Educational Support Tool Research Articles

The role of artificial intelligence in higher medical education and the ethical challenges of its implementation

Artificial intelligence (AI) is penetrating higher medical education; however, its adoption remains low. A PRISMA-S search of the Web of Science database from 2020 to 2024, utilizing the search terms “artificial intelligence,” “medicine,” “education,” and “ethics,” reveals this trend. Four key areas of AI application in medical education are examined for their potential benefits: Educational support (such as personalized distance education), radiology (diagnostics), virtual reality (VR) (visualization and simulations), and generative text engines (GenText), such as ChatGPT (from the production of notes to syllabus design). However, significant ethical risks accompany AI adoption, and specific concerns are linked to each of these four areas. While AI is recognized as an important support tool in medical education, its slow integration hampers learning and diminishes student motivation, as evidenced by the challenges in implementing VR. In radiology, data-intensive training is hindered by poor connectivity, particularly affecting learners in developing countries. Ethical risks, such as bias in datasets (whether intentional or unintentional), need to be highlighted within educational programs. Students must be informed of the possible motivation behind the introduction of social and political bias in datasets, as well as the profit motive. Finally, the ethical risks accompanying the use of GenText are discussed, ranging from student reliance on instant text generation for assignments, which can hinder the development of critical thinking skills, to the potential danger of relying on AI-generated learning and treatment plans without sufficient human moderation.

S1206 Provider Education and Clinical Decision Support Tool Improve Proficiency in Advanced Therapies for Inflammatory Bowel Disease

S1206 Provider Education and Clinical Decision Support Tool Improve Proficiency in Advanced Therapies for Inflammatory Bowel Disease

Improving Evidence-based Management of Children and Adolescents with Elevated Blood Pressure during a Well-Child Encounter: A Quality Initiative

INTRODUCTION: Pediatric hypertension requires accurate diagnosis and management to reduce the burden of cardiovascular disease across the lifespan. Despite national guidelines, hypertension (HTN) is one of the most frequently missed diagnoses within pediatric primary care. This quality improvement (QI) project aimed to improve the management of patients aged 3–18 years with elevated blood pressure (BP) by 25% during a well-child encounter. METHODS: Over one year, a single-center QI project was conducted at an academic general pediatrics center. Multidisciplinary interventions, including team education, workflow standardization, and clinical decision support tools, were implemented using Plan-Do-Study-Act cycles to improve adherence to evidence-based guidelines. Outcome measures were the percentage of youth with an elevated BP on screening who had documentation of provider actions. We used run charts to analyze the effect of interventions, and descriptive statistics for demographic data and process measures pre- and postintervention. Chi-square tests compared process measures pre- and postintervention and provider actions stratified by age. RESULTS: Key drivers of change were the percentage of documented confirmatory BPs, BP stage, and scheduled follow-up appointments. At baseline, 13% of children with elevated BP on screening had guideline-adherent provider actions documented. This increased to 40% postintervention; however, discrepancies in adherence stratified by age were observed. Youth 13 and older were significantly more likely to receive a provider action than younger children (P < 0.0001). CONCLUSION: BP management during a well-child encounter improved with multidisciplinary interventions that increased knowledge of evidence-based guidelines and standardized care.

Management of physical and psychological trauma resulting from motor vehicle crashes in Australian general practice: a mixed-methods approach

BackgroundIn Australia, motor vehicle crashes (MVC)-related health data are available from insurance claims and hospitals but not from primary care settings. This study aimed to identify the frequency of MVC-related consultations in Australian general practices, explore the pharmacological management of health conditions related to those crashes, and investigate general practitioners’ (GPs) perceived barriers and enablers in managing these patients.MethodsMixed-methods study. The quantitative component explored annual MVC-related consultation rates over seven years, the frequency of chronic pain, depression, anxiety or sleep issues after MVC, and management with opioids, antidepressants, anxiolytics or sedatives in a sample of 1,438,864 patients aged 16 + years attending 402 Australian general practices (MedicineInsight). Subsequently, we used content analysis of 81 GPs’ qualitative responses to an online survey that included some of our quantitative findings to explore their experiences and attitudes to managing patients after MVC.ResultsMVC-related consultation rates remained stable between 2012 and 2018 at around 9.0 per 10,000 consultations. In 2017/2018 compared to their peers, those experiencing a MVC had a higher frequency of chronic pain (48% vs. 26%), depression/anxiety (20% vs. 13%) and sleep issues (7% vs. 4%). In general, medications were prescribed more after MVC. Opioid prescribing was much higher among patients after MVC than their peers, whether they consulted for chronic pain (23.8% 95%CI 21.6;26.0 vs. 15.2%, 95%CI 14.5;15.8 in 2017/2018, respectively) or not (15.8%, 95%CI 13.9;17.6 vs. 6.7%, 95% CI 6.4;7.0 in 2017/2018). Qualitative analyses identified a lack of guidelines, local referral pathways and decision frameworks as critical barriers for GPs to manage patients after MVC. GPs also expressed interest in having better access to management tools for specific MVC-related consequences (e.g., whiplash/seatbelt injuries, acute/chronic pain management, mental health issues).ConclusionChronic pain, mental health issues and the prescription of opioids were more frequent among patients experiencing MVC. This reinforces the relevance of appropriate management to limit the physical and psychological impact of MVC. GPs identified a lack of available resources (e.g. education, checklists and management support tools) for managing MVC-related consequences, and the need for local referral pathways and specific guidelines to escalate treatments.

Diagnosis in Bytes: Comparing the Diagnostic Accuracy of Google and ChatGPT 3.5 as an Educational Support Tool.

Adopting advanced digital technologies as diagnostic support tools in healthcare is an unquestionable trend accelerated by the COVID-19 pandemic. However, their accuracy in suggesting diagnoses remains controversial and needs to be explored. We aimed to evaluate and compare the diagnostic accuracy of two free accessible internet search tools: Google and ChatGPT 3.5. To assess the effectiveness of both medical platforms, we conducted evaluations using a sample of 60 clinical cases related to urological pathologies. We organized the urological cases into two distinct categories for our analysis: (i) prevalent conditions, which were compiled using the most common symptoms, as outlined by EAU and UpToDate guidelines, and (ii) unusual disorders, identified through case reports published in the 'Urology Case Reports' journal from 2022 to 2023. The outcomes were meticulously classified into three categories to determine the accuracy of each platform: "correct diagnosis", "likely differential diagnosis", and "incorrect diagnosis". A group of experts evaluated the responses blindly and randomly. For commonly encountered urological conditions, Google's accuracy was 53.3%, with an additional 23.3% of its results falling within a plausible range of differential diagnoses, and the remaining outcomes were incorrect. ChatGPT 3.5 outperformed Google with an accuracy of 86.6%, provided a likely differential diagnosis in 13.3% of cases, and made no unsuitable diagnosis. In evaluating unusual disorders, Google failed to deliver any correct diagnoses but proposed a likely differential diagnosis in 20% of cases. ChatGPT 3.5 identified the proper diagnosis in 16.6% of rare cases and offered a reasonable differential diagnosis in half of the cases. ChatGPT 3.5 demonstrated higher diagnostic accuracy than Google in both contexts. The platform showed satisfactory accuracy when diagnosing common cases, yet its performance in identifying rare conditions remains limited.

Addressing ChatGPT Localization and Instructional Separation Challenges in Chinese Higher Education

ChatGPT exhibits both advantages and disadvantages in the field of education. To a certain extent, its application necessitates a shift in the evaluation system and a reformation of teaching methods. ChatGPT can serve as an educational support tool, enhancing classroom teaching efficiency for both educators and students. It also facilitates personalized and customized education, thereby stimulating students' innovative capabilities. On the other hand, it presents several challenges, including ethical concerns, issues related to fragmented teaching, and the risk of eroding traditional evaluation systems. This study discusses the phenomenon of a division between teaching and learning caused by the application of ChatGPT, as well as the challenges of localization. Drawing from policy cases in foreign universities and the policies of the University of Hong Kong, Chinese universities should ensure widespread access to ChatGPT, improve curriculum structures, and train teaching staff. Furthermore, collaboration among universities is vital to collectively cultivate AI tailored for education.

ChatGPT as an educational support tool: an analysis of its potential in the teaching and learning process

The integration of new technologies in education has been strengthening in recent years, and Artificial Intelligence-based tools are becoming increasingly popular for enhancing the learning experience. This paper discusses the potential of ChatGPT, an Artificial Intelligence-based language model trained with millions of text examples from the internet, to improve learning and enhance teaching efficiency. This paper explores four main areas where we can use ChatGPT: computer-mediated teaching and content creation; online and distance learning environments; personalized feedback; and self-directed learning. The results suggest that ChatGPT has the potential to be a valuable tool for students and teachers, although further optimization and examination of its usage in diverse contexts is required.

Informal prenatal genetic screening education: What can you learn from Google and YouTube?

PurposeThe goal of this article is to explore what online education and decision support tools are freely available to patients about prenatal screening. MethodsWe (1) conducted an environmental scan using Google Trends to identify and evaluate prenatal screening search terms, (2) created a list of websites and YouTube videos that would be easily accessed by a searcher, and (3) characterized the information within those websites and videos, including an examination of their qualities as a decision support tool and a readability analysis. ResultsFifty websites, containing 62 unique educational resources, and 39 YouTube videos were analyzed. The websites were primarily educational, although the education was provided by a range of sources, including non-profit and for-profit organizations, universities, and governments (ie, public health departments). Readability scores of Patient Education Materials Assessment Tool for Printable Materials for the sites ranged from 50% to 92%, with a median score of 74%. Two of the websites we evaluated met all of the limited decision support standards we applied; 4 of the websites included patient stories or experiences, and 8 included some element of values clarification. Videos were more likely to include values clarification. ConclusionThe information available to patients online is variable. Although most is balanced and informative, much is difficult to read and missing key decision-making factors. Health care providers should work with patients to ensure they have basic comprehension of the prenatal genetic screening materials, possible result outcomes, and expected steps following a positive screening result.

Health Outcomes Following Engagement With a Digital Health Tool Among People With Prediabetes and Type 2 Diabetes: Prospective Evaluation Study.

Diabetes is a worldwide chronic condition causing morbidity and mortality, with a growing economic burden on health care systems. Complications from poorly controlled diabetes are associated with increased socioeconomic costs and reduced quality of life. Smartphones have become an influential platform, providing feasible tools such as health apps to deliver tailored support to enhance the ability of patients with diabetes for self-management. Gro Health is a National Health Service division X-certified digital health tool used to deliver educational and monitoring support to facilitate the development of skills and practices for maintaining good health. This study aims to assess self-reported outcomes of the Gro Health app among users with diabetes and prediabetes and identify the factors that determine engagement with the digital health tool. This was a service evaluation of self-reported data collected prospectively by the developers of the Gro Health app. The EQ-5D questionnaire is a standardized tool used to measure health status for clinical and economic appraisal. Gro Health users completed the EQ-5D at baseline and 6 months after using the app. Users provided informed consent for the use of their anonymized data for research purposes. EQ-5D index scores and visual analogue scale (VAS) scores were calculated at baseline and 6 months for individuals with prediabetes and type 2 diabetes. Descriptive statistics and multiple-regression models were used to assess changes in the outcome measures and determine factors that affected engagement with the digital tool. A total of 84% (1767/2114) of Gro Health participants completed EQ-5D at baseline and 6 months. EQ-5D index scores are average values that reflect people's preferences about their health state (1=full health and 0=moribund). There was a significant and clinically meaningful increase in mean EQ-5D index scores among app users between baseline (0.746, SD 0.23) and follow-up (0.792, SD 0.22; P<.001). The greatest change was observed in the mean VAS score, with a percentage change of 18.3% improvement (61.7, SD 18.1 at baseline;73.0, SD 18.8 at follow-up; P<.001). Baseline EQ-5D index scores, age, and completion of educational modules were associated with significant changes in the follow-up EQ-5D index scores, with baseline EQ-5D index scores, race and ethnicity, and completion of educational modules being significantly associated with app engagement (P<.001). This study provides evidence of a significant positive effect on self-reported quality of life among people living with type 2 diabetes engaging with a digital health intervention. The improvements, as demonstrated by the EQ-5D questionnaire, are facilitated through access to education and monitoring support tools within the app. This provides an opportunity for health care professionals to incorporate National Health Service-certified digital tools, such as Gro Health, as part of the holistic management of people living with diabetes.

Evaluating GPT-4V’s performance in the Japanese national dental examination: A challenge explored

Background/purposeRapid advancements in AI technology have led to significant interest in its application across various fields, including medicine and dentistry. This study aimed to assess the capabilities of ChatGPT-4V with image recognition in answering image-based questions from the Japanese National Dental Examination (JNDE) to explore its potential as an educational support tool for dental students. Materials and methodsThe dataset used questions from the JNDE, which was conducted in January 2023, with a focus on image-related queries. ChatGPT-4V was utilized, and standardized prompts, question texts, and images were input. Data and statistical analyses were conducted using Qlik Sense® and GraphPad Prism. ResultsThe overall correct response rate of ChatGPT-4V for image-based JNDE questions was 35.0 %. The correct response rates were 57.1 % for compulsory questions, 43.6 % for general questions, and 28.6 % for clinical practical questions. In specialties like Dental Anesthesiology and Endodontics, ChatGPT-4V achieved correct response rates above 70 %, while response rates for Orthodontics and Oral Surgery were lower. A higher number of images in questions was correlated with lower accuracy, suggesting an impact of the number of images on correct and incorrect responses. ConclusionWhile innovative, ChatGPT-4V’s image recognition feature exhibited limitations, especially in handling image-intensive and complex clinical practical questions, and is not yet fully suitable as an educational support tool for dental students at its current stage. Further technological refinement and re-evaluation with a broader dataset are recommended.

Manfaat dan Kesenjangan Alat Pendidikan di Era Digital

Educational programs are one of the crucial pillars in human life. Through education, individuals can acquire fundamental knowledge, skills, and attitudes to face various challenges in life. In addition, education also has a central role in shaping the character of the nation's children, creating individuals who are able to contribute to society. In the context of education, the use of educational support tools is a critical aspect that needs attention. Educational support tools include devices and materials that support the effectiveness and efficiency of the teaching and learning process. Its function involves delivering information in an interesting and interactive manner, facilitating the understanding of the material by learners, and increasing their active involvement in learning. However, along with technological advances, educational tools are experiencing rapid development. This provides opportunities for learning that are more accessible to various groups. However, challenges arise in the form of educational gaps. Schools in remote areas, for example, may face limited access to the internet, computers, or mobile devices that are essential to the learning process. Therefore, the role of educational tools is crucial in creating inclusive education, overcoming gaps, and ensuring that every individual can access learning in this digital era.

A Bioecological Approach to the Life of a Child with Autism Spectrum Disorder

Introduction: The aim of this study was to examine the lives of children with autism spectrum disorder from the perspective of the bioecological theory. Method: The research was designed as a descriptive phenomenological study focusing on the participants' descriptions and experiences of living with autism spectrum disorder. The starting point of descriptive phenomenology involves concrete descriptions of the events experienced by the participants from the perspective of their everyday life. Seventeen caregivers of children with autism spectrum disorder participated in the study. Semi-structured interview technique was used to collect the data. Findings: As a result of data analysis, the following sub-themes emerged: caregiver and child, other family members and child, immediate environment and child, teacher and child, the school in the microsystem; social field ties in the mesosystem; parent and teacher in the exosystem; the education system, support, community, laws, and communication tools in the macrosystem; and time and participation in the chronosystem. Discussion: When a child is diagnosed with autism spectrum disorder, the interactions of family members within themselves and with other people in society differ. Many factors such as the level of acceptance of the diagnosis of autism spectrum disorder by other individuals including parents and siblings, personality traits, and their opinions about autism spectrum disorder may have been determinant in interpersonal communication. The views on the teachers' approach can be explained by the education and personality traits of the teachers. In addition, variables such as the resources of the school or the level of acceptance of disability by the school staff may also have been effective in the results. Conclusion and Recommendations: Mothers were the primary caregivers of children, that the socioeconomic characteristics of parents and the personality traits of teachers affected children's development and education, and that the society was prejudiced and distant towards children due to lack of knowledge about children and the subject. It was expected that the quality and quantity of social awareness-raising activities would be improved. Parents who did not have sufficient financial income stated that they could not provide their children with the care and education they needed. It is believed that non-governmental organizations can help children with autism spectrum disorder access training and support in different disciplines such as sensory integration, sports activities, psychology, and nutrition.

Exploring the Possible Use of AI Chatbots in Public Health Education: Feasibility Study.

Artificial intelligence (AI) is a rapidly developing field with the potential to transform various aspects of health care and public health, including medical training. During the "Hygiene and Public Health" course for fifth-year medical students, a practical training session was conducted on vaccination using AI chatbots as an educational supportive tool. Before receiving specific training on vaccination, the students were given a web-based test extracted from the Italian National Medical Residency Test. After completing the test, a critical correction of each question was performed assisted by AI chatbots. The main aim of this study was to identify whether AI chatbots can be considered educational support tools for training in public health. The secondary objective was to assess the performance of different AI chatbots on complex multiple-choice medical questions in the Italian language. A test composed of 15 multiple-choice questions on vaccination was extracted from the Italian National Medical Residency Test using targeted keywords and administered to medical students via Google Forms and to different AI chatbot models (Bing Chat, ChatGPT, Chatsonic, Google Bard, and YouChat). The correction of the test was conducted in the classroom, focusing on the critical evaluation of the explanations provided by the chatbot. A Mann-Whitney U test was conducted to compare the performances of medical students and AI chatbots. Student feedback was collected anonymously at the end of the training experience. In total, 36 medical students and 5 AI chatbot models completed the test. The students achieved an average score of 8.22 (SD 2.65) out of 15, while the AI chatbots scored an average of 12.22 (SD 2.77). The results indicated a statistically significant difference in performance between the 2 groups (U=49.5, P<.001), with a large effect size (r=0.69). When divided by question type (direct, scenario-based, and negative), significant differences were observed in direct (P<.001) and scenario-based (P<.001) questions, but not in negative questions (P=.48). The students reported a high level of satisfaction (7.9/10) with the educational experience, expressing a strong desire to repeat the experience (7.6/10). This study demonstrated the efficacy of AI chatbots in answering complex medical questions related to vaccination and providing valuable educational support. Their performance significantly surpassed that of medical students in direct and scenario-based questions. The responsible and critical use of AI chatbots can enhance medical education, making it an essential aspect to integrate into the educational system.

Artificial Intelligence Chatbots for medical training in Public Health: a tool to explore

Abstract Background Artificial intelligence (AI) is a rapidly developing field with the potential to transform various aspects of healthcare and public health including medical training. During the ‘Hygiene and Public Health’ course for fifth-year medical students, a practical training session was conducted on vaccination using AI as an educational supportive tool. Before receiving specific training on vaccination, the students were given an online questionnaire on vaccination. After completing the questionnaire, a correction of each question was performed using AI chatbots. Objectives The main aim was to identify whether AI chatbots can be considered as educational support tool for training in public health. Secondary objective was to assess performance of 6 different AI chatbot models. Results The questionnaire consisted of 15 items selected from the Italian National Medical Residency Test (years 2015-2022) on the topic of vaccination. 36 medical students participated in the training, achieving a mean score of 8.22/15 on the quiz (range:3-15,median:8). 6 different AI chatbot models (3 modes of BingChat, ChatGPT, ChatSonic, and YouChat) were asked the same questions and achieved a mean score of 12.17/15 (range:10-15,median:11.5), ranking in the top 25% of medical student scores. During the class, the answers provided by the AI chatbots were evaluated with the students, paying particular attention to the completeness of the information, reliability of the sources cited, and use of technical language. Conclusions AI chatbots have shown to be efficient tools for retrieving bibliographic references from the web and answering questions related to specific topics such as vaccination. However, it is important to note that they cannot be considered more intelligent than students, as they may not perform as well when faced with situational questions. The responsible and critical use of AI should be integrated into medical education to ensure its effective utilization. Key messages • AI chatbots use as support tool in public health medical training should be further investigated and endorsed. • AI chatbots could be a helpful resource for medical students in terms of researching and revising their knowledge.

The use of quality improvement interventions in reducing rarely appropriate echocardiograms: A systematic review and meta-analysis.

The volume of cardiac imaging continues to increase, with many tests performed for rarely appropriate indications. Appropriate use criteria (AUC) documents were published by the American Society of Echocardiography and American College of Cardiology, with quality improvement (QI) interventions developed in various institutions. However, the effectiveness of these interventions has not been assessed in a systematic fashion. We searched Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL for studies reporting association between cardiac imaging, AUC and QI. The search was not restricted to time or publication status. We selected studies assessing the effect of QI interventions on performance of rarely appropriate echocardiograms. The primary endpoint was reduction of rarely appropriate testing. Nine studies with 22,070 patients met inclusion criteria. Mean follow up was 15 months (1-60 months). QI interventions resulted in statistically significant reduction in rarely appropriate tests (OR 0.52, 95% CI: .41-.66; p < .01). The effects of QI interventions were analyzed over both the short (<3 months) and long-term (>3 months) post intervention (OR 0.62, 95% CI: .49-.79; p < .01 in the short term, and OR 0.47, 95% CI: .35-.62; p < .01 in the long term). Subgroup analysis of the type of intervention, classified as education tools or decision support tools showed both significantly reduced rarely appropriate testing (OR 0.54, 95% CI: .41-.73; p < .01; OR .47, 95% CI: .36-.61; p < .01). Adding a feedback tool did not change the effect compared to not using a feedback tool (OR 0.49 vs. 0.57, 95% CI: .36-.68 vs. 39-.84; p > .05). QI interventions are associated with a significant reduction in performance of rarely appropriate echocardiography testing, the effects of which persist over time. Both education and decision support tools were effective, while adding feedback tools did not result in further reduction of ordering rarely appropriate studies.

Evaluating the DR-ED Listserv as a Medical Education Networking and Support Tool.

The listserv, although considered old technology by some, continues to show benefit for and growth in subscribers. We investigated the roles the DR-ED listserv plays within the medical education community. We asked, Who subscribes? Why do they subscribe? and How do they use the listserv? We conducted a mixed-methods evaluation of the DR-ED listserv based on message content analysis and user surveys. We found the DR-ED listserv fulfills medical educators' need to network collegially; keep current with issues and ideas in the field; share solutions to problems; share resources; and advertise development opportunities. We found two types of listserv engagement: a) one-way engagement by using it as a resource, or two-way engagement by using and sharing resources. Our findings also highlight the value users attribute to virtual resources and the role listservs can play as economical professional development in a time of constrained costs, and our analysis methods can be used to guide future listserv evaluations. We conclude the relatively easy access to a global medical education listserv is one strategy to create a community of practice for medical education practitioners.

Pengelolaan Lingkungan Belajar Mengenai Alat Permainan Edukatif (APE) untuk Meningkatkan Minat Belajar di TK Khalifah

Abstrak: Management of the Learning Environment Regarding Educational Game Tools (APE) to Increase Learning Interest in Khalifa Kindergarten. This study aims to increase interest in learning in early childhood through the use of educational support tools using descriptive qualitative research methods. The data collection technique carried out by researchers is by conducting interviews with the Principal of Khalifah Kindergarten by filling out questionnaires. The purpose of using educational support tools (APE) in Khalifah Kindergarten is to increase interest in learning in students. APE can help increase students' motivation and interest in learning through more engaging and interactive ways. Some of the benefits of using APE include; Enriching the learning experience, APE can provide a more varied and interesting learning experience, so that students can be more involved in the teaching-learning process; Increasing creativity and imagination, namely APE can trigger the creativity and imagination of students by presenting more visual and interactive material; Improving memory i.e. APE can help learners to more easily remember the information provided, due to the use of more interesting visuals and audio; Increase participation, namely APE can increase student participation in the teaching-learning process, because the material presented is more interesting and interactive. In the context of Khalifa Kindergarten, the use of APE can help increase students' interest in learning, especially for material that is difficult to understand in conventional ways. With the use of APE, students can learn more enjoyably and experience a more varied learning experience. As a result, it is expected that students' interest in learning can increase and create a more active and dynamic learning atmosphere.

Construction and validation of an educational booklet for patients in the postoperative period of cardiac surgery: a methodological study.

to construct and validate an educational booklet for self-care of patients in the postoperative period of cardiac surgery. methodological study, including bibliographic survey, construction of the booklet and validation with judges and the target audience. For validation with judges, the Health Educational Content Validation Instrument was used, and with the target audience, an instrument was used with questions related to organization, writing style, appearance and motivation. To analyze the judges' answers, the content validation index was used. the booklet was prepared with 14 topics. The content validation index among the eight judges was 1 and the concordance index among the ten patients was above 80%. The final version of the material was made available in printed format. the educational booklet was developed and validated by judges and the target audience, serving as an educational support tool for self-care of patients in the postoperative period of cardiac surgery.

GAMIFICATION: APPLYING THE PLAYFUL THROUGH DIGITAL GAMES

This article has as object of study gamification in education, presenting a discussion about the importance of playful activity for the teaching-learning process through gamification in the construction of learning and points out the challenges of gamification in current education. Due to the intensive use of technologies today, the school needs to adapt to the context of this new era, seeking other strategies to teach and learn it. Gamification in education can be thought of as a possibility of innovation in current teaching and learning techniques, using ludicity and digital games as educational support tools that enable the achievement of learning objectives. An experiment is presented aimed at the construction of digital game proposals by undergraduate students of information systems courses at the Fametro University Center.

Design, Development, and Testing of BEST4Baby, an mHealth Technology to Support Exclusive Breastfeeding in India: Pilot Study.

BackgroundExclusive breastfeeding (EBF) at 6 months of age in most low- and middle-income countries, including India, is surprisingly low. There is a relative lack of mobile health apps that specifically focus on leveraging the use of peer counselors (PCs) to support mothers as a means of increasing EBF practices in low- and middle-income countries.ObjectiveThis study aimed to design, develop, and test the usability of Breastfeeding Education Support Tool for Baby (BEST4Baby), a mobile health app specifically designed to support PCs in providing in-home breastfeeding counseling support to mothers in rural India on optimal breastfeeding practices.MethodsA user-centered design process with an agile development methodology was used. The approach involved stakeholders and mothers who were trained to serve as PCs to guide BEST4Baby’s design and development, including the app’s content and features. PCs were engaged through focus groups with interactive wireframes. During the 24-month pilot study period, we conducted a feasibility test of the BEST4Baby app with 22 PCs who supported home visits with mothers residing in rural India. The intervention protocol required PCs to provide education and follow mothers using the BEST4Baby app, with 9 scheduled home visits from the late prenatal stage to 6 months post partum. BEST4Baby’s usability from the PCs’ perspective was assessed using the translated System Usability Scale (SUS).ResultsThe findings of this study align with best practices in user-centered design (ie, understanding user experience, including context with iterative design with stakeholders) to address EBF barriers. This led to the cultural tailoring and contextual alignment of an evidence-based World Health Organization breastfeeding program with an iterative design and agile development of the BEST4Baby app. A total of 22 PCs tested and rated the BEST4Baby app as highly usable, with a mean SUS score of 85.3 (SD 9.1), placing it over the 95th percentile for SUS scores. The approach translated into a highly usable BEST4Baby app for use by PCs in breastfeeding counseling, which also statistically increased EBF practices.ConclusionsThe findings suggest that BEST4Baby was highly usable and accepted by mothers serving as PCs to support other mothers in their EBF practices and led to positive outcomes in the intervention group’s EBF rates. The pilot study demonstrated that using the specially designed BEST4Baby app was an important support tool for mothers to serve as PCs during the 9 home visits.Trial RegistrationClinicaltrials.gov NCT03533725; https://clinicaltrials.gov/ct2/show/NCT03533725