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a virus that causes the infectious disease coronavirus disease-2019. Currently, there is no effective drug for the prevention and treatment of this virus. This study aimed to identify secondary metabolites that potentially inhibit the key proteins of SARS-CoV-2. This was an in silico molecular docking study of several secondary metabolites of Indonesian herbal plant compounds and other metabolites with antiviral testing history. Virtual screening using AutoDock Vina of 216 Lipinski rule-compliant plant metabolites was performed on 3C-like protease (3CL^pro), RNA-dependent RNA polymerase (RdRp), and spike glycoprotein. Ligand preparation was performed using JChem and Schrödinger's software, and virtual protein elucidation was performed using AutoDockTools version 1.5.6. Virtual screening identified several RdRp, spike, and 3CL^pro inhibitors. Justicidin D had binding affinities of −8.7, −8.1, and −7.6 kcal mol⁻¹ on RdRp, 3CL^pro, and spike, respectively. 10-methoxycamptothecin had binding affinities of −8.5 and −8.2 kcal mol⁻¹ on RdRp and spike, respectively. Inoxanthone had binding affinities of −8.3 and −8.1 kcal mol⁻¹ on RdRp and spike, respectively, while binding affinities of caribine were −9.0 and −7.5 mol⁻¹ on 3CL^pro and spike, respectively. Secondary metabolites of compounds from several plants were identified as potential agents for SARS-CoV-2 therapy.

A Comprehensive Understanding of the Use of e-Learning in Continuing Education: Experiences of Pharmacists in a Public Health System

INTRODUCTION

The health and education sectors have experienced rapid technological development. In this scenario, the use of Internet technology has grown as an option for the expansion of continuing education (CE), as it allows professionals to develop educational activities with flexibility, autonomy, and convenience. E-learning has gained popularity and currently, thousands of online courses are being offered. However, studies of e-learning in professional training have presented only a few specific foci of study.

OBJECTIVE

to develop a comprehensive approach to understand both the experience and the complex scenario of the use of e-learning in the CE for pharmacists.

METHOD

Field research in 10 Brazilian states through interviews and focus groups with alumni of a CE e-learning specialization course for pharmacists in public health. Data analysis used the model of socio-technical systems and was based on a framework with the components Objectives, People, Processes, Culture, Technology, Infrastructure, and Scenario.

RESULTS

The People and Culture components indicated the assimilation and normalization of technologies in the educational process. Although the infrastructure (technical and organizational) was deficient in some regions, the Technology component suggested that the characteristics of the course design, associated with the personal characteristics of the students, provided ways to overcome obstacles. The objectives of the use of distance education seem to be related to the possibility of greater accessibility and autonomy. The Processes component, in turn, revealed the burden that a e-learning course puts on the pharmacist.

CONCLUSION

E-learning proved to be useful to enable and expand access to education, providing pharmacists with an opportunity for CE. On the other hand, e-learning contributes to the normalization of the precarious working conditions of pharmacists, attributing to individuals the sole responsibility for the CE even in an institutional CE program, which results in work overload.

Psychological Impact of COVID-19 Emergency on Health Professionals: Burnout Incidence at the Most Critical Period in Spain

BACKGROUND

The health profession is a burnout producer due to the continuous contact with pain and suffering. In addition, excessive workloads can generate stress and psychological distress.

OBJECTIVES

The aim of this study was to determine the degree of burnout and its main triggers in health professionals in Spain at the most critical period of the COVID-19 emergency.

METHOD

A quantitative research was developed through a simple random sampling in different Spanish hospitals through the period of greatest impact of the pandemic (N = 157). Data were collected using a standardized questionnaire from Maslach burnout inventory (MBI) containing 22 items, which measures three subscales: emotional burnout, depersonalization, and self-fulfillment.

RESULTS

depersonalization values reached 38.9%. A total of 90.4% of the health professionals considered that psychological care should be provided from the work centers. Furthermore, 43.3% of the health professionals estimated that they might need psychological treatment in the future. Finally, 85.4% stated that the lack of personal protective equipment (PPE) generated an increase in stress and anxiety.

CONCLUSION

This study demonstrates the need to consider specific mental health care services and training in crises to avoid possible psychological disorders. The information obtained is also valuable for the development of future prevention protocols and training of health personnel to face pandemics of these characteristics or emergency scenarios. Having the necessary physical means for their protection, as well to updated regular and accurate information, is essential to avoid feelings of fear and uncertainty. This would promote the health of these professionals.

Impact of COVID-19 on medical education: introducing homo digitalis

Purpose

To determine how members of the Société Internationale d’Urologie (SIU) are continuing their education in the time of COVID-19.

Methods

A survey was disseminated amongst SIU members worldwide by email. Results were analyzed to examine the influence of age, practice region and settings on continuing medical education (CME) of the respondents.

Results

In total, 2494 respondents completed the survey. Internet searching was the most common method of CME (76%; all ps < 0.001), followed by searching journals and textbook including the online versions (62%; all ps < 0.001). Overall, 6% of the respondents reported no time/interest for CME during the pandemic. Although most urologists report using only one platform for their CME (26.6%), the majority reported using ≥ 2 platforms, with approximately 10% of the respondents using up to 5 different platforms. Urologists < 40 years old were more likely to use online literature (69%), podcasts/AV media (38%), online CME courses/webinars (40%), and social media (39%). There were regional variations in the CME modality used but no significant difference in the number of methods by region. There was no significant difference in responses between urologists in academic/public hospitals or private practice.

Conclusion

During COVID-19, urologists have used web-based learning for their CME. Internet learning and literature were the top frequently cited learning methods. Younger urologists are more likely to use all forms of digital learning methods, while older urologists prefer fewer methods.

Perceptions of Digital Health Education Among European Medical Students: Mixed Methods Survey

BACKGROUND

Digital health technologies hold promise to enhance patient-related outcomes, to support health care staff by reducing their workload, and to improve the coordination of care. As key users of digital health technologies, health care workers are crucial to enable a meaningful digital transformation of health care. Digital health literacy and digital skills should become prerequisite competencies for health professionals to facilitate the implementation and leverage the potential of digital technologies to improve health.

OBJECTIVE

We aimed to assess European medical students' perceived knowledge and opinions toward digital health, the status of digital health implementation in medical education, and the students' most pressing needs.

METHODS

The explanatory design of our mixed methods study was based on an online, anonymous, self-administered survey targeted toward European medical students. A linear regression analysis was used to identify the influence of the year of medical studies on the responses. Additional analysis was performed by grouping the responses by the self-evaluated frequency of eHealth technology use. Written responses to four qualitative questions in the survey were analyzed using an inductive approach.

RESULTS

The survey received a total of 451 responses from 39 European countries, and there were respondents for every year of medical studies. The majority of respondents saw advantages in the use of digital health. While 40.6% (183/451) felt prepared to work in a digitized health care system, more than half (240/451, 53.2%) evaluated their eHealth skills as poor or very poor. Medical students considered lack of education to be the reason for this, with 84.9% (383/451) agreeing or strongly agreeing that more digital health education should be implemented in the medical curriculum. Students demanded introductory and specific eHealth courses covering data management, ethical aspects, legal frameworks, research and entrepreneurial opportunities, role in public health and health systems, communication skills, and practical training. The emphasis lay on tailoring learning to future job requirements and interprofessional education.

CONCLUSIONS

This study shows a lack of digital health-related formats in medical education and a perceived lack of digital health literacy among European medical students. Our findings indicate a gap between the willingness of medical students to take an active role by becoming key players in the digital transformation of health care and the education that they receive through their faculties.