Expert Involvement and Adherence to Medical Evidence in Medical Mobile Phone Apps: A Systematic Review.

BACKGROUND: Both clinicians and patients use medical mobile phone apps. Anyone can publish medical apps, which leads to contents with variable quality that may have a serious impact on human lives. We herein provide an overview of the prevalence of expert involvement in app development and whether or not app contents adhere to current medical evidence. OBJECTIVE: To systematically review studies evaluating expert involvement or adherence of app content to medical evidence in medical mobile phone apps. METHODS: We systematically searched 3 databases (PubMed, The Cochrane Library, and EMBASE), and included studies evaluating expert involvement or adherence of app content to medical evidence in medical mobile phone apps. Two authors performed data extraction independently. Qualitative analysis of the included studies was performed. RESULTS: Based on inclusion criteria, 52 studies were included in this review. These studies assessed a total of 6520 apps. Studies dealt with a variety of medical specialties and topics. As much as 28 studies assessed expert involvement, which was found in 9-67% of the assessed apps. Thirty studies (including 6 studies that also assessed expert involvement) assessed adherence of app content to current medical evidence. Thirteen studies found that 10-87% of the assessed apps adhered fully to the compared evidence (published studies, recommendations, and guidelines). Seventeen studies found that none of the assessed apps (n=2237) adhered fully to the compared evidence. CONCLUSIONS: Most medical mobile phone apps lack expert involvement and do not adhere to relevant medical evidence.

The acquisition and retention of ECG interpretation skills after a standardized web-based ECG tutorial-a randomised study.

BACKGROUND: Electrocardiogram (ECG) interpretation is of great importance for patient management. However, medical students frequently lack proficiency in ECG interpretation and rate their ECG training as inadequate. Our aim was to examine the effect of a standalone web-based ECG tutorial and to assess the retention of skills using multiple follow-up intervals. METHODS: 203 medical students were included in the study. All participants completed a pre-test, an ECG tutorial, and a post-test. The participants were also randomised to complete a retention-test after short (2-4 weeks), medium (10-12 weeks), or long (18-20 weeks) follow-up. Intragroup comparisons of test scores were done using paired-samples t-test. Intergroup comparisons of test scores were performed using independent-samples t-test and ANOVA, whereas demographic data were compared using ANOVA and Chi-squared test. RESULTS: The overall mean test score improved significantly from 52.7 (SD 16.8) in the pre-test to 68.4 (SD 12.3) in the post-test (p < 0.001). Junior and senior students demonstrated significantly different baseline scores (45.5 vs. 57.8 points; p < 0.001), but showed comparable score gains (16.5 and 15.1 points, respectively; p = 0.48). All three follow-up groups experienced a decrease in test score between post-test and retention-test: from 67.4 (SD 12.3) to 60.2 (SD 8.3) in the short follow-up group, from 71.4 (SD 12.0) to 60.8 (SD 8.9) in the medium follow-up group, and from 66.1 (SD 12.1) to 58.6 (SD 8.6) in the long follow-up group (p < 0.001 for all). However, there were no significant differences in mean retention-test score between the groups (p = 0.33). Both junior and senior students showed a decline in test score at follow-up (from 62.0 (SD 10.6) to 56.2 (SD 9.8) and from 72.9 (SD 11.4) to 62.5 (SD 6.6), respectively). When comparing the pre-test to retention-test delta scores, junior students had learned significantly more than senior students (junior students improved 10.7 points and senior students improved 4.7 points, p = 0.003). CONCLUSION: A standalone web-based ECG tutorial can be an effective means of teaching ECG interpretation skills to medical students. The newly acquired skills are, however, rapidly lost when the intervention is not repeated.

Massive open online courses are relevant for postgraduate medical training.

INTRODUCTION: The CanMEDS framework describes seven roles in postgraduate training, but training and courses relevant to these roles can be limited. Massive open online courses (MOOCs) - free online courses in which anyone can participate, anywhere - may improve course participation. This study investigates the relevance of MOOCs for postgraduate medical training within the CanMEDS framework. MATERIAL AND METHODS: We extracted a list of all courses posted by the two largest MOOC providers, Coursera and EdX, and reviewed all course descriptions and categorised each course into one of three categories--"relevant," "possibly relevant" or "not relevant"--reflecting the degree of relevance to each of the seven CanMEDS roles. We also noted course workload, duration and the name of the educational institution. RESULTS: We agreed the most on the role of health advocate (Cronbach's α = 0.85) and the least on the role of collaborator (Cronbach's α = 0.46). After a consensus-building process, 165 courses were found to be relevant or possibly relevant, mostly to the roles as scholar (n = 75) and medical expert (n = 57). The courses had a median duration of seven weeks and a median weekly workload of 4.5 hours, and were predominantly from North American universities. CONCLUSION: A large number of MOOCs are relevant for postgraduate medical training. A weekly workload of 4.5 hours may enable course participation even for busy clinicians. Physicians should consider these free and universally available courses as relevant and potentially effective means of education. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.