Educating the next generation of radiologists: a comparative report of ChatGPT and e-learning resources

Rapid technological advances have transformed medical education, particularly in radiology, which depends on advanced imaging and visual data. Traditional electronic learning (e-learning) platforms have long served as a cornerstone in radiology education, offering rich visual content, interactive sessions, and peer-reviewed materials. They excel in teaching intricate concepts and techniques that necessitate visual aids, such as image interpretation and procedural demonstrations. However, Chat Generative Pre-Trained Transformer (ChatGPT), an artificial intelligence (AI)-powered language model, has made its mark in radiology education. It can generate learning assessments, create lesson plans, act as a round-the-clock virtual tutor, enhance critical thinking, translate materials for broader accessibility, summarize vast amounts of information, and provide real-time feedback for any subject, including radiology. Concerns have arisen regarding ChatGPT's data accuracy, currency, and potential biases, especially in specialized fields such as radiology. However, the quality, accessibility, and currency of e-learning content can also be imperfect. To enhance the educational journey for radiology residents, the integration of ChatGPT with expert-curated e-learning resources is imperative for ensuring accuracy and reliability and addressing ethical concerns. While AI is unlikely to entirely supplant traditional radiology study methods, the synergistic combination of AI with traditional e-learning can create a holistic educational experience.

Educational video demonstrating collapsibility of the upper airway during sleep improves initial acceptance of CPAP in patients with severe obstructive sleep apnea: a retrospective study

STUDY OBJECTIVES

To investigate if an audio-visual educational video demonstrating collapsibility of the upper airway during sleep influences initial CPAP acceptance among patients with severe obstructive sleep apnea (OSA).

METHODS

Between January 2017 and December 2018, a single-center retrospective study was conducted. We implemented an educational video demonstrating upper airway collapsibility during sleep in February 2018. We analyzed the medical records from 145 consecutive patients diagnosed with severe OSA who underwent in-lab polysomnography (PSG) both before and after implementing the educational video. Among them, 76 patients received standard care before the video's introduction (standard care group), and another 69 patients were managed after its implementation (video group).

RESULTS

Baseline characteristics including age, BMI, educational level, occupation category, comorbidities, Mallampati score, Epworth Sleepiness Scale (ESS) score, apnea hypopnea index (AHI) and sleep time with SpO2 below 90% (T90%) were not significantly different between the two groups. Acceptance of CPAP following in-lab overnight titration study was significantly higher in the video group (80%) compared to the standard care group (57%), P= .004.

Multivariate regression analyses revealed that watching the video was a strong predictor of initial CPAP acceptance (OR 4.162, 95%, CI 1.627-10.646; P= .004). Both T90% (OR 1.020 95% CI 1.002 to 1.038; P= .029) and sleep efficiency (OR 1.052 95% CI 1.023 to 1.083; P< .001) were weak predictors for initial CPAP acceptance. At 12 months, adherence among those who accepted the CPAP treatment was similar between the two groups (78% vs 74%, P= .662). However, within the initial cohorts, a significantly higher proportion of patients in the video group (62%) were using CPAP at 12 months compared to the standard care group (42%), P= .015.

CONCLUSIONS

Among patients with severe OSA, an educational video demonstrating upper airway collapsibility during sleep improved initial CPAP acceptance rates when compared to standard care.

Do peer-based short-form educational videos created by nursing students improve youths' knowledge of sexually transmitted diseases? A quasi-experimental study

BACKGROUND

The prevalence of sexually transmitted diseases (STDs) remains high worldwide in today's society, especially among young people. Youth education on STDs could help to reduce the prevalence of the condition in society and prevent new cases.

AIM

The aim of this study is to assess the effectiveness of peer-based short-form educational videos on youths' knowledge of STDs.

METHODS

This quasi-experimental study was conducted in Turkey. The sample consisted of 121 students divided into experimental and control groups. Pre- and post-test control group quasi-experimental research design was employed in this study during the spring semester of the academic year 2021-2022. Peer-based short-form educational videos created by nursing students were used as an intervention. The survey form and Sexually Transmitted Disease Knowledge Questionnaire were used to collect data.

RESULTS

Participants with parental responsibilities and had previous STD experience had higher knowledge score than the other subgroups. There was a significant main effect of peer-based short-form educational video on participants overall knowledge score of STDs. Additionally, the effect of intervention continued at 12-week follow-up measurement.

CONCLUSION

Peer-based short-form educational videos increase young people's knowledge of STD, and the impact of the intervention continued at 12-week follow up.

Cricothyrotomy Online: Quality Assessment of Educational Videos on YouTube

BACKGROUND

Medical learners may use YouTube® videos to prepare for procedures. Videos are convenient and readily available, but without any uploading standards, their accuracy and quality for education are uncertain. We assessed the quality of emergency cricothyrotomy videos on YouTube through an expert panel of surgeons with objective quality metrics.

METHODS

A YouTube® search for "emergency cricothyrotomy" was performed and results were filtered to remove animations and lectures. The 4 most-viewed videos were sent to a panel of trauma surgeons for evaluation. An educational quality (EQ) score was generated for each video based on its ability to explain the procedure indications, orient the viewer to the patient, provide accurate narration, provide clear views of procedure, identify relevant instrumentation and anatomy, and explain critical maneuvers. Reviewers were also asked if safety concerns were present and encouraged to give feedback in a free-response field.

RESULTS

Four surgical attendings completed the survey. The median EQ score was 6 on a 7-point scale (95% CI [6, 6]). All but one of the individual parameters had a median EQ score of 6 (95% CI: indications [3, 7], orientation [5, 7], narration [6, 7], clarity [6, 7], instruments [6, 7], anatomy [6, 6], critical maneuvers [5, 6]). Safety received a lower EQ score (5.5, 95% CI [2, 6]).

CONCLUSIONS

The most-viewed cricothyrotomy videos were rated positively by surgical attendings. Still, it is necessary to know if medical learners can distinguish high from low quality videos. If not, this suggests a need for surgical societies to create high-quality videos that can be reliably and efficiently accessed on YouTube®.

Time-lapse dissection videos: traditional practice in a new, digital format

This research introduces an innovative series of time-lapse dissection videos that enable accelerated observation of the dissection process. Cadaveric dissection has consistently been described in the literature as a reliable method for enhancing student understanding and visualisation, however as a process it is expensive and extremely time-consuming, hence it is often inaccessible to learners. When active dissection is unavailable, prosections can be used to teach anatomy, however a considerable amount of spatial and structural information is lost during the dissection process. These time-lapse videos demonstrate dissection quickly and accurately and allow an irreversible process to be rewound and rewatched with flexibility. Results suggest that time-lapse offers a comprehensive and engaging view of the dissection process that students appreciate being able to observe within a concise timeframe. Written annotation, audio narration and colourful highlighting were essential inclusions following student feedback. These videos can provide instruction before dissection classes or can expose the dissection process to learners without access to cadaveric specimens. However, certain invaluable elements of practical dissection are rooted within constructivism and cannot be replicated by video. Time-lapse dissection videos should therefore be used to supplement and not replace active dissection.

[Questionnaire Survey of Hands-on Seminar Using a Web Conferencing System in the COVID-19 Pandemic]

The purpose of this study was to evaluate the effectiveness of a hands-on seminar using a Web conferencing system, based on the post-event questionnaires of the face-to-face and online seminars of the hands-on seminar. For participants to feel realistic training in the online seminars, four educational videos explaining the procedure of the practical skill were created. We compared results of questionnaires acquired from participants after the face-to-face and online seminars. The questions about expectation, comprehension, satisfaction level, and lecture time for the seminars were graded on a 5-point scale. The higher the scores, the higher the rating, except for lecture time. A score of 3 was appropriate for the lecture time, with a higher score indicating that the seminar felt longer and a lower score indicating that the seminar felt shorter. In the evaluation of classroom lectures, such as expectation, comprehension, and satisfaction level for the seminars, there were no significant differences between the face-to-face and online seminars, and both achieved high scores of 4 or more. There was a significant difference in the evaluation of lecture time for classroom lectures, with participants feeling that it was too short in the face-to-face but just right in the online. In all evaluations for hands-on training and discussion, there were no significant differences between the face-to-face and online seminars, and both achieved high scores of 4 or more and time was short. It was concluded that our proposed online seminar approach could achieve a high level of evaluation as face-to-face seminars.

Animated Videos Based on Food Processing for Guidance of Brazilian Adults: Validation Study

BACKGROUND

Ultraprocessed foods (UPFs) contribute almost one-fifth of the calories consumed by the Brazilian population. This consumption has been favored by aspects such as the ease of acquisition and low cost of this food group. Initiatives focused on supporting and promoting healthy eating practices have been implemented. Among them, the availability of educational resources is an important strategy to maximize the effectiveness of these actions in the field of food and nutrition education (FNE).

OBJECTIVE

This study aims to describe the development and validation process of animated videos based on the NOVA food classification for FNE actions aimed at Brazilian adults.

METHODS

This methodological study was developed in the following 4 phases: planning, preproduction, production, and postproduction. In the planning phase, a literature review was con-ducted on the topic and to define the content to be covered. The design of the material was based on the cognitive theory of multimedia learning. In the preproduction phase, video scripts were developed and evaluated by 7 content specialists. In the production phase, videos were developed based on the assessed scripts and then assessed by 3 multimedia production specialists. In the postproduction phase, the videos were evaluated by 15 representatives of the target audience. All results obtained in the evaluation phases were analyzed using the content validity index (CVI).

RESULTS

We developed 3 animated videos covering the following themes: food processing levels, food categories according to processing levels, and UPFs and their impact on health. In the evaluation by the content specialists, the scripts of videos 1, 2, and 3 obtained CVIs at the scale level and average method equal to 0.96, 0.98, and 0.98, respectively. When the animated videos were evaluated by multimedia production specialists and representatives of the target audience, these indexes were equal to 1.0. These results attest to the videos' adequacy and quality in communicating the addressed content.

CONCLUSIONS

The animated videos developed and validated in this study proved to be adequate for their purpose. Thus, it is expected that they will be an important instrument for FNE actions aimed at an adult audience and for disseminating the Dietary Guidelines for the Brazilian Population.

Educational Videos Versus Question Banks: Maximizing Medical Student Performance on the United States Medical Licensing Examination Step 1 Exam

Objective The aim of this research was to determine if medical students' use of the active study strategy of working practice questions is associated with improved performance on the United States Medical Licensing Examination (USMLE) Step 1 exam when compared to students who used the passive study strategy of watching educational videos. Methods The study used a correlational design. Participants were students from two cohorts in a United States medical school (N=164 and N=163) who completed their first two years and took the USMLE Step 1 exam. Data collected retrospectively included the number of practice questions completed, educational videos watched, Step 1 exam scores, average scores on in-class exams, and scores on the Medical College Admission Test (MCAT). Results The number of videos watched was negatively and significantly correlated with the Step 1 score for cohort 2022 (r= -0.294, α=0.01) and cohort 2023 (r= -0.175, α=0.05). The number of practice questions worked was positively and significantly correlated with the Step 1 score for cohort 2022 (r=0.176, α=0.05) and cohort 2023 (r=0.143 though not significant). The number of practice questions was a significant positive predictor of Step 1 score for cohort 2022 (β=0.141, p=0.017) and cohort 2023 (β=0.133, p=0.015). Videos were significant negative predictors for cohort 2023 (β= -0.118, p=0.034). Conclusions Answering practice questions appears to be a more effective study method than passively watching videos. Though other studies have supported the use of active learning methods, this study is unique in finding a negative correlation between test scores and the number of educational videos watched. Medical students should be urged to make the most effective use of study time by incorporating working practice questions and limiting watching educational videos.

Lessons learned from using whiteboard videos and YouTube for deprescribing guidelines knowledge mobilization

OBJECTIVES

Deprescribing is the planned and supervised process of dose reduction or stopping medication. Few clinical guidelines exist to help health care professionals in making decisions about deprescribing. The Bruyère Deprescribing Guidelines Team developed a series of evidence-based medication-class specific deprescribing guidelines and, to extend reach and uptake, disseminated them as whiteboard videos published on YouTube. This paper reports on the creation, sharing and evaluation of videos on proton pump inhibitor (PPI), antihyperglycemic (AHG), antipsychotic (AP) and benzodiazepine receptor agonist (BZRA) deprescribing guidelines.

METHODS

Whiteboard videos depict an animator drawing on a whiteboard, while the narrator reads the script. In each video, the deprescribing algorithm is applied to mock patient cases. The videos were shared on YouTube and promoted via Twitter and other web-based tools. Evaluation methods included YouTube analytics and the validated Information Assessment Method (IAM) questionnaire.

KEY FINDINGS

The four videos have a combined total of 26 387 views over the approximately 50 months since publishing, with viewers watching 34-40% of the videos' runtimes on average. The PPI and AHG deprescribing videos were viewed 4318 times in 97 countries during the first year. IAM respondents perceived the PPI, AHG and AP video content to be relevant, useful to learning and applicable to patient care.

CONCLUSIONS

Using whiteboard videos on YouTube to explain deprescribing guidelines was a successful approach to knowledge mobilization. The evaluation approach is innovative as it combines typical success factors for online learning videos (e.g. views, estimated minutes watched) with responses to a validated information assessment tool.

Health cadres empowerment program through smartphone application-based educational videos to promote child growth and development

Indonesia's health care system relies on non-health professionals called cadres to operate child health promotion programs in the Public Health Center (Puskesmas). Despite this effort, the child malnutrition rate remains high. This study aimed to identify and develop health promotion media that can assist health cadres in promoting child health. This study was divided into three-phase. The first phase was the need assessment using focus group discussion and knowledge, attitude, and practice (KAP); the second phase is video development, which involves medical students, general practitioners, pediatricians, and health promotion experts; and the third phase was video viewing by cadres and post-viewing tests for health cadres. A comparison of pre-test and post-test participants' total scores was performed with the student's T-test. Need assessment showed that the knowledge of the cadres needs improvement and there was a need for proper educational media material that can be used by the Puskesmas. Five videos were produced, four videos were about children's nutritional intake recommendations during four different age groups and one video was about the information and invitation to come to Integrated Health Service Post (Posyandu). There was a significant improvement from pre-test total scores to post-test total scores (p < 0.001). Smartphone application-based educational videos are effective and reliable child health promotion media for Puskesmas staff and parents.

Dissemination of validated health literacy videos: A tailored approach

BACKGROUND

Previously, we showed that chemotherapy terminology is difficult for patients to understand. Therefore, we developed short videos explaining key terminology and though proven effective, they will only be helpful if appropriately disseminated. Therefore, we aimed to determine the best dissemination method at three different healthcare settings.

METHODS

With consent, we interviewed healthcare workers from (1) an academic cancer center, Winship Cancer Institute (Winship) serving higher SES patients, (2) an inner-city, safety-net hospital Grady Memorial (GMH), (3) clinics serving rural Georgia, from the Winship Community Network (Network). All interviews were transcribed and analyzed using a semantic content analysis method. Suggested dissemination plans were then implemented.

RESULTS

Twenty-two Winship, 11 GMH, and 4 Network healthcare workers were interviewed. Seventy-two percent (n = 8) of the GMH and 100% (n = 4) of Network healthcare workers felt that the best place for patients to view the videos was in the clinic, compared to 27% (n = 6) of the Winship clinicians. 68% (n = 15) of the Winship clinicians stated an app would be the most useful format, compared to 27% (n = 3) at GMH, and 0% at Network sites. Video viewing increased after dissemination plans were implemented.

CONCLUSION

Educational materials explaining oncology treatment terminology enhance patient understanding, yet without proper dissemination, these tools may never reach the intended patient population. Our study shows that dissemination plans need to be tailored to each individual patient population, with rural and lower SES patients needing to view the videos during clinic visits, and patients of more means viewing them using technology at home.

Evaluation of YouTube laparoscopic hysterectomy videos as educational materials during the COVID-19 era using the LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) and LAP-VEGaS video assessment tool

With increasing numbers of laparoscopic hysterectomies, surgical trainees are compelled to learn more about endoscopy. Owing to coronavirus disease-related social distancing requirements, online education has gained prominence. Here, we aimed to investigate the laparoscopic hysterectomy video quality on YouTube using the LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS). YouTube was searched on June 7, 2020 using 'laparoscopic hysterectomy'. Three examiners evaluated videos using Global Operative Assessment of Laparoscopic Skills (GOALS). Subsequently, videos were assessed for their conformity to the LAP-VEGaS and LAP-VEGaS Video Assessment Tool. Interobserver reliability was estimated using intraclass coefficients and Cronbach's alpha. Cochran's Q test was used to determine correlations among quantitative data. The median GOALS score was 21.50. The observers' GOALS scores were significantly correlated. The results showed low conformity to the LAP-VEGaS. YouTube is the most used platform among trainees. The low YouTube video educational quality highlights the necessity for peer review, as trainees increasingly seek such resources during the pandemic.IMPACT STATEMENTWhat is already known on this subject? YouTube is the most commonly used online resource for educational material among surgical trainees. Online videos usually do not undergo a peer-review process. The LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) may be used to assess the educational quality of surgical videos.What do the results of this study add? To our knowledge, this is the first study on the quality of laparoscopic hysterectomy videos available on YouTube and the first study to evaluate YouTube laparoscopic surgery videos using the LAP-VEGaS Video Assessment Tool (VAT). Our study revealed the low educational quality of YouTube laparoscopic hysterectomy videos. The LAP-VEGaS VAT seems to be a valid and practical tool for assessing online laparoscopic hysterectomy videos.What are the implications of these findings for clinical practice and/or further research? Medical communities, especially tertiary care or academic centres, may upload educational peer-reviewed videos for trainees seeking this type of resource, especially during the coronavirus disease pandemic, as surgical education alternatives are limited.

Comparison of Traditional Videos With Telenovelas for Hospice Family Caregivers Education

BACKGROUND

While research has shown that hospice family caregivers (HFCG) seek additional information related to patient care, pain and symptom management, and self-care, it is unknown how the use of telenovela videos for education in hospice would be received by HFCG.

OBJECTIVE

To explore HFCG perceived benefits and challenges with the use of telenovelas as compared to traditional educational videos during online support group.

METHODS

A mixed methods study with a concurrent triangulated design that analyzed qualitative interviews and YouTube analytics report to identify how viewers responded (number of views and their feedback) to telenovela videos as compared to traditional educational videos.

RESULTS

Among 39 (n = 39) HFCGs, most participants were female (80%) of White/Caucasian race, with more than high school education (85%) and they were adult children of hospice cancer patient (49%). Comparing HFCG that viewed traditional videos with HFCG that viewed telenovela videos, the telenovela video was watched more (12% longer viewing duration) and caregivers reported better content recall with informative benefits, more follow up actions and reflection about their own hospice experience.

CONCLUSION

Caregiver feedback indicated that watching the telenovela was engaging, acceptable and produced more conversations about patient care, than watching a non-telenovela format video. Further research is needed to test telenovela efficacy in enhancing HFCG outcomes.

[Effectiveness of an educational video about infant crying on prevention of shaken baby syndrome among pregnant Japanese women and their partners]

Objectives　Previous studies have shown that educating new mothers or pregnant women about infant crying, may prevent shaken baby syndrome (SBS). However, no studies in Japan have examined the effectiveness of educational materials during pregnancy. This study aims to determine whether pregnant women and their partners improve their knowledge about infant crying and SBS, after watching an educational video created by the Ministry of Health, Labour, and Welfare.Methods　The study was conducted from April 1, 2013, to March 31, 2014, in 46 municipalities nationwide. Pregnant women and their partners, who participated in prenatal classes, watched the educational video and responded to pre- and post-questionnaires that included questions about: the characteristics of parents and family, and knowledge about infant crying and SBS. Out of the 4769 respondents who completed the questionnaires, responses of 4647 respondents with knowledge about infant crying and SBS were analyzed. We asked six questions about infant crying, such as "When an infant cries it is always a sign that something is wrong", and two questions about SBS, such as "Shaking a baby is a good way to help a baby stop crying" using a 4-point Likert scale (0-3 points). The total scores were calculated and placed within the range of 0 to 100, where higher scores indicated better knowledge. These scores were then compared for the pre- and post-conditions. Furthermore, a stratified analysis was performed based on respondents' characteristics and a regression analysis was conducted to examine the differences in knowledge categorized by these characteristics.Results　The scores displayed a significant increase in knowledge about infant crying and SBS by 17.5 points (95% CI; 17.1-17.9) and 6.8 points (95% CI; 6.3-7.2) respectively, after watching the educational video. The results of the stratified analysis found that the effect of the intervention did not differ depending on characteristics such as age, sex, education, and prevalence of depression. Furthermore, our regression analysis on the scores of knowledge about infant crying and SBS found that the increases in knowledge were more pronounced among males and couples having their first child. Increase in knowledge about infant crying was more pronounced among those who were not depressed, while increase in knowledge about SBS was more pronounced among those who answered "unexpected but happy" for their feelings about pregnancy.Conclusion　The educational video on infant crying and shaken baby syndrome was effective in increasing knowledge about infant crying and SBS among couples during pregnancy, regardless of their characteristics.

Using mHealth to Provide Mobile App Users With Visualization of Health Checkup Data and Educational Videos on Lifestyle-Related Diseases: Methodological Framework for Content Development

Background

The number of people with lifestyle-related diseases continues to increase worldwide. Improving lifestyle behavior with health literacy may be the key to address lifestyle-related diseases. The delivery of educational videos using mobile health (mHealth) services can replace the conventional way of educating individuals, and visualization can replace the provision of health checkup data.

Objective

This paper aimed to describe the development of educational content for MIRAMED, a mobile app aimed at improving users’ lifestyle behaviors and health literacy for lifestyle-related diseases.

Methods

All videos were based on a single unified framework to provide users with a consistent flow of information. The framework was later turned into a storyboard. The final video contents were created based on this storyboard and further discussions with leading experts and specialist physicians on effective communication with app users about lifestyle-related diseases.

Results

The app uses visualization of personal health checkup data and educational videos on lifestyle-related diseases based on the current health guidelines, scientific evidence, and expert opinions of leading specialist physicians in the respective fields. A total of 8 videos were created for specific lifestyle-related diseases affecting 8 organs: (1) brain–cerebrovascular disorder, (2) eyes–diabetic retinopathy, (3) lungs–chronic obstructive pulmonary disease, (4) heart–ischemic heart disease, (5) liver–fatty liver, (6) kidneys–chronic kidney disease (diabetic kidney disease), (7) blood vessels–peripheral arterial disease, and (8) nerves–diabetic neuropathy.

Conclusions

Providing enhanced mHealth education using novel digital technologies to visualize conventional health checkup data and lifestyle-related diseases is an innovative strategy. Future studies to evaluate the efficacy of the developed content are planned.

Developing Patient-Centered Inflammatory Bowel Disease-Related Educational Videos Optimized for Social Media: Qualitative Research Study

BACKGROUND

Important knowledge gaps have been identified related to the causes and symptoms of inflammatory bowel disease (IBD) and medical treatments and their side effects. Patients with IBD turn to social media to learn more about their disease. However, such information found on the web is misleading and often of low quality.

OBJECTIVE

This study aims to gain an in-depth understanding of the unmet educational needs of patients with IBD and to use the resulting insights to develop a collection of freely available, evidence-based educational videos optimized for dissemination through social media.

METHODS

We used design thinking, a human-centered approach, to guide our qualitative research methodology. We performed focus groups and interviews with a diverse sample of 29 patients with IBD. Data collection was performed in 3 phases (inspiration, ideation, and implementation) based on IDEO design thinking. Phase 1 offered insights into the needs of patients with IBD, whereas phases 2 and 3 involved ideation, prototyping, and video testing. A thematic analysis was performed to analyze the resulting data.

RESULTS

Patients emphasized the need for educational videos that address their challenges, needs, and expectations. From the data analysis, 5 video topics and their content emerged: IBD treatments' risks and benefits; how to be a self-advocate; how to stay healthy with IBD; how to cope with IBD; and educating families, friends, and colleagues about experiences of patients with IBD.

CONCLUSIONS

Design thinking offers a deep understanding and recognition of the unmet educational needs of patients with IBD; this approach informed the development of 5 evidence-based educational videos. Future research will formally test and disseminate these freely available videos through social media.

[Effectiveness of an educational video on infant crying for prevention of shaken baby syndrome among Japanese caregivers of infants]

Objectives　Spreading awareness of shaken baby syndrome is considered to be essential in the prevention of infant deaths resulting from abuse. This study aimed to determine whether an educational video on infant crying, developed by the Ministry of Health, Labour and Welfare, was effective at increasing knowledge of infant crying and shaking among Japanese caregivers of infants aged under 1 year.Methods　We targeted caregivers who had infants aged under 1 year for intervention through health checkups and home visits in 29 municipalities across Japan from April 2013 to March 2014. The educational video on infant crying and danger of shaking and smothering was used as intervention. A questionnaire was administered to caregivers to assess their knowledge on infant crying and shaking prior to and after the intervention (N=1,444, response rate 93.8%). A sample of 1,232 caregivers was used for analysis, after excluding those who did not report the outcome of interest (i.e., knowledge on shaking or smothering) and demographics. In the analysis, pre- and post-test mean scores on crying knowledge scales and shaking knowledge scales (out of 100) were compared separately. Subgroup analysis and regression analysis were also conducted to examine whether the effect of the intervention varied by infant age, birth order, parent's sex, age, education, marital status, household income, grandparents' co-residence, postpartum depression, domestic violence during pregnancy, feelings about pregnancy, and resident area (urban/rural).Results　Scores on infant crying significantly increased by 12.4 points (95% confidence interval: 11.7-13.2), and those on shaking knowledge increased by 4.7 points (95% confidence interval: 3.9-5.6) after the caregivers had watched the educational video. Subgroup analysis confirmed that the effect of the intervention did not differ among the subgroups except shaking knowledge scores among those who were not married and those who experienced physical violence from their partner. A regression analysis on change in scores revealed that parents with higher education gained more knowledge on infant crying, and fathers and those not living with grandparents gained more knowledge on shaking than mothers.Conclusion　The educational video on infant crying was effective in increasing knowledge of infant crying and shaking, regardless of demographics of infants and parents and postnatal situation.

Developing Cognitive Task Analysis-based Educational Videos for Basic Surgical Skills in Plastic Surgery

OBJECTIVE

To describe the development of cognitive task analysis (CTA)-based multimedia educational videos for surgical trainees in plastic surgery.

DESIGN

A needs assessment survey was used to identify 5 plastic surgery skills on which to focus the educational videos. Three plastic surgeons were video-recorded performing each skill while describing the procedure, and were interviewed with probing questions. Three medical student reviewers coded transcripts and categorized each step into "action," "decision," or "assessment," and created a cognitive demands table (CDT) for each skill. The CDTs were combined into 1 table that was reviewed by the surgeons performing each skill to ensure accuracy. The final CDTs were compared against each surgeon's original transcripts. The total number of steps identified, percentage of steps shared, and the average percentage of steps omitted were calculated.

SETTING

Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, an urban tertiary care teaching center.

PARTICIPANTS

Canadian junior plastic surgery residents (n = 78) were sent a needs assessment survey. Four plastic surgeons and 1 orthopedic surgeon performed the skills.

RESULTS

Twenty-eight residents responded to the survey (36%). Subcuticular suturing, horizontal and vertical mattress suturing, hand splinting, digital nerve block, and excisional biopsy had the most number of residents (>80%) rank the skills as being skills that students should be able to perform before entering residency. The number of steps identified through CTA ranged from 12 to 29. Percentage of steps shared by all 3 surgeons for each skill ranged from 30% to 48%, while the average percentage of steps that were omitted by each surgeon ranged from 27% to 40%.

CONCLUSIONS

Instructional videos for basic surgical skills may be generated using CTA to help experts provide comprehensive descriptions of a procedure. A CTA-based educational tool may give trainees access to a broader, objective body of knowledge, allowing them to learn decision-making processes before entering the operating room.

Medical student case presentation performance and perception when using mobile learning technology in the emergency department

BACKGROUND

Hand-held mobile learning technology provides opportunities for clinically relevant self-instructional modules to augment traditional bedside teaching. Using this technology as a teaching tool has not been well studied. We sought to evaluate medical students' case presentation performance and perception when viewing short, just-in-time mobile learning videos using the iPod touch prior to patient encounters.

METHODS

Twenty-two fourth-year medical students were randomized to receive or not to receive instruction by video, using the iPod Touch, prior to patient encounters. After seeing a patient, they presented the case to their faculty, who completed a standard data collection sheet. Students were surveyed on their perceived confidence and effectiveness after using these videos.

RESULTS

Twenty-two students completed a total of 67 patient encounters. There was a statistically significant improvement in presentations when the videos were viewed for the first time (p=0.032). There was no difference when the presentations were summed for the entire rotation (p=0.671). The reliable (alpha=0.97) survey indicated that the videos were a useful teaching tool and gave students more confidence in their presentations.

CONCLUSIONS

Medical student patient presentations were improved with the use of mobile instructional videos following first time use, suggesting mobile learning videos may be useful in medical student education. Clinical educators should consider whether, in an instance where live bedside or direct interactive teaching is unavailable, using just-in-time educational videos on a handheld device might be useful as a supplemental instructional strategy.