Medical Education Research Study Quality Instrument Score Research Articles

Learning Outcomes and Educational Effectiveness of Social Media as a Continuing Professional Development Intervention for Practicing Surgeons: A Systematic Review and Narrative Synthesis

Objective: The objective of this systematic review was to assess the learning outcomes and educational effectiveness of social media as a continuing professional development intervention for surgeons in practice. Background: Social media has the potential to improve global access to educational resources and collaborative networking. However, the learning outcomes and educational effectiveness of social media as a continuing professional development (CPD) intervention are yet to be summarized. Methods: We searched MEDLINE and Embase databases from 1946 to 2022. We included studies that assessed the learning outcomes and educational effectiveness of social media as a CPD intervention for practicing surgeons. We excluded studies that were not original research, involved only trainees, did not evaluate educational effectiveness, or involved an in-person component. The 18-point Medical Education Research Study Quality Instrument (MERSQI) was used for quality appraisal. Learning outcomes were categorized according to Moore’s Expanded Outcomes Framework (MEOF). Results: A total of 830 unique studies revealed 14 studies for inclusion. The mean MERSQI score of the included studies was 9.0 ± 0.8. In total, 3227 surgeons from 105 countries and various surgical specialties were included. Twelve studies (86%) evaluated surgeons’ satisfaction (MEOF level 2), 3 studies (21%) evaluated changes in self-reported declarative or procedural knowledge (MEOF levels 3A and 3B), 1 study (7%) evaluated changes in self-reported competence (MEOF level 4), and 5 studies (36%) evaluated changes in self-reported performance in practice (MEOF level 5). No studies evaluated changes in patient or community health (MEOF levels 6 and 7). Conclusions: The use of social media as a CPD intervention among practicing surgeons is associated with improved self-reported declarative and procedural knowledge, self-reported competence, and self-reported performance in practice. Further research is required to assess whether social media use for CPD in surgeons is associated with improvements in higher level and objectively measured learning outcomes.

Learning Outcomes and Educational Effectiveness of Social Media as a Continuing Professional Development Intervention for Practicing Surgeons: A Systematic Review and Narrative Synthesis

Objective: The objective of this systematic review was to assess the learning outcomes and educational effectiveness of social media as a continuing professional development intervention for surgeons in practice. Background: Social media has the potential to improve global access to educational resources and collaborative networking. However, the learning outcomes and educational effectiveness of social media as a continuing professional development (CPD) intervention are yet to be summarized. Methods: We searched MEDLINE and Embase databases from 1946 to 2022. We included studies that assessed the learning outcomes and educational effectiveness of social media as a CPD intervention for practicing surgeons. We excluded studies that were not original research, involved only trainees, did not evaluate educational effectiveness, or involved an in-person component. The 18-point Medical Education Research Study Quality Instrument (MERSQI) was used for quality appraisal. Learning outcomes were categorized according to Moore’s Expanded Outcomes Framework (MEOF). Results: A total of 830 unique studies revealed 14 studies for inclusion. The mean MERSQI score of the included studies was 9.0 ± 0.8. In total, 3227 surgeons from 105 countries and various surgical specialties were included. Twelve studies (86%) evaluated surgeons’ satisfaction (MEOF level 2), 3 studies (21%) evaluated changes in self-reported declarative or procedural knowledge (MEOF levels 3A and 3B), 1 study (7%) evaluated changes in self-reported competence (MEOF level 4), and 5 studies (36%) evaluated changes in self-reported performance in practice (MEOF level 5). No studies evaluated changes in patient or community health (MEOF levels 6 and 7). Conclusions: The use of social media as a CPD intervention among practicing surgeons is associated with improved self-reported declarative and procedural knowledge, self-reported competence, and self-reported performance in practice. Further research is required to assess whether social media use for CPD in surgeons is associated with improvements in higher level and objectively measured learning outcomes.

Assessing methodological quality in dental education research using MERSQI: Analysis of publications from two journals.

The Medical Education Research Study Quality Instrument (MERSQI) has been used frequently to assess the methodological quality of medical education but not for dental education. The present study aimed to assess the methodological quality using MERSQI scores of articles published in the Journal of Dental Education (JDE) and the European Journal of Dental Education (EJDE). A cross-sectional assessment of the quality of manuscripts published in 2012, 2017, and 2022 JDE and EJDE was conducted. MERSQI data, numbers of authors, first and corresponding author degrees, geographic origins, and funding information were also extracted for each included study. Descriptive and analytical statistics were conducted, and significance level was set at α<0.05. Four hundred ninety-five articles met the inclusion criteria. The most common study design was a single-group cross-sectional or single-group posttest and conducted in one institution for all studied years. In all journals and years, studies were assessed mainly by participants. The study outcome was mostly satisfaction, attitudes, perceptions, opinions, and general facts. The total mean MERSQI score for each journal and year varied. Year and geographic origin significantly affected the total MERSQI score. Papers originating from Asia had the highest score, followed by South America, Europe, North America, Oceania, and Africa. MERSQI score is applicable to the assessment of the methodological quality of dental educational research. The MERSQI score for most of the domains was similar for both journals. The MERSQI score was affected by publication years and geographic origins.

A Systematic Review of the Application of Simulation to Promote Empathy in Nursing Education.

This systematic review aimed to identify, appraise, and synthesize evidence for the effectiveness of simulation modalities in promoting nursing students' empathy. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was followed with 20 studies included. The Medical Education Research Study Quality Instrument (MERSQI) was used to evaluate the quality of the publications. The mean MERSQI score was 10.95 with an SD of 1.62, which was above the average in the literature.Five simulation modalities were identified: standardized patient, simulated suit, manikin, virtual simulation, and virtual reality simulation. Most of the studies (n = 15) reported significant differences in the measured outcomes after their simulation activities, including all 5 simulation modalities, but the most effective modality was the simulation suit. The simulation suit replicates the lived experiences of others, which enhances perspective taking by "turning the student into the patient" through the physical and sensory effects of simulated suits. However, outcome measures were limited to self-report instruments in the studies.

Medical education research study quality instrument: an objective instrument susceptible to subjectivity

ABSTRACT Background: The medical education research study quality instrument (MERSQI) was designed to appraise medical education research quality based on study design criteria. As with many such tools, application of the results may have unintended consequences. This study applied the MERSQI to published medical education research identified in a bibliometric analysis. Methods: A bibliometric analysis identified highly cited articles in medical education that two authors independently evaluated using the MERSQI. After screening duplicate or non-research articles, the authors reviewed 21 articles with the quality instrument. Initially, five articles were reviewed independently and results were compared to ensure agreed upon understanding of the instrument items. The remainder of the articles were independently reviewed. Overall scores for the articles were analyzed with a paired samples t-test and individual item ratings were analyzed for inter-rater reliability. Results: There was a significant difference in mean MERSQI score between reviewers. Inter-rater reliability for MERSQI items labeled response rate, validity and outcomes were considered unacceptable. Conclusions: Based on these results there is evidence that MERSQI items can be significantly influenced by interpretation, which lead to a difference in scoring. The MERSQI is a useful guide for identifying research methodologies. However, it should not be used to make judgments on the overall quality of medical education research methodology in its current format. The authors make specific recommendations for how the instrument could be revised for greater clarity and accuracy.

Interprofessional Climate Change Curriculum in Health Professional Programs: A Scoping Review

Background: We conducted this scoping review to (1) comprehensively compile the published literature on interprofessional education focused on climate change and health, (2) assess the quality and outcomes of the existing curriculum interventions, and (3) highlight potential areas for further growth. By evaluating published curricular interventions, our goal was to highlight effective and validated developments that could be utilized by health professional educators seeking to include topics on climate change in the curriculum. Methods: We searched Ovid MEDLINE databases (MEDLINE, In-Process, In-Data-Review and Other Non-Indexed Citations, and Epub Ahead of Print), Embase, Clarivate Web of Science, and EBSCOhost Education Abstracts from inception through March 2023. Resulting articles were screened for relevance, and data were extracted from the included studies. The Medical Education Research Study Quality Instrument (MERSQI) was used to assess the quality of each included study. Findings: We screened 688 unique articles, and 6 met inclusion criteria. Publications dated from 2013 to 2023. Three studies included students or healthcare professionals from at least three health profession education programs. The mean MERSQI score was 8·17 (SD = 1·34; range 6–10). Curricular interventions varied by study, and topics included effects of climate change on human health, effect of climate change on extreme weather events and infectious disease exposures, and role of health professionals in climate change communication. Studies did not utilize a two-group comparison design. Most studies used an assessment tool with content validity evidence, but no study provided evidence of validity for internal structure or relationships to other variables. Studies reported that curricular interventions improved outcomes related to both climate change and interprofessional education. Interpretation: Despite the growing call for health professional education focused on climate change and health, there remains a gap in the interprofessional curricular interventions that have been assessed.

Shared decision-making training in general practice: a rapid review.

Although shared decision-making (SDM) is key to providing patient-centred care, SDM is lacking in primary care. Training programmes seeking to improve GP SDM have yet to be reviewed. Therefore, a rapid review of the literature was conducted to evaluate GP SDM training methods and their outcomes. MEDLINE, EMBASE and CENTRAL were systematically searched. Results of the studies included were synthesised narratively. Study quality was appraised using the Medical Education Research Study Quality Instrument (MERSQI). Seven studies were identified. Study quality was high, with a mean MERSQI score of 17.2/18 (range 16-18). Theory/presentation was the most prevalent training method (n=6). Of the five studies assessing the impact of SDM training on patient outcomes, only one yielded positive results. Contrastingly, both studies assessing clinician behaviour produced positive results. SDM training improved GP behaviour but the effects on patient outcomes were lacking. SDM training programmes that utilised teaching methods targeting practical SDM skills, such as role play, observed some positive findings. However, because their prevalence was lacking, further research into these methods, and their cost-effectiveness, are needed.

The Global Use of Artificial Intelligence in the Undergraduate Medical Curriculum: A Systematic Review.

Artificial intelligence (AI) is a rapidly advancing technology that has the potential to revolutionize medical education. AI can provide personalized learning experiences, assist with student assessment, and aid in the integration of pre-clinical and clinical curricula. Despite the potential benefits, there is a paucity of literature investigating the use of AI in undergraduate medical education. This study aims to evaluate the role of AI in undergraduate medical curricula worldwide and compare AI to current teaching and assessment methods. This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Texts unavailable in English were excluded alongside those not focused on medical students alone or with little mention of AI. The key search terms were "undergraduate medical education," "medical students," "medical education," and "artificial intelligence." The methodological rigor of each study was assessed using the Medical Education Research Study Quality Instrument (MERSQI). A total of 36 articles were screened from 700 initial articles, of which 11 were deemed eligible. These were categorized into the following three domains: teaching (n = 6), assessing (n = 3), and trend spotting (n = 2). AI was shown to be highly accurate in studies that directly tested its ability. The mean overall MERSQI score for all selected papers was 10.5 (standard deviation = 2.3; range = 6 to 15.5) falling below the expected score of 10.7 due to notable weaknesses in study design, sampling methods, and study outcomes. AI performance was synergized with human involvement suggesting that AI would be best employed as a supplement to undergraduate medical curricula. Studies directly comparing AI to current teaching methods demonstrated favorable performance. While shown to have a promising role, there remains a limited number of studies in the field, and further research is needed to refine and establish clear foundations to assist in its development.

Publication rates of congress abstracts is associated with abstract quality: Evaluation of Turkish National Medical Education Congresses and Symposia between 2010 and 2014 using MERSQI

There are many parameters that could be used to evaluate the quality of scientific meetings such as publication rates of meeting abstracts as full-text articles after the meeting or scoring with validated quality scales/tools that evaluate individual papers, project proposals, or submitted abstracts. This study aimed to determine the full-text publication rates for abstracts presented at Turkish National Medical Education Congresses and Symposia and to assess the quality of given abstracts. s presented at national medical education congresses and symposia between 2010 and 2014 in Türkiye were evaluated. Initially, the abstracts were evaluated if they were published as full-text articles in international and national peer-reviewed journals following the meeting. Secondly, the quality of presented abstracts was assessed with the Medical Education Research Study Quality Instrument (MERSQI) scale. Overall publication rate for the abstracts was 11.3%. The publication rate of oral and poster presentations were 26.6% and 8.1%, respectively. Oral presentations had a statistically higher publication rate than poster presentations (p = .000). The mean MERSQI score for abstracts was 7.73 ± 2.59. The oral presentations had higher MERSQI mean scores than poster presentations (8.28 ± 2.46 vs. 7.61 ± 2.6; p = .032). Similarly, published abstracts had a significantly higher score compared to unpublished abstracts (10.07 ± 2.74 vs. 7.43 ± 2.41; p = .000). Interestingly, there was no statistical difference between the mean MERSQI scores of the published oral and poster presentations (9.33 ± 2.45 vs. 10.61 ± 2.72; p = .101). This study showed that the main factor for a meeting abstract to be published as a full-text article is the scientific quality of the study. The quality of presentations at annual medical education meetings in Türkiye were low compared with international meetings which did not improve over five years. An institutional policy that would set quality standards for medical education research and increase the awareness of researchers on the topic might help improve the design, execution, and reporting of such studies in Türkiye. The MERSQI could be a valuable tool to monitor the quality of submitted abstracts and to increase the awareness of novice researchers on high quality research.

Neurosurgical skills analysis by machine learning models: systematic review.

Machine learning (ML) models are being actively used in modern medicine, including neurosurgery. This study aimed to summarize the current applications of ML in the analysis and assessment of neurosurgical skills. We conducted this systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed and Google Scholar databases for eligible studies published until November 15, 2022, and used the Medical Education Research Study Quality Instrument (MERSQI) to assess the quality of the included articles. Of the 261 studies identified, we included 17 in the final analysis. Studies were most commonly related to oncological, spinal, and vascular neurosurgery using microsurgical and endoscopic techniques. Machine learning-evaluated tasks included subpial brain tumor resection, anterior cervical discectomy and fusion, hemostasis of the lacerated internal carotid artery, brain vessel dissection and suturing, glove microsuturing, lumbar hemilaminectomy, and bone drilling. The data sources included files extracted from VR simulators and microscopic and endoscopic videos. The ML application was aimed at classifying participants into several expertise levels, analysis of differences between experts and novices, surgical instrument recognition, division of operation into phases, and prediction of blood loss. In two articles, ML models were compared with those of human experts. The machines outperformed humans in all tasks. The most popular algorithms used to classify surgeons by skill level were the support vector machine and k-nearest neighbors, and their accuracy exceeded 90%. The "you only look once" detector and RetinaNet usually solved the problem of detecting surgical instruments - their accuracy was approximately 70%. The experts differed by more confident contact with tissues, higher bimanuality, smaller distance between the instrument tips, and relaxed and focused state of the mind. The average MERSQI score was 13.9 (from 18). There is growing interest in the use of ML in neurosurgical training. Most studies have focused on the evaluation of microsurgical skills in oncological neurosurgery and on the use of virtual simulators; however, other subspecialties, skills, and simulators are being investigated. Machine learning models effectively solve different neurosurgical tasks related to skill classification, object detection, and outcome prediction. Properly trained ML models outperform human efficacy. Further research on ML application in neurosurgery is needed.

Effectiveness of Flexible Bronchoscopy Simulation-Based Training: A Systematic Review

The implementation of simulation-based training (SBT) to teach flexible bronchoscopy (FB) skills to novice trainees has increased during the last decade. However, it is unknown whether SBT is effective to teach FB to novices and which instructional features contribute to training effectiveness. How effective is FB SBT and which instructional features contribute to training effectiveness? We searched Embase, Pubmed, Scopus and Web of Science for articles on FB SBT for novice trainees until November 10, 2022. We assessed methodological quality of included studies using a modified version of the Medical Education Research Study Quality Instrument (MERSQI), evaluated risk of bias with relevant tools depending on study design, assessed instructional features and intended to correlate instructional features to outcome measures. We identified 14 studies from an initial pool of 544 studies. Eleven studies reported positive effects of FB SBT on the majority of their outcome measures. However, risk of bias was moderate or high in 8 studies and only 6 studies were of high quality (modified MERSQI score ≥ 12.5). Moreover, instructional features and outcome measures varied highly across studies and only 4 studies evaluated intervention effects on behavioral outcome measures in the patient setting. Simulation training programs in studies with the highest methodological quality and most relevant outcome measures all included curriculum integration and range in task difficulty. Although most studies reported positive effects of simulation training programs on their outcome measures, definitive conclusions regarding training effectiveness on actual bronchoscopy performance in patients could not be made, due to heterogeneity of training features and the sparse evidence of training effectiveness on validated behavioral outcome measures in a patient setting.

A Scoping Review and Appraisal of Extracorporeal Membrane Oxygenation Education Literature.

BackgroundDespite a recent rise in publications describing extracorporeal membrane oxygenation (ECMO) education, the scope and quality of ECMO educational research and curricular assessments have not previously been evaluated.ObjectiveThe purposes of this study are 1) to categorize published ECMO educational scholarship according to Bloom’s educational domains, learner groups, and content delivery methods; 2) to assess ECMO educational scholarship quality; and 3) to identify areas of focus for future curricular development and educational research.MethodsA multidisciplinary research team conducted a scoping review of ECMO literature published between January 2009 and October 2021 using established frameworks. The Medical Education Research Study Quality Instrument (MERSQI) was applied to assess quality.ResultsA total of 1,028 references were retrieved; 36 were selected for review. ECMO education studies frequently targeted the cognitive domain (78%), with 17% of studies targeting the psychomotor domain alone and 33% of studies targeting combinations of the cognitive, psychomotor, and affective domains. Thirty-three studies qualified for MERSQI scoring, with a median score of 11 (interquartile range, 4; possible range, 5–18). Simulation-based training was used in 97%, with 50% of studies targeting physicians and one other discipline.ConclusionECMO education frequently incorporates simulation and spans all domains of Bloom’s taxonomy. Overall, MERSQI scores for ECMO education studies are similar to those for other simulation-based medical education studies. However, developing assessment tools with multisource validity evidence and conducting multienvironment studies would strengthen future work. The creation of a collaborative ECMO educational network would increase standardization and reproducibility in ECMO training, ultimately improving patient outcomes.

Educational interventions to improve ergonomics in gastrointestinal endoscopy: a systematic review.

Background and study aims Endoscopists are at high risk of musculoskeletal pain and injuries (MSPI). Recently, ergonomics has emerged as an area of interest to reduce and prevent the incidence of MSPI in endoscopy. The aim of this systematic review was to determine educational interventions using ergonomic strategies that target reduction of endoscopist MSPI from gastrointestinal endoscopy. Methods In December 2020, we conducted a systematic search in MEDLINE, EMBASE, PsycINFO, Web of Science, Scopus, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews for articles published from inception to December 16, 2020. Studies were included if they investigated educational interventions aimed at changing knowledge and/or behaviors related to ergonomics in gastrointestinal endoscopy. After screening and full-text review, we extracted data on study design, participants, type of training, and assessment of primary outcomes. We evaluated study quality with the Medical Education Research Study Quality Instrument (MERSQI). Results Of the initial 575 records identified in the search, five met inclusion criteria for qualitative synthesis. We found that most studies (n = 4/5, 80 %) were single-arm interventional studies that were conducted in simulated and/or clinical settings. The most common types of interventions were didactic sessions and/or videos (n = 4/5, 80%). Two (40 %) studies used both standardized assessment studies and formal statistical analyses. The mean MERSQI score was 9.7. Conclusions There is emerging literature demonstrating the effectiveness of interventions to improve ergonomics in gastrointestinal endoscopy.

The use of objective assessments in the evaluation of technical skills in cardiothoracic surgery: a systematic review.

Summary OBJECTIVESWith reductions in training time and intraoperative exposure, there is a need for objective assessments to measure trainee progression. This systematic review focuses on the evaluation of trainee technical skill performance using objective assessments in cardiothoracic surgery and its incorporation into training curricula.METHODSDatabases (EBSCOHOST, Scopus and Web of Science) and reference lists of relevant articles for studies that incorporated objective assessment of technical skills of trainees/residents in cardiothoracic surgery were included. Data extraction included task performed; assessment setting and tool used; number/level of assessors; study outcome and whether the assessments were incorporated into training curricula. The methodological rigour of the studies was scored using the Medical Education Research Study Quality Instrument (MERSQI).RESULTSFifty-four studies were included for quantitative synthesis. Six were randomized-controlled trials. Cardiac surgery was the most common speciality utilizing objective assessment methods with coronary anastomosis the most frequently tested task. Likert-based assessment tools were most commonly used (61%). Eighty-five per cent of studies were simulation-based with the rest being intraoperative. Expert surgeons were primarily used for objective assessments (78%) with 46% using blinding. Thirty (56%) studies explored objective changes in technical performance with 97% demonstrating improvement. The other studies were primarily validating assessment tools. Thirty-nine per cent of studies had established these assessment tools into training curricula. The mean ± standard deviation MERSQI score for all studies was 13.6 ± 1.5 demonstrating high validity.CONCLUSIONSDespite validated technical skill assessment tools being available and demonstrating trainee improvement, their regular adoption into training curricula is lacking. There is a need to incorporate these assessments to increase the efficiency and transparency of training programmes for cardiothoracic surgeons.

A Systematic Review of Pain Management Education in Graduate Medical Education.

Despite the importance of pain management across specialties and the effect of poor management on patients, many physicians are uncomfortable managing pain. This may be related, in part, to deficits in graduate medical education (GME). We sought to evaluate the methodological rigor of and summarize findings from literature on GME interventions targeting acute and chronic non-cancer pain management. We conducted a systematic review by searching PubMed, MedEdPORTAL, and ERIC (Education Resources Information Center) to identify studies published before March 2019 that had a focus on non-cancer pain management, majority of GME learners, defined educational intervention, and reported outcome. Quality of design was assessed with the Medical Education Research Study Quality Instrument (MERSQI) and Newcastle-Ottawa Scale-Education (NOS-E). One author summarized educational foci and methods. The original search yielded 6149 studies; 26 met inclusion criteria. Mean MERSQI score was 11.6 (SD 2.29) of a maximum 18; mean NOS-E score was 2.60 (SD 1.22) out of 6. Most studies employed a single group, pretest-posttest design (n=16, 64%). Outcomes varied: 6 (24%) evaluated reactions (Kirkpatrick level 1), 12 (48%) evaluated learner knowledge (level 2), 5 (20%) evaluated behavior (level 3), and 2 (8%) evaluated patient outcomes (level 4). Interventions commonly focused on chronic pain (n=18, 69%) and employed traditional lectures (n=16, 62%) and case-based learning (n=14, 54%). Pain management education research in GME largely evaluated chronic pain management interventions by assessing learner reactions or knowledge at single sites.

Quality of cost evaluations of physician continuous professional development: Systematic review of reporting and methods.

IntroductionWe sought to evaluate the reporting and methodological quality of cost evaluations of physician continuing professional development (CPD).MethodsWe conducted a systematic review, searching MEDLINE, Embase, PsycInfo, and the Cochrane Database for studies comparing the cost of physician CPD (last update 23 April 2020). Two reviewers, working independently, screened all articles for inclusion. Two reviewers extracted information on reporting quality using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS), and on methodological quality using the Medical Education Research Study Quality Instrument (MERSQI) and a published reference case.ResultsOf 3338 potentially eligible studies, 62 were included. Operational definitions of methodological and reporting quality elements were iteratively revised. Articles reported mean (SD) 43% (20%) of CHEERS elements for the Title/, 56% (34%) for Introduction, 66% (19%) for Methods, 61% (17%) for Results, and 66% (30%) for Discussion, with overall reporting index 292 (83) (maximum 500). Valuation methods were reported infrequently (resource selection 10 of 62 [16%], resource quantitation 10 [16%], pricing 26 [42%]), as were descriptions/discussion of the physicians trained (42 [68%]), training setting (42 [68%]), training intervention (40 [65%]), sensitivity analyses of uncertainty (9 [15%]), and generalizability (30 [48%]). MERSQI scores ranged from 6.0 to 16.0 (mean 11.2 [2.4]). Changes over time in reporting index (initial 241 [105], final 321 [52]) and MERSQI scores (initial 9.8 [2.7], final 11.9 [1.9]) were not statistically significant (p ≥ 0.08).DiscussionMethods and reporting of HPE cost evaluations fall short of current standards. Gaps exist in the valuation, analysis, and contextualization of cost outcomes.Supplementary InformationThe online version of this article (10.1007/s40037-022-00705-z) contains supplementary material, which is available to authorized users. This material includes the full search strategy, operational definitions of the CHEERS elements, and a list of all included studies with key information.

A92 EDUCATIONAL INTERVENTIONS TO IMPROVE ERGONOMIC PERFORMANCE IN GASTROINTESTINAL ENDOSCOPY: A SYSTEMATIC REVIEW

BackgroundPhysicians in procedural specialties, such as gastrointestinal endoscopy, are at a high risk of musculoskeletal injuries (MSPI) which can affect physician wellness and productivity. Training in ergonomic principles for endoscopy may help reduce and prevent the incidence of MSPI.AimsThe aim of this systematic review was to identify educational interventions using ergonomic strategies that target the reduction of MSPI and/or pain from GI endoscopy.MethodsWe conducted a systematic search following PRESS guidelines in MEDLINE, EMBASE, PsycINFO, Web of Science, Scopus, the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews for articles published from inception to December 16, 2020. Studies were included if they investigated educational interventions aimed at changing knowledge and/or behaviours related to ergonomics in gastrointestinal endoscopy. After screening and full-text review, we extracted data on the study design, participants, type of training and assessment of primary outcomes. We evaluated study quality with the Medical Education Research Study Quality Instrument (MERSQI). A qualitative synthesis of the data was conducted.ResultsOf the initial 575 records identified in the search, 5 met inclusion criteria for qualitative synthesis. We found that most studies (n=4, 90%) were single armed interventional studies that were conducted in simulated and/or clinical settings. The most common types of intervention were didactic sessions and/or videos (n=4, 80%). Other interventions included individualized feedback (n=2, 40%), checklists (n=2, 40%), and simulated training (n=1, 20%). Two (40%) studies used both standardized assessment studies and formal statistical analyses to assess primary outcomes. All included studies reported a benefit of their interventions on their respective dimensions assessed for ergonomics. The mean MERSQI score was 9.7.ConclusionsThere is emerging literature demonstrating the effectiveness of interventions to improve ergonomic performance in gastrointestinal endoscopy, which is likely to reduce MSPI among endoscopists. Further higher quality research in this field is required to make robust recommendations. Study flow diagramFunding AgenciesNone

Learning Outcomes of Immersive Technologies in Health Care Student Education: Systematic Review of the Literature.

BackgroundThere is a lack of evidence in the literature regarding the learning outcomes of immersive technologies as educational tools for teaching university-level health care students.ObjectiveThe aim of this review is to assess the learning outcomes of immersive technologies compared with traditional learning modalities with regard to knowledge and the participants’ learning experience in medical, midwifery, and nursing preclinical university education.MethodsA systematic review was conducted according to the Cochrane Collaboration guidelines. Randomized controlled trials comparing traditional learning methods with virtual, augmented, or mixed reality for the education of medicine, nursing, or midwifery students were evaluated. The identified studies were screened by 2 authors independently. Disagreements were discussed with a third reviewer. The quality of evidence was assessed using the Medical Education Research Study Quality Instrument (MERSQI). The review protocol was registered with PROSPERO (International Prospective Register of Systematic Reviews) in April 2020.ResultsOf 15,627 studies, 29 (0.19%) randomized controlled trials (N=2722 students) were included and evaluated using the MERSQI tool. Knowledge gain was found to be equal when immersive technologies were compared with traditional learning modalities; however, the learning experience increased with immersive technologies. The mean MERSQI score was 12.64 (SD 1.6), the median was 12.50, and the mode was 13.50. Immersive technology was predominantly used to teach clinical skills (15/29, 52%), and virtual reality (22/29, 76%) was the most commonly used form of immersive technology. Knowledge was the primary outcome in 97% (28/29) of studies. Approximately 66% (19/29) of studies used validated instruments and scales to assess secondary learning outcomes, including satisfaction, self-efficacy, engagement, and perceptions of the learning experience. Of the 29 studies, 19 (66%) included medical students (1706/2722, 62.67%), 8 (28%) included nursing students (727/2722, 26.71%), and 2 (7%) included both medical and nursing students (289/2722, 10.62%). There were no studies involving midwifery students. The studies were based on the following disciplines: anatomy, basic clinical skills and history-taking skills, neurology, respiratory medicine, acute medicine, dermatology, communication skills, internal medicine, and emergency medicine.ConclusionsVirtual, augmented, and mixed reality play an important role in the education of preclinical medical and nursing university students. When compared with traditional educational modalities, the learning gain is equal with immersive technologies. Learning outcomes such as student satisfaction, self-efficacy, and engagement all increase with the use of immersive technology, suggesting that it is an optimal tool for education.

Effectiveness of the Structured and Conventional Methods of Viva Examination in Medical Education: A Systematic Review and Meta-analysis

Introduction: Oral examination (viva voce) is one of the common assessment methods for medical students. Literature shows that Conventional Oral Examination (COE), is a widely adopted method and uses a consolidated scoring system. There came an alternative method, Structured Oral Examination (SOE) that uses the recommended rating scale (prevalidated questions and markings). The emergence of a new method raised the research question of whether the conventional or structured oral examination is effective in assessing medical students. Aim: To evaluate the effectiveness of traditional and structured vivavoce examination across the specialties in medical education. Materials and Methods: A systematic review was conducted on 18 peer-reviewed articles about conventional and structured oral examination among medical students. Medical Education Research Study Quality Instrument (MERSQI) was used to assess the quality of evidence. Results: The level of evidence was moderate where the MERSQI score ranges from 7.5 to 15.5 for the 18 articles included in the review process. SOE overcomes COE by assessing students’ cognitive skills, communication skills, behaviour, and attitude whereas COE principally assesses the recall knowledge. Analytical and reasoning power remains the predominant domain in SOE. With psychometric properties like good reliability, sensitivity, and acceptability, SOE remains the best strategy for the evaluation of medical students. Pooled results in the forest plot showed no difference in the viva voce marks between COE and SOE with a mean difference of 0.46 (p=0.53). Conclusion: The review analysis revealed that there is no difference in the mean marks scored by COE and SOE. However, a SOE will allow examiners to assess the medical students’ learning achievement with no partiality, stress, and anxiety compared to COE.

Perceptions of medical students towards and effectiveness of online surgical curriculum: a systematic review

BackgroundOnline education has been used as an adjunct modality for teaching and it attracts attention in recent years as many medical students can not accomplish their clerkship in the hospital due to COVID-19 pandemic. This study aims to collect the articles related to online surgical education for medical students, and to analyze the effectiveness of online education and the perceptions of the medical students.MethodWe performed a systemic literature search in PubMed, MEDLINE, EMBASE, ERIC and Cochrane library. Keywords used for searching included “medical student”, “online education”, “online teaching”, “online learning”, “distance learning”, “electronic learning”, “virtual learning” and “surgical”. Medical education research study quality instrument (MERSQI) was used for the evaluation of the quality of the searched articles.ResultsFrom 1240 studies retrieved from the databases, 13 articles were included in this study after screening. The publication year was from 2007 to 2021. The mean MERSQI score of the 13 searched articles was 12.5 +/− 1.7 (range 10.0-14.5). There were totally 2023 medical students who attended online surgical curriculum. By online course, improvement of understanding and knowledge on the studied topics could be reached. The confidence in patient encounters could be improved by online curriculum with sharing experiences, discussing, and role playing. However, students felt concentration was poor during online course. Medical students studying through video platform could get better test scores than those studying with textbooks. Regarding basic surgical skills, online teaching of suturing and knot-tying could be possible and was appreciated by the students who could practice away from the hospital and get feedbacks by instructors through online environment. The scores for the clinical competence assessment for incision, suturing and knot-tying were found to be no significant difference between the online teaching group and face-to-face teaching group.ConclusionOnline surgical curriculum for medical students is not easy but inevitable in the era of COVID-19 pandemic. Although online course is not the same as physical course, there are some efforts which could be tried to increase the effectiveness. Basic surgical skills could also be taught effectively through online platform. Even if the COVID-19 pandemic is over in the future, online curriculum could still be a helpful adjunct for surgical education.