M-health adoption by healthcare professionals : a systematic review

Objective The aim of this systematic review was to synthesize current knowledge of the factors influencing healthcare professional adoption of mobile health (m-health) applications. Methods Covering a period from 2000 to 2014, we conducted a systematic literature search on four electronic databases (PubMed, EMBASE, CINAHL, PsychInfo). We also consulted references from included studies. We included studies if they reported the perceptions of healthcare professionals regarding barriers and facilitators to m-health utilization, if they were published in English, Spanish, or French and if they presented an empirical study design (qualitative, quantitative, or mixed methods). Two authors independently assessed study quality and performed content analysis using a validated extraction grid with pre-established categorization of barriers and facilitators. Results The search strategy led to a total of 4223 potentially relevant papers, of which 33 met the inclusion criteria. Main perceived adoption factors to m-health at the individual, organizational, and contextual levels were the following: perceived usefulness and ease of use, design and technical concerns, cost, time, privacy and security issues, familiarity with the technology, risk-benefit assessment, and interaction with others (colleagues, patients, and management). Conclusion This systematic review provides a set of key elements making it possible to understand the challenges and opportunities for m-health utilization by healthcare providers

Leveraging informal learning practices for broadening participation in university education: A Kenyan case study

Kenyan public universities primarily provide classroom-based courses. However, socioeconomic realities limit many rural-based learners from regularly attending classes. Interestingly, because of the willingness of Kenyans to further their education, informal education is picking up fast. Individuals are forming informal learning circles and have proactively found ways to use smartphones to access online educational resources. This paper explores ways to leverage the strengths of these informal learning practices to enhance participation in formal higher education for Kenyans. One way this can be achieved is through blended learning. With blended learning, students will experience the convenience of online learning without losing the social on-campus interactions they are accustomed to. Currently, the use of blended learning in Kenyan public universities is not at the desired level. Lack of conventional computing resources (laptops/desktop PCs) due to economical constraints is a contributing factor. Given their widespread adoption, we suggest smartphones could serve as a viable platform for blended learning in Kenya. To explore this idea, a survey was conducted with 114 students in Tom Mboya University College (TMUC), a rural-based public university in Kenya. The survey examined students’ attitudes towards using smartphones in education. Results indicate smartphones are already an integral part of the students’ informal education and the students have a strong desire to integrate smartphones into their formal education. We envisage that our research will contribute knowledge towards the adoption of blended learning in resource-constrained university environments

Leveraging informal learning practices for broadening participation in university education: A Kenyan case study

Kenyan public universities primarily provide classroom-based courses. However, socioeconomic realities limit many rural-based learners from regularly attending classes. Interestingly, because of the willingness of Kenyans to further their education, informal education is picking up fast. Individuals are forming informal learning circles and have proactively found ways to use smartphones to access online educational resources. This paper explores ways to leverage the strengths of these informal learning practices to enhance participation in formal higher education for Kenyans. One way this can be achieved is through blended learning. With blended learning, students will experience the convenience of online learning without losing the social on-campus interactions they are accustomed to. Currently, the use of blended learning in Kenyan public universities is not at the desired level. Lack of conventional computing resources (laptops/desktop PCs) due to economical constraints is a contributing factor. Given their widespread adoption, we suggest smartphones could serve as a viable platform for blended learning in Kenya. To explore this idea, a survey was conducted with 114 students in Tom Mboya University College (TMUC), a rural-based public university in Kenya. The survey examined students’ attitudes towards using smartphones in education. Results indicate smartphones are already an integral part of the students’ informal education and the students have a strong desire to integrate smartphones into their formal education. We envisage that our research will contribute knowledge towards the adoption of blended learning in resource-constrained university environments

Describing the use of social media as a point-of-care tool in facility-based emergency care in Africa

Background Despite privacy and legal concerns, social media is used to provide real-time clinical support to emergency care providers. It can be particularly beneficial for those in Africa, who might lack adequate training or access to information. This PhD aimed to describe the use of social media as a point-of-care telemedicine tool in facility-based emergency care in Africa, to further inform its use. Methods A scoping review was conducted to map available literature on use, benefits, and risks associated with social media as a point-of-care platform. A mixed methods approach was then taken using a cross-sectional survey and semi-structured interviews to obtain a comprehensive description of use of social media as a point-of-care tool in facility-based emergency care in Africa. Results The scoping review identified 13 publications describing use of social media as a point-of-care tool in emergency medical settings. No studies were located in low-income countries. All studies evaluated WhatsApp use for real-time consultations, and those that assessed reliability found it to be highly reliable for consultations. A total of 70 emergency care providers in African facilities responded to the survey; nearly all worked in low- or lower-middle-income countries. Responses showed that clinicians use social media multiple times each day, primarily to share and receive advice. The majority felt social media positively impacts patient and provider experiences and improves speed and safety. Finally, eight African emergency care providers were interviewed to gain an in-depth understanding of how social media use impacts emergency care. All participants noted routine use for a range of professional purposes, including consultations, administrative tasks, and education. Concerns were mentioned by all participants, including legality, privacy, and lack of employer regulations. Conclusions This dissertation provides insight into social media use of African emergency care physicians, showing that social media use in this group is ubiquitous. Most clinicians use social media multiple times each day for a range of point-of-care purposes, and many feel social media is positively impacting both the patient and provider experiences. Post-doctoral work will focus on developing a framework to guide use of social media in facility-based emergency care in the African setting

Evaluating a South African mobile application for healthcare professionals to improve diagnosis and notification of pesticide poisonings

Acute pesticide poisoning (APP) is a major global public health problem, particularly in low- and middle-income countries (LMICs) including South Africa. However, healthcare professionals (HCPs) worldwide have limited training in handling environmental health risks such as from pesticide exposures. Most HCPs lack basic training on APP and, this presents a challenge to HCPs when diagnosing and notifying pesticide-related poisonings. With a recent increase in mobile application technology, this gives a convenient platform to provide training support for HCPs in their clinical practice. An example is the integration of a South African pesticide notification guideline into an existing Emergency Medicine (EM) mobile application. This pesticide notification guideline (PNG) within the EM mobile application aims to provide an immediate point-of-care tool to help HCPs in diagnosis and notify pesticide poisoning cases. Despite this useful platform for training HCPs, there are limited studies that have evaluated mobile applications or technologies to promote HCPs training in LMICs. This study, therefore, aimed to evaluate the Centre for Environmental and Occupational Health Research (CEOHR)'s PGN adapted for the EM mobile application as a tool for improving HCP's ability to diagnose and report APPs. The protocol (Part A) provides information and a justification for the research study and, describes the methods used to gather and analyse the data. The extended literature review (Part B) provides an overview of studies assessing HCPs' knowledge of and training in pesticide poisonings and the role mobile health technologies play in improving HCPs' knowledge and training in clinical practice. Furthermore, the literature review illustrates the relevant theoretical frameworks and concepts that helps to understand HCPs' behaviour changes when using clinical guidelines or algorithms. The journal manuscript article (Part C) provides this study's research findings and how it could contribute to the body of knowledge. A total of 50 emergency medicine physicians and registrars participated in th

Trends in smartphone-supported medical education: A review of journal publications from 2007 to 2016

Issues relevant to smartphone-supported mobile learning have been extensively discussed and investigated over the past years. Unlike general mobile devices, the advantages of smartphones, such as recording learning and portability, can cross formal and informal education. Smartphones can promote communication between health professionals; however, there is still a lack of systematic analysis of the application and development trends of smartphone use in medical education. The present study systematically reviewed research articles published in international academic journals from 2007 to 2016, analyzed the application domains, subjects, and adopted learning strategies, and investigated the research issues of smartphone-supported medical education. The findings revealed that the application of smartphones in medical education and training has not gained much popularity over the past years. In addition to the changes in the software technology in smartphones and the rising number of studies on mobile learning in medical education, research issues have become increasingly diverse in recent years. Smartphone-supported learning has mainly been implemented to develop basic concepts of biomedical information and in information technology environments; moreover, applying smartphones in medical education did not extensively adopt such learning strategies as inquiry-based learning, contextual mobile learning, mindtools, game-based learning, or synchronous sharing. This indicates that most of the studies adopting smartphones focused on skills training and basic knowledge acquisition rather than on the development of learners’ higher-order thinking, for example, problem solving or critical thinking. On the other hand, it was found that the number of experimental studies related to smartphones has increased recently. The majority of research adopted questionnaire surveys and reported learners’ cognitive performances and concepts, while learning behaviors were seldom analyzed. Therefore, this study indicates the research trends and potential research issues of integrating smartphones into medical education, and provides suggestions and references for researchers, medical teachers, and decision-makers

Introducing mobile technologies to strengthen the national continuing medical education program in Vietnam

BACKGROUND: In 2009, the Government of the Republic of Vietnam adopted legislation requiring all clinicians to complete continuing medical education (CME) credits in order to maintain licensure. Several CME in-person and distance-based courses have been developed and as of 2015, a national distance-based electronic learning (eLearning) network was being established. However, the uptake of CME courses remained low despite high clinician demand. Vietnam’s high mobile phone ownership rate of 1.4 mobile subscriptions per person presents an opportunity to leverage this for CME. This study investigated how mobile technologies could strengthen delivery of distance-based CME courses and improve national CME program administration. METHODS: A literature and policy review was conducted. Qualitative methods were employed to collect and analyze key informant interviews of 52 global and Vietnamese experts, including selected policy makers. Interviews were supplemented by six focus group discussions with Vietnamese physicians, nurses, midwives and physician assistants. Transcripts were analyzed using an inductive coding methodology. A framework was developed to organize and present results for government consumption. RESULTS: Globally, examples and supporting evidence related to mobile technologies for CME were limited. Experts reported three main use cases for using mobile technology for CME in Vietnam: 1) delivery of CME courses (N=34; 65%); 2) registration and tracking of CME credits (n=28; 54%); and 3) sending alerts and reminders on CME opportunities (n=23; 44%). The national CME policy environment in Vietnam was supportive of introducing mobile technologies within the eLearning network. However, there was a widespread lack of awareness and capacity to design and deliver distance-based CME courses. Mobile phone ownership was high and health workers reported interest in acquiring CME credits via mobile. Financing options to develop and implement distance-based CME courses were limited. CONCLUSION: Despite the paucity of evidence related to mobile technologies for learning, there is potential to innovate and strengthen the evidence base using these technologies for CME in Vietnam. Introducing mobile technologies within the national eLearning network would improve clinicians’ access to CME, particularly in rural areas, and can strengthen national CME program administration. Key recommendations were developed to provide the government with concrete steps for national level adoption

Investigating the Use of M-Health for Learning and Clinical Training by Medical Students in Ghana

There is a challenge with healthcare access in most developing countries. With the high rate of mobile technology penetration in these countries, there is a strong belief that mobile technology can help address this and other health system and education challenges. This study investigated how clinical year medical students in Ghana used m-health and with what outcomes. This was a mixed-methods study to assess what technologies students used, what the impact of use was, what enablers and barriers they encountered, what factors explained m-health adoption and what the attitudes of students, staff and faculty members were towards m-health use. The study was conducted in four out of five medical schools in Ghana with clinical year students, namely, Kwame Nkrumah University of Science and Technology School of Medical Sciences (KNUST-SMS), University of Cape Coast School of Medical Sciences (UCC-SMS), University of Development Studies School of Medicine and Health Sciences (UDS-SMHS) and University of Ghana School of Medicine and Dentistry (UG-SMD). Online and paper questionnaires were distributed to 828 students and 291 questionnaires were returned. Questionnaires from dental students at UG-SMD (n = 5) were excluded from the analysis.Two focus group discussions were held involving seven students while three students, seven faculty members and five staff were interviewed. Qualitative data were analyzed using thematic analysis. Only one student did not own a mobile device. About 78% of students reported using m-health at some point during their medical education. The most popular devices used by students were laptop computers (90.8%), smartphones (66.2%), cellular phones (46.6%) and tablets (44.1%). Over 84% of the students owned Android devices, while 21% owned iPhones and iPads. Majority of students owned three devices or less. Students used mobile technologies in ways that suited their learning needs and contexts. M-health helped students to participate better in lessons and improve their knowledge, skills and efficiency in various contexts. The main drawbacks of m-health use were distraction and time wasting, difficulty in determining credibility of some online information and the risk of using these technologies inappropriately around patients and during assessments. The main facilitating conditions for m-health use were availability, quality and reliability of technological services, technical support, security, price value, technology competence and training, portability, task and goal fit, social influence and organizational factors. Habit and Hedonic Motivation were the only significant factors that explained intention to use m-health and actual m-health use respectively in the UTAUT2 model, in the presence of age, gender and experience. Students, staff and faculty members were open to using m-health in teaching and learning, although they recommended regulation of use through policies and guidelines to ensure effective teaching and learning and ethical m-health use. Considering the benefits offered by m-health, the study encourages medical schools in Ghana to explore mobile learning with the possibility of incorporating it into their curricula. This should be accompanied by development of policies and guidelines to spell out how mobile technologies should be used in order to mitigate most of the drawbacks identified. This study contributed empirical evidence from the Ghanaian context regarding m-health adoption and use in medical education. This evidence will contribute to theory regarding benefits, drawbacks, facilitating conditions and factors that influence m-health adoption among medical students in a developing country context. Understanding how medical students use mobile technology in learning will be useful in planning how m-health can be incorporated into their curricula. It will also help in informing development and deployment of m-health in healthcare in contexts similar to Ghana

From gimmick to game-changer : a study on the use smartphones to expand access to higher education in sub-Saharan Africa : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Information Technology at Massey University, New Zealand

Today, blended university courses are designed with an unspoken assumption that students will use desktop PCs and laptops for online learning. Recent studies regarding smartphone usage in educational settings explore ways to adapt desktop PC and laptop content for viewing on smartphones; however, the impact of these studies is limited. Smartphones are still subservient to conventional platforms. While this is not an issue in developed countries, it is problematic for developing countries in sub-Saharan Africa. Only 20% of the population in sub-Saharan Africa own desktop PCs and laptops compared to 80% smartphone ownership. The dearth of these conventional platforms means many learners in sub-Saharan Africa are excluded from the benefits of blended learning. This research took the first steps to explore whether a student who owns a smartphone and does not have access to a desktop PC or laptop can successfully participate in a blended university course. Shaped by the pragmatist philosophical perspective, the research utilised a mixed-methods case study design. The case examined was Tom Mboya University College (TMUC), a Kenyan public university that exclusively offers on-campus courses. The research progressed in four phases: a feasibility study; survey with students (n = 114); interviews with lecturers (n = 17); and beta-testing of a smartphone-supported blended course with students. Results indicate that smartphones could provide a viable learning platform. Key findings identify that TMUC students and lecturers value smartphone-supported learning due to its ability to enhance collaborative learning activities. Furthermore, the results led to the development of a novel framework entitled ‘Smartphone Only Learning Environment’ (SOLE), that provides guidelines on how teachers can deliver blended university courses solely to smartphones.The research implication is three-fold: First, it facilitates introduction of blended learning in extraordinarily resource-constrained public universities of sub-Saharan Africa. Second, it provides the foundations for critical discussions on smartphone-supported online learning policies; notably, discussions about supporting teachers by providing an institution LMS are necessary. Finally, underpinned by the collectivist culture of sub-Saharan Africa, this research showcases opportunities for educators around the world to uncover learning theories that focus on more collaborative forms of blended learning

Сучасна вища медична освіта: поточний інформаційний список за вересень - жовтень 2018 року

Поточний інформаційний список містить перелік статей з періодичних видань, що надійшли до бібліотеки в період з вересня по жовтень 2019 року і висвітлюють основні питання та проблеми вищої медичної школи