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Prashar J, Ranasinghe C, Rao CB. Twelve tips for medical students to enhance clinical skills learning during disrupted placements. MEDICAL TEACHER 2022; 44:596-600. [PMID: 33856946 DOI: 10.1080/0142159x.2021.1910644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Disruption to healthcare settings can present a significant challenge to traditional, face-to-face models of learning in medical education. Reductions in undergraduate medical students' clinical exposure, whether due to periods of increased healthcare demand, localised service changes or infectious disease outbreaks, are likely to result in fewer opportunities to develop key clinical and practical skills. Proficiency in these skills is often essential to progression and future practice, creating a broad incentive for students to develop techniques to maintain and refine their clinical skills during disrupted placements. These tips, based on our experiences as senior medical students, are intended to help students on disrupted placements to engage in reflective practice, discover ways to facilitate further opportunities for clinical skills learning, and to make the most of clinical skills learning opportunities that they do receive.
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Affiliation(s)
- Jai Prashar
- UCL Medical School, University College London, London, UK
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Quyam S, Abumehdi M. An Interpretive Phenomenological Analysis of paediatric cardiology trainee experiences during COVID-19. MEDICAL EDUCATION 2022; 56:527-534. [PMID: 35088419 DOI: 10.1111/medu.14738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
CONTEXT Medical training during the COVID-19 pandemic has placed extra-ordinary demands on individuals within a context of rapid and iterative systems changes. The contemporaneous lived experience of trainees during this time has mainly been examined with surveys. Our study aims to provide a rich account of the experience of being a trainee during the pandemic to deepen our conceptual understanding of wellness. This holds relevance as we move away from examining the immediate innovations of the pandemic and towards long-term adjustments. METHODS We used Interpretative Phenomenological Analysis (IPA) to explore the experiences of trainees in paediatric cardiology during the pandemic. Five trainees were purposively recruited. Initial semi-structured interviews were held during the first wave of the pandemic with follow-up interviews held during the second wave. RESULTS Three superordinate paradoxical themes were recognised in the data: connectedness and isolation, disruption and stasis and vulnerability and strength. DISCUSSION Disruption to routine activities of service delivery, training and home-life pervaded the pandemic and was experienced as stasis. Technology maintained the trainee's connection to the content of work but left them feeling isolated from its context. Vulnerability arose from interplay between illness, uncertainty and perception of risk, contrasted against strength drawn from compassion and the discovery of resilience. Supporting trainees as we emerge from the initial phase of the pandemic requires us to review how we understand and address wellness, including the contribution of organisational and systemic factors to its protection. Participants described varying states of impaired wellness and experienced a normalisation of aspects of vulnerability. We theorise that trainees were able to find opportunities for growth and the development of resilience within the space that this created.
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Affiliation(s)
- Sadia Quyam
- Pulmonary Hypertension Service for Children, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Mohammad Abumehdi
- The Heart Unit, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK
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Alexander NL, Sheu JC, Villagran AM, Guerrini CJ, Storch EA. Impact of the Texas-Wide Premedical Mentoring Program during the COVID-19 pandemic. Proc AMIA Symp 2022; 35:35-42. [PMID: 34970029 DOI: 10.1080/08998280.2021.1980357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The COVID-19 pandemic disrupted the usual processes and support systems related to applying to medical school in the United States. The Texas-Wide Premedical Mentoring Program (TPMP) was established to pair medical student mentors in Texas with medical school applicants attending Texas colleges and universities. Our objective was to demonstrate the effect of the TPMP on application preparedness and self-reported mental health outcomes of program participants. A survey was developed to understand the program's impact on both mentees and mentors. Participants were sent a survey link 3 months after the TPMP launch. In total, 313 participants, comprising 62% premedical student mentees and 38% medical student mentors, completed the survey. Mentees reported a significantly positive effect of the program on anxiety, uncertainty of acceptance, connection to medicine, and making the road to medical school seem less impossible. After participation, mentees felt less alone and reported a positive impact on their perception of the application process. The TPMP positively impacted the mental wellness of both mentees and mentors, and about 80% of mentors felt more fulfilled despite not participating in clinical duties in light of suspensions. In conclusion, program participation was associated with decreasing application knowledge gaps, easing anxiety, and providing alliance for mentees. The TPMP had a similarly positive influence on the mental wellness of mentees and mentors as well as contributed to medical student mentors' sense of fulfillment.
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Affiliation(s)
| | | | | | - Christi J Guerrini
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
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Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on medical educational curricula. We aimed to examine the impact of these unprecedented changes on the formal education of paediatric cardiology fellows through a nationwide survey. A REDCap™-based voluntary anonymous survey was sent to all current paediatric cardiology fellows in the United States of America in May, 2020. Of 143 respondents, 121 were categorical fellows, representing over one-fourth of all categorical paediatric cardiology fellows in the United States of America. Nearly all (140/143, 97.9%) respondents utilised online learning during the pandemic, with 134 (93.7%) reporting an increase in use compared to pre-pandemic. The percentage of respondents reporting curriculum supplementation with outside lectures increased from 11.9 to 88.8% during the pandemic. Respondents considered online learning to be "equally or more effective" than in-person lectures in convenience (133/142, 93.7%), improving fellow attendance (132/142, 93.0%), improving non-fellow attendance (126/143, 88.1%), and meeting individual learning needs (101/143, 70.6%). The pandemic positively affected the lecture curriculum of 83 respondents (58.0%), with 35 (24.5%) reporting no change and 25 (17.5%) reporting a negative effect. A positive effect was most noted by those whose programmes utilised supplemental outside lectures (62.2 versus 25.0%, p = 0.004) and those whose lecture frequency did not decrease (65.1 versus 5.9%, p < 0.001). Restrictions imposed by the COVID-19 pandemic have greatly increased utilisation of online learning platforms by medical training programmes. This survey reveals that an online lecture curriculum, despite inherent obstacles, offers advantages that may mitigate some negative consequences of the pandemic on fellowship education.
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Akinkugbe AA, Garcia DT, Smith CS, Brickhouse TH, Mosavel M. A descriptive pilot study of the immediate impacts of COVID-19 on dental and dental hygiene students' readiness and wellness. J Dent Educ 2021; 85:401-410. [PMID: 33084054 PMCID: PMC8043566 DOI: 10.1002/jdd.12456] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/21/2020] [Accepted: 10/06/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND The ongoing novel coronavirus disease 2019 (COVID-19) pandemic has impacted dental students training across the U.S. academic dental institutions by moving classroom instruction to an online modality, limiting patient care, canceling external rotations, and rescheduling of licensure examinations. OBJECTIVE The aim of this study was to assess the immediate impacts of COVID-19 on students' readiness to enter clinical practice or residency and its association with well-being (anxiety, perceived stress, coping and social support, and resilience). METHODS An online REDCap survey was distributed to 407 D1-D4 year dental students and 29 DH3-DH4 year dental hygiene students enrolled at a U.S. dental school. The survey consisted of readiness and wellness measures as well as socio-demographic variables. RESULTS Overall response rate was 58% (N = 252) ranging from 40% among D4 students to 72% among D1 students. About half (55%) of the respondents were White, a third (34%) Asians and 5% were African Americans. Ninety-two percent were non-Hispanics while 62% were female. Overall mean (SD) anxiety score was 6.5 (5.3) and 26% of respondents reported moderate or severe levels of anxiety. Anxiety score differed significantly by gender with females reporting higher anxiety levels, mean (SD) = 7.3 (5.5) versus 5.2 (4.7) for males; P = 0.002). Furthermore, mean anxiety score differed significantly among the dental school classes, ranging from 5.5 (5.3) among D2 students to 11.8 (6.2) in DH4 students (P = 0.02). CONCLUSION Academic dental institutions need to be responsive to the heightened anxiety and uncertainly levels of students and provide responsive training and support to mitigate its effects.
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Affiliation(s)
- Aderonke A. Akinkugbe
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, VA
- Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA
| | - Dina T. Garcia
- Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA
- Department of Health Behavior and Policy, School of Medicine. Virginia Commonwealth University, Richmond, VA
| | - Carlos S. Smith
- Director, Ethics Curriculum & Director, Pre-Doctoral Practice Group, Department of General Practice, Virginia Commonwealth University School of Dentistry
| | - Tegwyn H. Brickhouse
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, VA
- Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA
| | - Maghboeba Mosavel
- Department of Health Behavior and Policy, School of Medicine. Virginia Commonwealth University, Richmond, VA
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Schaffir J, Strafford K, Worly B, Traugott A. Challenges to Medical Education on Surgical Services During the COVID-19 Pandemic. MEDICAL SCIENCE EDUCATOR 2020; 30:1667-1671. [PMID: 32904384 PMCID: PMC7455508 DOI: 10.1007/s40670-020-01072-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Jonathan Schaffir
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 West 12th Avenue, 5th floor, Columbus, OH USA
| | - Katherine Strafford
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 West 12th Avenue, 5th floor, Columbus, OH USA
| | - Brett Worly
- Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, 395 West 12th Avenue, 5th floor, Columbus, OH USA
| | - Amber Traugott
- Department of Surgery, The Ohio State University College of Medicine, 395 West 12th Avenue, 6th floor, Columbus, OH USA
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The AJM, Adam L, Meldrum A, Brunton P. Dental students' and staff perceptions of the impact of learning environment disruption on their learning and teaching experiences. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22:151-159. [PMID: 28985011 DOI: 10.1111/eje.12293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/04/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION This project is a qualitative investigation into student and staff experiences of the effect of a major building redevelopment on their Dental School learning and teaching environments. Currently, there is little research exploring the impact of disruptions to the learning environment on students' learning and staff teaching experiences. METHOD Data were collected in 2016 using an online survey, semi-structured interviews and focus groups with students and staff. Data were analysed using a general inductive approach. RESULTS Four broad themes emerged as follows: (i) students valued having a space for personal and collaborative work within the Dental School; (ii) both staff and students positioned staff contributions to learning experiences above the role of the physical learning environment; (iii) the majority of staff and students not feel that the physical environment limited their clinical training; and (iv) staff and students were able to adapt to the impact of building redevelopment through resilience and organisation. DISCUSSION Results of this research have informed the provision of collegial spaces at the School, both as the building redevelopment continues, and in planning for the completed building.
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Affiliation(s)
- A J M The
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - L Adam
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - A Meldrum
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - P Brunton
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Trip H, Tabakakis K, Maskill V, Richardson S, Dolan B, Josland H, McKay L, Richardson A, Cowan L, Hickmott B, Houston G. Psychological health and resilience: the impact of significant earthquake events on tertiary level professional students. A cross-sectional study. Contemp Nurse 2018; 54:319-332. [PMID: 30045677 DOI: 10.1080/10376178.2018.1503549] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND The effect of natural disasters internationally is linked to intensity and duration and the impact of these events for tertiary level professional students is not clearly understood. Following a 7.1 magnitude earthquake in New Zealand in 2010 (with aftershocks lasting 27 months) a number of tertiary nursing students experienced significant disruption to their studies. AIM To compare the psychological health, resilience and the impact on learning for three cohorts of students engaged in tertiary nursing education during this time. METHOD A cross-sectional survey design and convenience sampling was used for three cohorts of learners. An online survey was completed (n = 290) and included: Depression Anxiety and Stress Scale; PTSD Checklist; Work and Social Adjustment Scale; Connor-Davidson Resilience Scale. RESULTS Statistically significant differences were found across the psychometric scales with regard to relationship status. Whilst an increase in self-reported physical and mental health issues prior to and following the earthquakes were noted, mitigating factors were also identified. CONCLUSIONS In order to support psychological health amongst nursing students, tertiary education systems need to plan for sustainable learning. The importance of facilitating future orientation within organisations is necessary to develop resilience amongst staff and students, which, in turn, will enable on-going education during significant disaster events.
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Affiliation(s)
- Henrietta Trip
- a Centre for Postgraduate Nursing Studies , University of Otago , P O Box 4345, Christchurch 8140 , New Zealand
| | - Kosta Tabakakis
- b Research and Enterprise , University of Otago , P O Box 4345, Christchurch 8140 , New Zealand
| | - Virginia Maskill
- a Centre for Postgraduate Nursing Studies , University of Otago , P O Box 4345, Christchurch 8140 , New Zealand
| | - Sandra Richardson
- a Centre for Postgraduate Nursing Studies , University of Otago , P O Box 4345, Christchurch 8140 , New Zealand.,c Emergency Department , Canterbury District Health Board (CDHB) , Private Bag 4710, Christchurch 8140 , New Zealand
| | - Brian Dolan
- d Service Improvement, CDHB , Private Bag 4710, Christchurch 8140 , New Zealand.,e Health Service 360 , Oak Tree House, Farnell Drive, Stratford Upon Avon , CV37 9DJ , United Kingdom.,f Oxford Institute of Nursing, Midwifery and Allied Health Research , Oxford Brookes University, & University of Salford , Maxwell Building, 43 Crescent, Salford M5 4WT , United Kingdom
| | - Heather Josland
- g Department of Nursing, Midwifery & Allied Health , Ara Institute of Canterbury , 130 Madras Street, P O Box 540, Christchurch 8140 , New Zealand
| | - Lisa McKay
- g Department of Nursing, Midwifery & Allied Health , Ara Institute of Canterbury , 130 Madras Street, P O Box 540, Christchurch 8140 , New Zealand
| | - Anna Richardson
- g Department of Nursing, Midwifery & Allied Health , Ara Institute of Canterbury , 130 Madras Street, P O Box 540, Christchurch 8140 , New Zealand
| | - Lois Cowan
- g Department of Nursing, Midwifery & Allied Health , Ara Institute of Canterbury , 130 Madras Street, P O Box 540, Christchurch 8140 , New Zealand
| | - Becky Hickmott
- h Workforce Development, CDHB , 32 Oxford Terrace, Christchurch 8140 , New Zealand
| | - Gail Houston
- i Specialist Mental Health Service, Hillmorton Hospital , Private Bag 4733, CDHB, Christchurch 8140 , New Zealand
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Myhre D, Bajaj S, Fehr L, Kapusta M, Woodley K, Nagji A. Precepting at the time of a natural disaster. CLINICAL TEACHER 2016; 14:104-107. [PMID: 26990586 DOI: 10.1111/tct.12523] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Natural disasters strike communities that have varied degrees of preparedness, both physical and psychological. Rural communities may be particularly vulnerable as they often do not have the infrastructure or resources to prepare in advance. The psychological impact of a natural disaster is amplified in learners who may be temporary members of the community and therefore cannot draw on personal support during the crisis. They may turn to their clinical preceptors for guidance. CONTEXT The Slave Lake fire (population 6782) in May 2011 and the High River flood (population 12 920) in June 2013 are examples of natural disasters that have occurred in rural Alberta, Canada. At the time of these critical incidents, three medical students and one family medicine resident from the two provincial medical schools were participating in rotations in these communities. INNOVATION Although disasters occur rarely, there is a need for guidelines for preceptors from the learner perspective. Accordingly, using a modified Delphi approach, we captured the experiences of learners that were then refined into two themes, each containing three recommendations: considerations for action during a natural disaster and considerations for action after the acute crisis has passed. Although disasters occur rarely, there is a need for guidelines for preceptors from the learner perspective IMPLICATIONS: Our recommendations provide suggestions for practical solutions that build on the usual expectations of mentors and may benefit the student-teacher relationship at the time of a disaster and beyond. They are meant to initiate discussion regarding further study aimed towards creating recommendations for preceptor response that may cross disciplines.
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Affiliation(s)
- Douglas Myhre
- Distributed Learning and Rural Initiatives, Cumming School of Medicine, University of Calgary, Canada
| | - Sameer Bajaj
- Distributed Learning and Rural Initiatives, Cumming School of Medicine, University of Calgary, Canada
| | - Lana Fehr
- Department of Family Medicine, University of Calgary, Canada
| | - Mike Kapusta
- Department of Family Medicine, University of Calgary, Canada
| | | | - Alim Nagji
- Department of Emergency Medicine, University of Alberta, Canada
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Wilkinson TJ, McKenzie JM, Ali AN, Rudland J, Carter FA, Bell CJ. Identifying medical students at risk of underperformance from significant stressors. BMC MEDICAL EDUCATION 2016; 16:43. [PMID: 26837428 PMCID: PMC4739335 DOI: 10.1186/s12909-016-0565-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 01/26/2016] [Indexed: 05/12/2023]
Abstract
BACKGROUND Stress is associated with poorer academic performance but identifying vulnerable students is less clear. A series of earthquakes and disrupted learning environments created an opportunity to explore the relationships among stress, student factors, support and academic performance within a medical course. METHODS The outcomes were deviations from expected performances on end of year written and clinical examinations. The predictors were questionnaire-based measures of connectedness/support, impact of the earthquakes, safety, depression, anxiety, stress, resilience and personality. RESULTS The response rate was 77%. Poorer than expected performance on all examinations was associated with greater disruptions to living arrangements and fewer years in the country; on the written examination with not having a place to study; and on the clinical examination with relationship status, not having the support of others, less extroversion, and feeling less safe. There was a suggestion of a beneficial association with some markers of stress. CONCLUSION We show that academic performance is assisted by students having a secure physical and emotional base. The students who are most vulnerable are those with fewer social networks, and those who are recent immigrants.
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MESH Headings
- Alcohol Drinking/epidemiology
- Disasters
- Earthquakes
- Education, Medical, Undergraduate/methods
- Education, Medical, Undergraduate/organization & administration
- Education, Medical, Undergraduate/standards
- Educational Measurement/methods
- Educational Measurement/statistics & numerical data
- Humans
- Marital Status
- Multivariate Analysis
- New Zealand/epidemiology
- Protective Factors
- Residence Characteristics
- Resilience, Psychological
- Risk Factors
- Social Support
- Stress Disorders, Post-Traumatic/diagnosis
- Stress Disorders, Post-Traumatic/epidemiology
- Stress Disorders, Post-Traumatic/etiology
- Stress Disorders, Post-Traumatic/psychology
- Students, Medical/psychology
- Surveys and Questionnaires
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Affiliation(s)
- Tim J Wilkinson
- University of Otago, Christchurch, P O Box 4345, Christchurch, 8140, New Zealand.
| | - Jan M McKenzie
- University of Otago, Christchurch, P O Box 4345, Christchurch, 8140, New Zealand
| | - Anthony N Ali
- University of Otago, Christchurch, P O Box 4345, Christchurch, 8140, New Zealand
| | - Joy Rudland
- University of Otago, Christchurch, P O Box 4345, Christchurch, 8140, New Zealand
| | - Frances A Carter
- University of Otago, Christchurch, P O Box 4345, Christchurch, 8140, New Zealand
| | - Caroline J Bell
- University of Otago, Christchurch, P O Box 4345, Christchurch, 8140, New Zealand
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Zhu E, Lilienthal A, Shluzas LA, Masiello I, Zary N. Design of Mobile Augmented Reality in Health Care Education: A Theory-Driven Framework. JMIR MEDICAL EDUCATION 2015; 1:e10. [PMID: 27731839 PMCID: PMC5041345 DOI: 10.2196/mededu.4443] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 08/24/2015] [Accepted: 08/24/2015] [Indexed: 05/23/2023]
Abstract
BACKGROUND Augmented reality (AR) is increasingly used across a range of subject areas in health care education as health care settings partner to bridge the gap between knowledge and practice. As the first contact with patients, general practitioners (GPs) are important in the battle against a global health threat, the spread of antibiotic resistance. AR has potential as a practical tool for GPs to combine learning and practice in the rational use of antibiotics. OBJECTIVE This paper was driven by learning theory to develop a mobile augmented reality education (MARE) design framework. The primary goal of the framework is to guide the development of AR educational apps. This study focuses on (1) identifying suitable learning theories for guiding the design of AR education apps, (2) integrating learning outcomes and learning theories to support health care education through AR, and (3) applying the design framework in the context of improving GPs' rational use of antibiotics. METHODS The design framework was first constructed with the conceptual framework analysis method. Data were collected from multidisciplinary publications and reference materials and were analyzed with directed content analysis to identify key concepts and their relationships. Then the design framework was applied to a health care educational challenge. RESULTS The proposed MARE framework consists of three hierarchical layers: the foundation, function, and outcome layers. Three learning theories-situated, experiential, and transformative learning-provide foundational support based on differing views of the relationships among learning, practice, and the environment. The function layer depends upon the learners' personal paradigms and indicates how health care learning could be achieved with MARE. The outcome layer analyzes different learning abilities, from knowledge to the practice level, to clarify learning objectives and expectations and to avoid teaching pitched at the wrong level. Suggestions for learning activities and the requirements of the learning environment form the foundation for AR to fill the gap between learning outcomes and medical learners' personal paradigms. With the design framework, the expected rational use of antibiotics by GPs is described and is easy to execute and evaluate. The comparison of specific expected abilities with the GP personal paradigm helps solidify the GP practical learning objectives and helps design the learning environment and activities. The learning environment and activities were supported by learning theories. CONCLUSIONS This paper describes a framework for guiding the design, development, and application of mobile AR for medical education in the health care setting. The framework is theory driven with an understanding of the characteristics of AR and specific medical disciplines toward helping medical education improve professional development from knowledge to practice. Future research will use the framework as a guide for developing AR apps in practice to validate and improve the design framework.
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Affiliation(s)
- Egui Zhu
- Centre for Learning and Knowledge, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
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