Predictability of Clinical Knowledge Through Mobile App-based Simulation for the Treatment of Pediatric Septic Arthritis: A Pilot Study

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.

Ponseti Clubfoot Casting: Factors That Affect Trainee Competency (Retrospective Observational Study)

Introduction:

This study investigates how previous simulation training and clinical experience affects trainee performance when manipulating a foot, applying a Ponseti clubfoot cast, and performing an Achilles tenotomy on a clubfoot simulator.

Methods:

Sixty-four Accreditation Council for Graduate Medical Education orthopaedic trainees participated in the 2017 to 2018 Top Gun (TG) skills competition at the International Pediatric Orthopaedic Symposium. Trainees were judged by expert pediatric orthopaedic surgeons on how they manipulated a clubfoot model, applied a cast, and performed a simulated tendoachilles tenotomy (TAT). An analysis was done to correlate the test variables with a contestant's TG Ponseti score.

Results:

Twenty-one contestants with previous residency training using synthetic clubfoot models scored higher (P = 0.007) than those trainees without training. Trainees who had applied >10 clubfoot casts and who participated in >10 TATs in training also scored higher (P = 0.038 and P = 0.01, respectively). Thirteen contestants who had previously attended an International Pediatric Orthopaedic Symposium meeting and seven contestants who attended a American Academy of Orthopaedic Surgery clubfoot workshop scored higher (P = 0.012 and P = 0.017 respectively).

Discussion:

Clinical and previous simulation experience related to the Ponseti method correlated with improved performance on our Ponseti simulation. Trainees who had previous experience with >10 clubfoot casts and >10 TATs scored higher during TG than less experienced trainees.

A Systematic Review of Educational Mobile-Applications (Apps) for Surgery Residents: Simulation and Beyond

INTRODUCTION

The number of mobile-applications (Apps) increases daily. The regulation of App content is minimal yet surgical residents use these in daily educational practice. Surgical educators must be aware of the quality, efficacy, and validity of Apps available to effectively educate residents. The aim of this review was to determine the quality, efficacy, and validity evidence for educational Apps used by surgical residents.

MATERIALS AND METHODS

We searched PubMed, Embase, and ERIC for articles published before September 1, 2019. Controlled vocabulary and natural language describing Apps/surgical residents were used. Two reviewers evaluated abstracts for inclusion.

INCLUSION CRITERIA

studies measuring the quality, efficacy, or validity of educational Apps for surgical residents. Data was extracted from full text of included articles: study design, participants, App investigated, App development, evidence for efficacy, or validity of App.

RESULTS

Initial search identified 278 articles. 64 articles were duplicates and 214 articles were screened. A further 156 were excluded with 58 full text articles assessed for eligibility. Forty-five were included in analysis. Simulation (9/45) and Feedback (15/45) Apps were the most commonly studied in surgical residents. These were the main Apps that provided validity evidence for their use in education.

CONCLUSION

Surgical education is evolving as educational technology becomes more prevalent. To be effective as surgical educators we must understand and appropriately use available tools. Of the educational Apps studied (21 Apps in 8 categories), only 3 categories reported validity evidence. Future studies should take care to measure validity and efficacy of educational Apps for surgical education to ensure quality control.