Digital Health Interventions (DHIs) to Support the Management of Children and Adolescents with Sickle‐Cell Disease

Sickle‐cell disease (SCD) is a very complex disorder alluding to all areas of medicine. Nevertheless, basic preventive and therapeutic interventions in patients suffering from SCD are extremely simple. However, in everyday life it is sometimes virtually impossible to motivate children and young adolescents to effectively self‐manage their disorder at an early stage. Digital health interventions (DHIs) provide new opportunities to support self‐management behaviours. DHIs may facilitate daily and recurrent routines such as drug intake or appointments along with helping the patients to better cope with their disease. This may be realized through mobile‐training programmes, disease‐specific social networks using secure communication channels, diaries, blogs and even games. Indeed, there are fascinating opportunities for modern disease‐training programmes to take advantage of several media that can be combined and didactically optimized to meet the individual needs and intellectual abilities of different patients. The technological progress is rapid, extremely dynamic and highly creative. Our chapter gives an overview of the multifarious world of DHIs with a focus on smartphone applications known as mobile health apps (mHealth apps). We elucidate the potential reasons why we think that numerous apps for SCD patients have not been successful and which app features developers should consider if they want to create a popular patient app

Evaluation of the free, open source software WordPress as electronic portfolio system in undergraduate medical education

Background Electronic portfolios (ePortfolios) are used to document and support learning activities. E-portfolios with mobile capabilities allow even more flexibility. However, the development or acquisition of ePortfolio software is often costly, and at the same time, commercially available systems may not sufficiently fit the institution’s needs. The aim of this study was to design and evaluate an ePortfolio system with mobile capabilities using a commercially free and open source software solution. Methods We created an online ePortfolio environment using the blogging software WordPress based on reported capability features of such software by a qualitative weight and sum method. Technical implementation and usability were evaluated by 25 medical students during their clinical training by quantitative and qualitative means using online questionnaires and focus groups. Results The WordPress ePortfolio environment allowed students a broad spectrum of activities – often documented via mobile devices – like collection of multimedia evidences, posting reflections, messaging, web publishing, ePortfolio searches, collaborative learning, knowledge management in a content management system including a wiki and RSS feeds, and the use of aid tools for studying. The students’ experience with WordPress revealed a few technical problems, and this report provides workarounds. The WordPress ePortfolio was rated positively by the students as a content management system (67 % of the students), for exchange with other students (74 %), as a note pad for reflections (53 %) and for its potential as an information source for assessment (48 %) and exchange with a mentor (68 %). On the negative side, 74 % of the students in this pilot study did not find it easy to get started with the system, and 63 % rated the ePortfolio as not being user-friendly. Qualitative analysis indicated a need for more introductory information and training. Conclusions It is possible to build an advanced ePortfolio system with mobile capabilities with the free and open source software WordPress. This allows institutions without proprietary software to build a sophisticated ePortfolio system adapted to their needs with relatively few resources. The implementation of WordPress should be accompanied by introductory courses in the use of the software and its apps in order to facilitate its usability

Survey of e-learning implementation and faculty support strategies in a cluster of mid-European medical schools

Background The use of electronic learning formats (e-learning) in medical education is reported mainly from individual specialty perspectives. In this study, we analyzed the implementation level of e-learning formats and the institutional support structures and strategies at an institutional level in a cluster of mid-European medical schools. Methods A 49-item online questionnaire was send to 48 medical schools in Austria, Germany and Switzerland using SurveyMonkey®. Data were collected between February and September of 2013 and analyzed using quantities, statistical and qualitative means. Results The response rate was 71 %. All schools had implemented e-learning, but mainly as an optional supplement to the curriculum. E-learning involved a wide range of formats across all disciplines. Online learning platforms were used by 97 % of the schools. Full-time e-learning staff was employed by 50 %, and these had a positive and significant effect on the presence of e-learning in the corresponding medical schools. In addition, 81 % offered training programs and qualifications for their teachers and 76 % awarded performance-oriented benefits, with 17 % giving these for e-learning tasks. Realization of e-learning offers was rewarded by 33 %, with 27 % recognizing this as part of the teaching load. 97 % would use curriculum- compatible e-learning tools produced by other faculties. Conclusions While all participating medical schools used e-learning concepts, this survey revealed also a reasonable support by institutional infrastructure and the importance of staff for the implementation level of e-learning offerings. However, data showed some potential for increasing tangible incentives to motivate teachers to engage in further use of e-learning. Furthermore, the use of individual tools and the distribution of e-learning presentations in various disciplines were quite inhomogeneous. The willingness of the medical schools to cooperate should be capitalized for the future, especially concerning the provision of e-learning tools and concepts

Script Concordance Test: a new method to measure development of competencies in critcal clincal thinking of medical students in pediatrics

Einleitung Die Prüfungen im universitären Umfeld bestehen in der studentischen Ausbildung zum großen Teil aus Multiple-Choice-Fragen. Dieses Format überprüft medizinisches Faktenwissen. Medizinische Handlungspraxis basiert neben dem theoretischen medizinischen Fachwissen auf unterschiedlichen Kompetenzen. Eine davon ist das klinisch-differentialdiagnostische Denken. Das Ziel dieser Studie ist die Überprüfung der Eignung des Skript Konkordanz Tests (SKT) als neues Prüfungsinstrument für die Messung der Kompetenz des klinisch- differentialdiagnostischen Denkens, im Fach der Kinderheilkunde bei Studierenden der Humanmedizin. Es soll überprüft werden inwiefern eine Beziehung zwischen dem Grad der Ausprägung klinischen Experten_innen-Wissens der Dozierenden und dem Abschneiden der Studierendengruppen dieser Dozierenden im SKT besteht. Methodik In einem Workshop wurde ein Fragenkatalog mit 150 Fragen aus den elf Fachbereichen des OHCs für Studierende des Blockpraktikums im sechsten klinischen Semesters (Regelstudiengang) entwickelt. Im Wintersemester 2008/2009 wurde eine prospektive Kohortenstudie durchgeführt. Alle 50 Dozierenden haben die Fragen freiwillig beantwortet. Die Ergebnisse des SKT wurden mit den Ergebnissen der MC-Klausur (Sommersemester 2008) verglichen. Die Ergebnisse der Dozierenden wurden korreliert mit den Ergebnissen der von Ihnen betreuten Gruppen. Ergebnisse 287 Studierende nahmen an der semesterübergreifenden auf Multiple Choice Fragen basierenden Abschlussklausur des fünften klinischen Semesters im Sommersemester 2008 teil. Von diesen nahmen 232 am Skript-Konkordanz Test des folgenden sechsten klinischen Semesters teil (Wintersemester 2008/2009). 64% von ihnen waren weiblich, 36% männlich. Alle 51 Dozenten, die im Blockpraktikum des Wintersemesters 2008/2009 unterrichteten nahmen freiwillig teil. Die SK- Testergebnisse der Studierenden lagen zwischen 49 und 95 Prozent der erreichbaren Punkte, mit einem Mittelwert von 80,4 Prozent. In der MC- Klausur erreichten die Studierenden Werte zwischen 12 und 38 von 39 erreichbaren (Mittelwert 30 Punkte) Punkten. Die Dozierenden erreichten Ergebnisse zwischen 63 und 96 Prozent im SKT (Mittelwert 82,5 Prozent). Der SKT erreichte bei den Studierenden einen optimierten Realiabilitätskoeffizienten, ausgedrückt durch den Faktor Cronbach Alpha von 0,72. (MC-Klausur 0,76). Die Korrelationskoeffizienten (r=0,11 r=0,04) der MC-Klausur und dem SKT waren statisch nicht signifikant. Der Vergleich der Mittelwerte der Dozierenden und Studierenden ergab einen statistisch signifikanten Unterschied, insbesondere unter Berücksichtigung des Einflusses der Dozierenden auf das Ergebnis ihrer Gruppe (r=0,55, p<0,001). Schlußfolgerung Der SK-Test erfüllt durch seine hohen Reliabilitäts- und Validitätswerte die Anforderungen, die an eine notengebenden Prüfung gerichtet werden. Der SKT unterscheidet zudem signifikat zwischen Studierenden und Dozierenden. Die schwache Korrelation zwischen den Ergebnissen der MC-Klausur und dem SKT ist ein Hinweis auf die unterschiedlichen Wissensdomänen sein, die von den beiden Formaten gemessen werden.Introduction Examinations in undergraduate medical education consist to a large extent of Multiple Choice Questions. Clinical reasoning represents one core competency addressed by undergraduate medical education. Aim of this study is to approve the appropriateness of a tool to assess clinical reasoning competence, the Script Concordance Test (SCT). It aims to find validity for the test as a tool to assess clinical reasoning competency by a large group of medical students related to the grade of competence of clinical experts from the same department. Methods A workshop was held to define a pool of 150 SCT- questions was developed, based on the learning objectives in eleven pediatric subspecialities. A prospective cohort study was conducted with all students of the sixth clinical semester during winter semester 2008/2009. Scores of the SCT were compared to student’s MCQ-scores. Scores of the teachers’ group were compared to those of their students to analyze their influence on the development of clinical reasoning competence during the course. Results 287 students took part in the obligatory MC-assessment in summer semester 2008 of whom 232 took part in the SCT in winter semester 2008/2009 at the end of the “Blockpraktikum Pädiatrie” course (64 percent female, 36 percent male). All 51 teachers of the course took part in SCT test. The SCT results of all students were correlated to their MC-test results (summer semester 2008) and to the results of their groups’ teachers results. The scores on the SCT of the students ranged from 49 to 95 percent (mean 80,4 percent). Teachers scores ranged from 63 to 96 percent (mean 82,5 percent). The optimized reliability of the SCT scores, using Cronbach’s alpha, was 0.72, of the MC test 0,76. The student’s correlations between the scores of the SC-Test and the MC-Test results were with r= 0,11 and r=0,04 statistically non-significant. Correlation between students’ and teachers’ mean scores was significant (r=0,55, p<0,001) Conclusion The SK-Test results could significantly differentiate between students and residents. The SC-Test could not show an increase in performance between residents and senior house officers. The poor correlation between the performance on the SCT and the performance on the MC- Test are due to the fact that the test evaluated a different domain. SCT has proven its ability to fulfill the needs of a high stakes examination tool and to assess students’ clinical reasoning capabilities as summative test tool

Human- und Tiermedizin. Technologieeinsatz im Gesundheitswesen

In der human- und tiermedizinischen Bildung spielt technologiebasiertes Lernen für den Erwerb praktischer und theoretischer Kompetenzen eine zentrale Rolle. Bildungsszenarien der medizinischen Aus- und Weiterbildung befinden sich in einem dauerhaften Reformprozess, deren Kern die Zusammenführung theoretischer und praktischer Inhalte in interdisziplinären, auf Kleingruppenunterricht basierenden Curricula ist. Der Technologieeinsatz spielt dabei in unterscheidlichen Szenarien eine Rolle, beispielweise in Blended-Learning-Veranstaltungen, bei ergänzenden virtuellen Patientenvisiten oder auch ¸multitouchbasierte 3D-Patientensimulatoren\u27. Virtuelle Patientinnen und Patienten erlauben so neben der Entlastung schwerkranker und schutzbedürftiger Menschen eine intensivere theoretische Vorbereitung der Lernenden auf den Alltag in der klinischen Praxis. In diesem Beitrag wird außerdem auch auf die Arbeit mit E-Portfolios sowie auf den Einsatz von Social-Media-Werkzeugen in der medizinischen Aus- und Weiterbildung eingegangen. (DIPF/Orig.

Serious Games for Health: Spielend lernen und heilen mit Computerspielen?

Sostmann K, Tolks D, Fischer M, Buron S. Serious Games for Health: Spielend lernen und heilen mit Computerspielen? GMS Medizinische Informatik, Biometrie und Epidemiologie. 2010;6(2).Serious Games (SG) stellen ein neues Medium im Bereich der E-Learning-Anwendungen dar. Sie nutzen die multimedialen Vorteile von Computerspielen, um die didaktischen Bedürfnisse der Zielgruppe in den klassischen oder neuen Lernszenarien zu erfüllen. Der Einsatzbereich für Serious Games for Health (SGH) kann in die Bereiche der medizinischen Therapie/Versorgung oder Gesundheitsversorgung, der medizinischen Fort- und Weiterbildung und in Prävention und Gesundheitsförderung unterteilt werden. In einigen lernpsychologischen Theorien wird die Wirksamkeit von Serious Games for Health als Lernmedium mit der didaktischen Integration motivierendender und multimedialer Anteile von Computerspielen in Lernszenarien begründet. Die Anwendung von Serious Games in der Gesundheitsversorgung kann für Patienten und deren Angehörige in allen Altersgruppen eine sinnvolle ergänzende Intervention darstellen, die den Behandlungserfolg und die Compliance von Patienten unterstützen kann. In der medizinischen Aus-, Fort- und Weiterbildung konnte die Wirksamkeit von Serious Games for Health in verschiedenen E-Learning gestützten Lernszenarien nachgewiesen werden. Serious Games in der Prävention und Gesundheitsförderung werden hauptsächlich im Rahmen von Aufklärungskampagnen eingesetzt, um gezielt schwer erreichbare Zielgruppen anzusprechen

Evaluation of the free, open source software WordPress as electronic portfolio system in undergraduate medical education

BACKGROUND Electronic portfolios (ePortfolios) are used to document and support learning activities. E-portfolios with mobile capabilities allow even more flexibility. However, the development or acquisition of ePortfolio software is often costly, and at the same time, commercially available systems may not sufficiently fit the institution's needs. The aim of this study was to design and evaluate an ePortfolio system with mobile capabilities using a commercially free and open source software solution. METHODS We created an online ePortfolio environment using the blogging software WordPress based on reported capability features of such software by a qualitative weight and sum method. Technical implementation and usability were evaluated by 25 medical students during their clinical training by quantitative and qualitative means using online questionnaires and focus groups. RESULTS The WordPress ePortfolio environment allowed students a broad spectrum of activities - often documented via mobile devices - like collection of multimedia evidences, posting reflections, messaging, web publishing, ePortfolio searches, collaborative learning, knowledge management in a content management system including a wiki and RSS feeds, and the use of aid tools for studying. The students' experience with WordPress revealed a few technical problems, and this report provides workarounds. The WordPress ePortfolio was rated positively by the students as a content management system (67 % of the students), for exchange with other students (74 %), as a note pad for reflections (53 %) and for its potential as an information source for assessment (48 %) and exchange with a mentor (68 %). On the negative side, 74 % of the students in this pilot study did not find it easy to get started with the system, and 63 % rated the ePortfolio as not being user-friendly. Qualitative analysis indicated a need for more introductory information and training. CONCLUSIONS It is possible to build an advanced ePortfolio system with mobile capabilities with the free and open source software WordPress. This allows institutions without proprietary software to build a sophisticated ePortfolio system adapted to their needs with relatively few resources. The implementation of WordPress should be accompanied by introductory courses in the use of the software and its apps in order to facilitate its usability