A Review of Digital, Social, and Mobile Technologies in Health Professional Education

Utilization of a 3D-Printed Mandibular Jaw for Ridge Reconstruction in Periodontics: A Case Report

Three-dimensional (3D) printing is an emerging manufacturing technology in dentistry with a range of applications. Digital dentistry presented in cone beam CT scan radiographs is a revolution that improved surgical outcomes by optimizing accurate diagnosis and analysis of the surgical sites before surgery. A periodontist can modify the treatment plan, surgical techniques, and incision design based on bone defects seen on cone beam CT scans. Block grafting has been a technique of choice when wound stability is required for guided bone regeneration. There was no significant difference between the different surgical procedures for reconstruction and choice should be given to the simpler and less invasive procedure. A xenograft or allograft block can work as an alternative to the autogenous bone block to reduce the surgery time and patient morbidity. Preparation and shaping of block graft during surgery time to match the defect shape can prolong the operative time, reduce the treatment success, and increase postoperative complications. In this case report, a sterilized 3D-printed mandibular jaw was utilized to visualize the defect size and shape. A bovine xenograft block was then prepared, shaped, and adapted on the 3D-printed jaw 30 minutes before the surgery. The block graft was then transferred and well-fitted on the surgical defect. Handling experience was greater and surgery time and postoperative pain were reduced.

Interprofessional collaboration (or lack thereof) between faculty and learning technologists in the creation of digital learning

BACKGROUND

As digital learning becomes more prevalent and important in health professions education, learning technologists play increasingly central roles in designing and delivering learning materials. However, little is understood about the process by which learning technologists have integrated into the existing teaching and learning ecosystem, and it seems that they remain marginal and undervalued. Our aim in this paper was therefore to examine the process of interprofessional co-development of course materials as experienced by educators and learning technologists.

METHODS

Our approach was qualitative, using individual semi-structured interviews (conducted between July 2021 to May 2022) to explore the working relationship between faculty and learning technologists. Transcripts were analysed abductively.

RESULTS

We found that the attitudes of both faculty and learning technologists towards collaborating to drive digital adoption in health professions education fell into two main themes: "embrace" and "replace" - and "conflict", which we present as a third theme. Our results revealed that faculty did not take an active and agentic role in developing their digital practices in respect of education delivery. Learning technologists positioned themselves as a resource to support faculty's knowledge and skill gap in digital competence. There was an obvious power differential between the two groups: learning technologists lacked agency and seemed in the position of servants to faculty masters. This created barriers to effective collaboration.

CONCLUSIONS

By examining the process of co-development of course materials by faculty and learning technologists, we open up a space to examine the social, relational and organisational complexities associated with interprofessional collaboration in digital health professions education. Our study also has important implications for guiding educational policy to better position learning technologists to effectively collaborate with faculty and realise the potential of digital health professions education.

Effectiveness of a blended learning intervention in cardiac physiotherapy. A randomized controlled trial

Background

Blended learning (BL) combines both face-to-face learning (FL) and online learning. This study aims to compare the effectiveness of a BL intervention vs. a FL intervention in relation to the knowledge, competencies, satisfaction, perceptions, usability, and BL acceptance of physiotherapy students.

Methods

An assessor-blinded randomized trial was performed. A total of 100 students were randomly allocated to either the BL group (BLG, n = 48) or FL group (FLG, n = 52). The BLG received face-to-face classes plus access to online resources (online syllabus, Moodle, scientific-based videos and websites, activities, glossary, and apps). The FLG received face-to-face classes and hardcopy resources (hardcopy syllabus, scientific-based information, activities, and a glossary). Knowledge, ethical and gender competencies, satisfaction, perceptions, usability, and BL acceptance were assessed.

Results

The BLG showed higher scores than the FLG for knowledge (p = 0.011), three ethical/gender competencies (p < 0.05), increased motivation to prepare themselves before class (p = 0.005), increased motivation and ability of thinking (p = 0.005), improved understanding of important topics (p = 0.015), course organization (p = 0.017), educational material (p = 0.001), easiness of understanding (p = 0.007), comprehensive coverage of the subject (p = 0.001), and clarity of instructions (p = 0.004), while usability was acceptable.

Conclusion

The BL intervention can be used for improving the knowledge, competencies, perceptions, and satisfaction of the students. In addition, BL acceptance was positive, and usability was found to be acceptable. This study supports the use of BL as a pedagogical approach to foster innovative learning.

Telepharmacy in oncology care: A scoping review

INTRODUCTION

Telepharmacy has the potential to enhance pharmacy services in oncology care, especially in remote areas. This scoping review explored the range, critical benefits and barriers of using telepharmacy services in oncology care.

METHODS

The scoping review followed the Arksey and O'Malley's five-stage framework to identify available evidence. PubMed, CINAHL, Embase, PsycINFO, Ovid MEDLINE and Scopus databases were searched for original research published between 2010 and 2020. The five dimensions of the Alberta Quality Matrix for Health were used to analyse reported outcomes.

RESULTS

Eligible articles (n = 21) were analysed. Telepharmacy in oncology care was used for follow-up, monitoring and counselling, intravenous chemotherapy and sterile compounding, expanding availability of pharmacy services, and remote education. Telepharmacy obtained high acceptability among cancer patients (n = 5) and healthcare professionals (n = 5), and increased accessibility of pharmaceutical services to underserved cancer populations (n = 2). Commonly cited effectiveness and safety outcomes were improved patient adherence (n = 5), increased pharmacy services (n = 3) and early identification of medication-related problems (n = 5). Telepharmacy improved efficiency in staffing and workload (n = 3), and increased cost savings (n = 3). A shortage of resources (n = 5), technical problems (n = 4) and prolonged turnaround time (n = 4), safety concerns (n = 2) and patient willingness to pay (n = 1) were identified barriers to implementing telepharmacy in oncology care.

DISCUSSION

Despite evidence pointing to the advantages and opportunities for expanding oncology pharmacy services through telepharmacy, certain challenges remain. Further research is needed to investigate safety concerns and patient willingness to pay for telepharmacy services.

Outline of a project for nursing health education on the Instagram social network

Objectives:

to characterize the outline of a project for health education and its contributions to the propagation of information on the Instagram social network.

Methods:

exploratory and descriptive research on an Instagram profile called “@resenhadasaude”;. Data collection: from July 23, 2020, to April 21, 2021. Interaction metrics were generated on 36 posts. Simple and percentage statistical analysis were applied.

Results:

there are 1,016 followers in Brazil, with a 206.02% growth. The largest audience is teenagers, young people, and women, with a gender difference of 41.8%. The greatest interest was about covid-19, sexual health, and drugs. Followers’ misconceptions reinforce the need for the dissemination of quality information.

Conclusions:

Instagram metrics point to the project’s validation in terms of audience interest, mostly adolescents and youth. Instagram proved to be powerful for educational purposes and information dissemination, as well as an autonomous field for nursing.

Online educational interventions in pediatric intensive care medicine

Background

Online education has experienced explosive growth, particularly in the wake of the COVID-19 pandemic. We explored the current state of the evidence base for online education targeted towards healthcare professionals working in pediatric intensive care units (PICUs), to report how we are using online education in our field.

Materials and Methods

We performed a literature review by systematically generating a list of publications indexed in PubMed describing online educational interventions in the PICU, using Medical Subject Header (MeSH)-based search terms and the following inclusion criteria: studies published after 2005 that describe online educational interventions aimed at healthcare professional working in the PICU. We reviewed the full text of all included articles, and summarized the study aims, design, and results.

Results

Our initial search yielded 1,071 unique articles. After screening abstracts and titles, then full texts, eight articles were included in the review. Many online learning modalities are represented, including websites, self-study modules, videos, videoconferencing, online self-assessment with feedback, virtual patient cases, screen-based simulation, and podcasts. Three studies focused on residents, two studies on nurses, two studies on a multidisciplinary team, and one study on transport nurses and paramedics. Most studies utilized participant surveys to assess satisfaction, and half included pre- and post-intervention multiple-choice question tests. Only one study included a patient-related outcome measure.

Conclusions

Despite growth in online medical educational intervention research, there are relatively few published studies in pediatric critical care, and only one study evaluated the impact of online learning on patient outcomes. There remain significant opportunities for PICU educators to assess the impact of online educational interventions, especially related to clinician behaviors and patient outcomes.

Perfil de um projeto de educação em saúde de enfermagem na rede social Instagram

RESUMO Objetivos: caracterizar o perfil de um projeto de educação em saúde e suas contribuições à difusão de informação na rede social Instagram. Métodos: pesquisa exploratória e descritiva sobre um perfil do Instagram denominado “@resenhadasaude”;. Coleta de dados: de 23 de julho de 2020 a 21 de abril de 2021. Geraram-se métricas de interação sobre 36 postagens. Aplicou-se análise estatística simples e percentual. Resultados: são 1.016 seguidores no Brasil, com crescimento de 206,02%. Maior público é adolescente, jovem e feminino, com diferença entre os gêneros de 41,8%. O maior interesse foi sobre a covid-19, saúde sexual e drogas. Equívocos de conhecimento dos seguidores reforçam a necessidade de difusão de informações de qualidade. Conclusões: as métricas do Instagram apontam a validação do projeto em termos de interesse do público, majoritariamente de adolescentes e jovens. O Instagram mostrou-se potente para fins educativos e difusão de informação, bem como campo autônomo para a enfermagem.

Publication activities relating to digital teaching and learning in the GMS Journal for Medical Education - a descriptive analysis (1984-2020)

AIMS AND OBJECTIVES

Digital teaching, learning and assessment have been part of medical education and continuing education for decades. The objective of this review paper is to highlight developments and perspectives in these areas in the GMS Journal for Medical Education (GMS JME).

METHODOLOGY

In the spring of 2020, we conducted a systematic literature search of the Journal for Medical Education (JME) and analysed the articles with regard to different categories such as article type, digital tools used or mode of data collection.

RESULTS

Of the 132 articles analysed, 78 were digital interventions (53 of which were exploratory-descriptive), 28 were project descriptions, 16 were surveys of needs or equipment and 10 were concept papers. About one-third of the studies and project reports each dealt with virtual patients or case-based learning, whereas no articles were published on trends such as serious games or virtual reality. Overall, our analysis shows that in many respects, the studies on digital teaching were more broadly based, especially between 2006 and 2010, after which this trend tended to decline again.

CONCLUSIONS

Our analysis shows that publications in the JME consider some key aspects of digital teaching in medical education and continuing education, such as educational videos or virtual patients. The variability of information and methods of presentation advocate the use of guidelines to optimise the quality of scientific papers. Furthermore, clues for future research topics and experimental study designs are identified.

Digital Educational Interventions for the Development of Advanced Care Planning Skills for Medical Practitioners: A Scoping Review

BACKGROUND

Medical practitioners are important facilitators of advanced care planning but are often reluctant to engage in these conversations with patients and their families. Barriers to participation can be addressed through medical education for medical practitioners.

INTRODUCTION

The primary objective was to examine the extent to which digital educational interventions are used to foster advanced care planning skills. Secondary objectives include understanding the acceptability of these interventions and whether electronic health records can be used to personalize learning.

METHODS

Online databases were used to identify relevant articles published from 2008 to 2021. Nine articles which evaluated the impact of digital learning for medical practitioners were selected. Studies eligible for inclusion in the review assessed changes in knowledge, attitudes, and practice regarding skills used in advanced care planning.

RESULTS

All publications used a pre-post study design with education delivered solely online. Only three studies focused on completing advance care plans or directives (33%). All but two studies recorded improvements in knowledge and/or attitudes toward planning (78%) while three studies recorded improvements in clinical practice (33%). The review suggests prior clinical or personal experiences could be used to personalize education.

DISCUSSION

The literature revealed that using digital education to develop advanced care planning skills is relatively unexplored despite the ability of this type of learning to improve professional knowledge and confidence. Digital devices can also improve access to relevant information at the point-of-care. Personalized interventions that incorporate prior clinical experiences, potentially extracted from health records, could be used to optimize outcomes.

Social media in the learning ecologies of communications students: Identifying profiles from students' perspective

Social media can be a support during the initial training of communication professionals, although most studies on social media and learning have mainly focused on other professional groups. The purpose of this article is to explore how communication students learn and their use of social media platforms, in order to identify the role of social media in supporting communication students' learning. Data was collected using a questionnaire sent to communication students of the UOC and analyzed using a clustering technique, to identify student profiles based on how they organize their learning and their use of social media platforms. Our results suggest that there are 5 main student profiles: (i) students that learn through many contexts with strong support of Wikipedia, Blogs and YouTube; (ii) students with preference for academically guided learning resources; (iii) students with preference for informal and digital learning contexts, supported by social networks; (iv) students with preference for physical and formal contexts with a slight support of interactive social media platforms and (v) students detached academically with low use of learning resources and occasional use of social media platforms. Findings show that in the formative stage, there is a different degree of utility of social media among communication students, with a division between platforms that we could designate as more static and sources of information (Wikipedia, blogs or YouTube) and more interactive and dynamic (Twitter, Facebook or LinkedIn). The findings of this article can help to inform and make communication studies more flexible, collaborative and personalized oriented. In follow up studies, it would be interesting to delve further into how COVID-19 has affected the role of social media platforms.

Digital Health and Learning in Speech-Language Pathology, Phoniatrics, and Otolaryngology: Survey Study for Designing a Digital Learning Toolbox App

BACKGROUND

The digital age has introduced opportunities and challenges for clinical education and practice caused by infinite incoming information and novel technologies for health. In the interdisciplinary field of communication sciences and disorders (CSD), engagement with digital topics has emerged slower than in other health fields, and effective strategies for accessing, managing, and focusing on digital resources are greatly needed.

OBJECTIVE

We aimed to conceptualize and investigate preferences of stakeholders regarding a digital learning toolbox, an app containing a library of current resources for CSD. This cross-sectional survey study conducted in German-speaking countries investigated professional and student perceptions and preferences regarding such an app's features, functions, content, and associated concerns.

METHODS

An open web-based survey was disseminated to professionals and students in the field of CSD, including speech-language pathologists (SLPs; German: Logopäd*innen), speech-language pathology students, phoniatricians, otolaryngologists, and medical students. Insights into preferences and perceptions across professions, generations, and years of experience regarding a proposed app were investigated.

RESULTS

Of the 164 participants, an overwhelming majority (n=162, 98.8%) indicated readiness to use such an app, and most participants (n=159, 96.9%) perceived the proposed app to be helpful. Participants positively rated app functions that would increase utility (eg, tutorial, quality rating function, filters based on content or topic, and digital format); however, they had varied opinions regarding an app community feature. Regarding app settings, most participants rated the option to share digital resources through social media links (144/164, 87.8%), receive and manage push notifications (130/164, 79.3%), and report technical issues (160/164, 97.6%) positively. However, significant variance was noted across professions (H₃=8.006; P=.046) and generations (H₃=9.309; P=.03) regarding a username-password function, with SLPs indicating greater perceived usefulness in comparison to speech-language pathology students (P=.045), as was demonstrated by Generation X versus Generation Z (P=.04). Participants perceived a range of clinical topics to be important; however, significant variance was observed across professions, between physicians and SLPs regarding the topic of diagnostics (H₃=9.098; P=.03) and therapy (H₃=21.236; P<.001). Concerns included technical challenges, data protection, quality of the included resources, and sustainability of the proposed app.

CONCLUSIONS

This investigation demonstrated that professionals and students show initial readiness to engage in the co-design and use of an interdisciplinary digital learning toolbox app. Specifically, this app could support effective access, sharing, evaluation, and knowledge management in a digital age of rapid change. Formalized digital skills education in the field of CSD is just a part of the solution. It will be crucial to explore flexible, adaptive strategies collaboratively for managing digital resources and tools to optimize targeted selection and use of relevant, high-quality evidence in a world of bewildering data.

Medical Students' Technology Use for Self-Directed Learning: Contributing and Constraining Factors

BACKGROUND

With medical education shifting towards competency-based models, medical students are expected to be self-directed lifelong learners. There is an urgent need to understand what technology students adopt for self-directed learning and what factors contributed to students' self-initiated technology use.

METHOD

This study took place in a midwestern university medical school, which implements a flipped classroom model where students are required to learn all the course materials independently before class. Twenty-six first- and second-year medical students participated in a semi-structured interview about their self-directed learning with technology, and contributing factors towards technology use. A qualitative description methodology using thematic analysis was used to identify key themes from the interview data.

RESULTS

Medical students reported using four types of technologies for learning video resources, self-assessment tools, management tools, and social media. Three key determinants of students' self-directed technology use were identified, including perceived usefulness, subjective norms, and educational compatibility.

CONCLUSIONS

By probing medical students' self-initiated technology use and its determinants, this study suggested that in a self-directed learning environment, medical students used a variety of third-party resources to facilitate learning and develop self-directed learning skills. This study also provided important practical implications to better support students' productive use of technologies for self-directed learning.

Application of digital education in undergraduate nursing and medical interns during the COVID-19 pandemic: A systematic review

BACKGROUND

Due to the rapid spread of coronavirus disease 2019 (COVID-19) around the world, the World Health Organization (WHO) declared it a global pandemic on March 11, 2020. This declaration had an unprecedented impact on health profession education, especially the clinical clerkship of nursing and medical students. The teaching hospitals had to suspend traditional bedside clinical teaching and switch to digital education.

OBJECTIVE

To systematically synthesize the available literature on the application of digital education in undergraduate nursing and medical interns during the COVID-19 pandemic.

DESIGN

A systematic review informed by PRISMA guidelines.

DATA SOURCES

Five electronic databases were systematically searched: PubMed, Embase, MEDLINE (OVID), CINAHL and the Cochrane Library.

REVIEW METHODS

The retrieved articles were screened at the title, abstract, and full text stages. The Mixed-Methods Appraisal Tool (MMAT) was used to assess the quality of quantitative and mixed-method studies. Then, two reviewers extracted the quantitative data of the included studies.

RESULTS

A total of 4596 studies were identified following a comprehensive search, and 16 studies were included after removing duplicates and screening, which focused on undergraduate nursing students (3 studies) and medical students (13 studies). We found that the standalone digital education modalities were as effective as conventional learning for knowledge and practice. Different educational technologies have different effects on the knowledge and practice of interns.

CONCLUSION

Digital education plays a significant role in distance training for nursing and medical interns both now and in the future. The overall risk of bias was high, and the quality of evidence was found to be variable. There is a need for further research designing more quasi-experimental studies to assess the effectiveness of standalone digital education interventions for the remote training of nursing or medical interns to be fully prepared for emergencies.

Grupos virtuais no enfrentamento do medo e da morte durante a epidemia de covid-19: contribuições da saúde coletiva

Resumo Este texto apresenta uma atividade grupal desenvolvida durante a epidemia de covid-19 em espaço virtual, com 13 participantes, estudantes e professores universitários. O objetivo foi oferecer um espaço de escuta protegido e criar estratégias para enfrentar a angústia e o medo decorrentes da epidemia. A ferramenta metodológica utilizada foi a intervenção grupal, realizada entre maio e agosto de 2020, que operou como uma rede de conversação. No grupo, produziu-se um diálogo horizontal com temas escolhidos conjuntamente e buscando soluções compartilhadas para diversos problemas. Este artigo analisa o diálogo ocorrido nos encontros em que se falou sobre o medo. Neles, os(as) participantes identificaram o medo da morte e da perda de pessoas amadas como aquele que desperta maior sofrimento, acentuado quando as pessoas estão distantes geograficamente. A avaliação mostrou que os encontros e os diálogos produziram alívio e bem-estar, e que trabalhar em plataforma virtual não constituiu empecilho à comunicação. Grupos de intervenção desenvolvidos em espaço virtual compõem metodologias de baixo custo, porém potentes, fáceis de operar e possíveis de serem nucleadas nos mais diversos coletivos.

Major Publications in the Critical Care Pharmacotherapy Literature: 2020

OBJECTIVES

To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2020.

DATA SOURCES

The Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update group screened 36 journals monthly for impactful publications.

STUDY SELECTION

The group reviewed a total of 119 articles during 2020 according to relevance for practice.

DATA EXTRACTION

Articles were selected with consensus and importance to clinical practice from those included in the monthly Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update. The group reviewed articles according to Grading of Recommendations, Assessment, Development, and Evaluations criteria. Articles with a 1A grade were selected.

DATA SYNTHESIS

Several trials were summarized, including two meta-analyses and five original research trials. Original research trials evaluating vitamin C, hydrocortisone, and thiamine versus hydrocortisone in sepsis, the use of nonsedation strategies, dexmedetomidine in cardiac surgery, remdesivir for severe acute respiratory syndrome coronavirus 2, and thrombectomy in acute ischemic stroke. Two meta-analyses determining the impact of norepinephrine initiation in patients with septic shock and the use of corticosteroids in severe acute respiratory syndrome coronavirus 2 was included.

CONCLUSIONS

This clinical review provides summary and perspectives of clinical practice impact on influential critical care pharmacotherapy publications in 2020.

A Meta-Analysis of the Effect of Paper Versus Digital Reading on Reading Comprehension in Health Professional Education

Objective. Despite a rise in the use of digital education in health professional education (HPE), little is known about the comparative effectiveness of paper-based reading and its digital alternative on reading comprehension. The objectives of this study were to identify, appraise, and synthesize the evidence regarding the effect of how media is read on reading comprehension in the context of HPE.Methods. Observational, quasi-experimental, and experimental studies published before April 16, 2021, were included if they compared the effectiveness of paper-based vs digital-based reading on reading comprehension among HPE students, trainees, and residents. Random-effects meta-analyses were performed using standardized mean differences.Results. From a pool of 2,208 references, we identified and included 10 controlled studies that had collectively enrolled 817 participants. Meta-analyses revealed a slight but nonsignificant advantage to students reading paper-based HPE texts rather than digital text (standardized mean difference, -0.08; 95% CI -0.28 to 0.12). Subgroup analyses revealed that students reading HPE-related texts had better reading comprehension when reading text on paper rather than digitally (SMD =  -0.36; 95% CI -0.69 to -0.03). Heterogeneity was low in all analyses. The quality of evidence was low because of risks of bias across studies.Summary. Current evidence suggests little to no difference in students' comprehension when reading HPE texts on paper vs digitally. However, we observed effects favoring reading paper-based texts when texts relevant to the students' professional discipline were considered. Rigorous studies are needed to confirm this finding and to evaluate new means of boosting reading comprehension among students in HPE programs.

How registered nurses balance limited resources in order to maintain competence: a grounded theory study

Background

Nurses have limited time outside of work for continuing professional development. Consequently, strategies need to be explored to enable them to better maintain their competence. This article describes recent research investigating if nursing behaviours in the use of mobile technologies could be leveraged to better facilitate mobile learning. It addresses a gap in the existing literature around how nurses resource their own professional development and learning in the absence of appropriate learning resources in the workplace.

Methods

The research employed a classic grounded theory methodology which was conducted with 27 registered nurses from Public and Private Hospitals in Queensland and external postgraduate nursing students from Victoria, South Australia and the Northern Territory enrolled at the University of Southern Queensland.

Results

The Theory of Economising Learning describes how nurses maintain competence with limited resources. Unfavourable staffing levels and a fast-paced workplace mean that nurses rarely prioritise their professional learning while at work. Instead, it requires the nurse to contribute personal resources including time and money.

Though the research revealed nurses were unconcerned about using mobile technologies, they were concerned about maintaining competence with limited resources. To counter this, nurses economised their learning by balancing personal resources against their motivation to maintain competence. The process of economising learning begins and ends with the development of the nurse’s personal curriculum in response to what they identify as being the most significant knowledge deficits at work that jeopardise their competence. A learning opportunity that addresses the knowledge deficit is sought. Nurses balance the opportunity to address the deficit against the cost of personal resources, to decide if they will engage with the opportunity and update their personal curriculum accordingly.

Conclusions

It is suggested that workplaces need to create reasonable expectations within nurses to address knowledge deficits and provide the resources, including time, to allow them to do so without personal cost. It is also necessary for workplaces to moderate the flow of learning opportunities so as not to overwhelm and demotivate the nurses. Currently, nurses use several strategies to optimise their learning using mobile technologies which could be leveraged in the workplace.

Longer-term effectiveness of eLearning and blended delivery of Mental Health First Aid training in the workplace: 2-Year follow-up of a randomised controlled trial

INTRODUCTION

Evidence relating to long-term outcomes of online education programs is largely lacking and head-to-head comparisons of different delivery formats are very rare. The aims of the study were to test whether eLearning Mental Health First Aid (MHFA) or blended training (eLearning plus face-to-face course delivery), implemented in an Australian public sector workplace, were more effective than a control intervention at 1-year and 2-year follow-up, and whether blended MHFA training was more effective than eLearning alone.

MATERIAL AND METHODS

Australian public servants (n = 608 at baseline) were randomly assigned to complete an eLearning MHFA course, a blended MHFA course or Red Cross eLearning Provide First Aid (PFA) (the control) and completed online questionnaires pre- and post-training and one and two years later (n = 289, n = 272, n = 243 at post, 1- and 2-year follow-up respectively). The questionnaires were based on vignettes describing a person with depression or post-traumatic stress disorder (PTSD). Primary outcomes were mental health first aid knowledge, desire for social distance and quality of support provided to a person in the workplace. Secondary outcomes were recognition of mental health problems, beliefs about treatment, helping intentions and confidence, personal stigma, quality of support provided to a person outside the workplace, self-reported professional help seeking and psychological distress.

RESULTS

At 1-year follow-up, both eLearning and blended courses produced greater improvements than PFA training in knowledge, confidence and intentions to help a person with depression or PTSD, beliefs about dangerousness and desire for social distance. At 2-year follow-up, some of these improvements were maintained, particularly those relating to knowledge and intentions to help someone with PTSD. When eLearning and blended courses were compared at 1-year follow-up, the blended course led to greater improvements in knowledge and in confidence and intentions to help a person with depression. At 2-year follow-up, improvements in the quality of help provided to a person with a mental health problem outside the workplace were greater in participants in the blended course.

CONCLUSIONS

Both blended and eLearning MHFA courses led to significant longer-term improvements in knowledge, attitudes and intentions to help a person with a mental health problem. Blended MHFA training led to an improvement in the quality of helping behaviours and appears to be more effective than online training alone.Trial registrationACTRN12614000623695 registered on 13/06/2014 (prospectively registered).Trial registry record url: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366410&isReview=true.

Educational program in onco-urology for young urologists: What are their needs?

PURPOSE

The emergence of new communication media such as digital contents are progressively replacing more traditional medias in the field of educational programs. Our purpose was to assess urologist in training aspirations regarding urological education.

METHODS

Members of a national urologist in training association were sent an anonymous online questionnaire regarding their medical formation in the field of urology. Responders interest for urological sub-specialty or education support (new tools and traditional support) were evaluated through a 5-point Likert scale.

RESULTS

Overall, 109 young urologists (26%) responded to the survey. Most of the respondents worked during their training in an academic hospital (n=89, 82%). The three favorite tools for training chosen by the responders were: videos, workshop or masterclass, and podcasts (responders very interested were respectively n=64 (58.7%), n=50 (45.9%), and n=49 (45%)). E-mail newsletters were reported as the less useful educational tool by participants (n=38, 34.9%). Participants were very interested in improving their surgical skills and their radiological knowledge. Responders who were the most attracted by PCa were much more looking to improve their systemic treatment and radiological knowledges.

CONCLUSIONS

Urologic-oncology was a priority regarding education for urologists in training. A majority of participants expressed a lack in their surgical education, revealing a reduced OR access and underlining utilization of new tools such as simulation. New digital contents such as social media or podcast achieved high interest for the participants, instead of more traditional media. There is a need that educational content evolve and uses new digital media.

LEVEL OF EVIDENCE

3.

Scoping reviews in medical education: A scoping review

OBJECTIVES

Over the last two decades, the number of scoping reviews in core medical education journals has increased by 4200%. Despite this growth, research on scoping reviews provides limited information about their nature, including how they are conducted or why medical educators undertake this knowledge synthesis type. This gap makes it difficult to know where the field stands and may hamper attempts to improve the conduct, reporting and utility of scoping reviews. Thus, this review characterises the nature of medical education scoping reviews to identify areas for improvement and highlight future research opportunities.

METHOD

The authors searched PubMed for scoping reviews published between 1/1999 and 4/2020 in 14 medical education journals. The authors extracted and summarised key bibliometric data, the rationales given for conducting a scoping review, the research questions and key reporting elements as described in the PRISMA-ScR. Rationales and research questions were mapped to Arksey and O'Malley's reasons for conducting a scoping review.

RESULTS

One hundred and one scoping reviews were included. On average, 10.1 scoping reviews (SD = 13.1, median = 4) were published annually with the most reviews published in 2019 (n = 42). Authors described multiple reasons for undertaking scoping reviews; the most prevalent being to summarise and disseminate research findings (n = 77). In 11 reviews, the rationales for the scoping review and the research questions aligned. No review addressed all elements of the PRISMA-ScR, with few authors publishing a protocol (n = 2) or including stakeholders (n = 20). Authors identified shortcomings of scoping reviews, including lack of critical appraisal.

CONCLUSIONS

Scoping reviews are increasingly conducted in medical education and published by most core journals. Scoping reviews aim to map the depth and breadth of emerging topics; as such, they have the potential to play a critical role in the practice, policy and research of medical education. However, these results suggest improvements are needed for this role to be fully realised.

A Nationwide Survey of Educational Resource Utilization and Perception Among Internal Medicine Residents

BACKGROUND

New virtual resources ("novel resources") have been incorporated into medical education. No recent large studies about their use and perception among internal medicine (IM) residents exist.

OBJECTIVE

Characterize the use and perceived helpfulness of educational resources.

DESIGN

Nationwide survey from December 2019 to March 2020.

PARTICIPANTS

IM residents in the USA.

MAIN MEASURES

Residents were surveyed on their use and their perceived helpfulness of resources for both attaining general medical knowledge and for point-of-care (POC) learning. Traditional resources included board review resources, clinical experience, digital clinical resources (e.g., UpToDate), journal articles, pocket references, professional guidelines, textbooks, and residency curricula. Novel resources included Twitter, video streaming platforms (e.g., YouTube), online blogs, podcasts, and Wikipedia.

KEY RESULTS

We had 662 respondents from 55 residency programs across 26 states. On average, residents used 9 total resources (7 traditional and 2 novel). Digital clinical resources and clinical experience were used by all residents and found helpful by the highest percentage of residents (96% and 94%, respectively). Journal articles were next (used by 90%), followed by board review resources and residency curricula (both used by 85%). Their perceived helpfulness varied, from 90% for board review resources, to 66% for journal articles and 64% for residency curricula, the lowest perceived helpfulness of any traditional resource. Podcasts and video streaming platforms were used as frequently as textbooks (58-59%), but were rated as helpful more frequently (75% and 82% vs 66%, respectively).

CONCLUSIONS

Digital clinical resources, video streaming platforms, and podcasts were perceived as helpful, underscoring the importance of ensuring their integration into medical education to complement clinical experience and other traditional resources which remain highly valued by residents.

IMPORTANCE

Our findings can inform residency programs as they transition to virtual curricula in the wake of the COVID-19 pandemic.

Effect of Continuing Professional Development on Health Professionals' Performance and Patient Outcomes: A Scoping Review of Knowledge Syntheses

PURPOSE

Continuing professional development (CPD) programs, which aim to enhance health professionals' practice and improve patient outcomes, are offered to practitioners across the spectrum of health professions through both formal and informal learning activities. Various knowledge syntheses (or reviews) have attempted to summarize the CPD literature; however, these have primarily focused on continuing medical education or formal learning activities. Through this scoping review, the authors seek to answer the question, What is the current landscape of knowledge syntheses focused on the impact of CPD on health professionals' performance, defined as behavior change and/or patient outcomes?

METHOD

In September 2019, the authors searched PubMed, Embase, CINAHL, Scopus, ERIC, and PsycINFO for knowledge syntheses published between 2008 and 2019 that focused on independently practicing health professionals and reported outcomes at Kirkpatrick's level 3 and/or 4.

RESULTS

Of the 7,157 citations retrieved from databases, 63 satisfied the inclusion criteria. Of these 63 syntheses, 38 (60%) included multicomponent approaches, and 29 (46%) incorporated eLearning interventions-either standalone or in combination with other interventions. While a majority of syntheses (n = 42 [67%]) reported outcomes affecting health care practitioners' behavior change and/or patient outcomes, most of the findings reported at Kirkpatrick level 4 were not statistically significant. Ten of the syntheses (16%) mentioned the cost of interventions though this was not their primary focus.

CONCLUSIONS

Across health professions, CPD is an umbrella term incorporating formal and informal approaches in a multicomponent approach. eLearning is increasing in popularity but remains an emerging technology. Several of the knowledge syntheses highlighted concerns regarding both the financial and human costs of CPD offerings, and such costs are being increasingly addressed in the CPD literature.

Medical Education in Nepal: Impact and Challenges of the COVID-19 Pandemic

During the COVID-19 pandemic, there has been a global shift toward online distance learning due to travel limitations and physical distancing requirements as well as medical school and university closures. In low- and middle-income countries like Nepal, where medical education faces a range of challenges-such as lack of infrastructure, well-trained educators, and advanced technologies-the abrupt changes in methodologies without adequate preparation are more challenging than in higher-income countries. In this article, the authors discuss the COVID-19-related changes and challenges in Nepal that may have a drastic impact on the career progression of current medical students. Outside the major cities, Nepal lacks dependable Internet services to support medical education, which frequently requires access to and transmission of large files and audiovisual material. Thus, students who are poor, who are physically disadvantaged, and who do not have a home situation conducive to online study may be affected disproportionately. Further, the majority of teachers and students do not have sufficient logistical experience and knowledge to conduct or participate in online classes. Moreover, students and teachers are unsatisfied with the digital methodologies, which will ultimately hamper the quality of education. Students' clinical skills development, research activities, and live and intimate interactions with other individuals are being affected. Even though Nepal's medical education system is struggling to adapt to the transformation of teaching methodologies in the wake of the pandemic, it is important not to postpone the education of current medical students and future physicians during this crisis. Looking ahead, medical schools in Nepal should ensure that mechanisms are proactively put into place to embrace new educational opportunities and technologies to guarantee a regular supply of high-quality physicians capable of both responding effectively to any future pandemic and satisfying the nation's future health care needs.

Major publications in the critical care pharmacotherapy literature: 2019

PURPOSE

To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2019.

MATERIALS AND METHODS

The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 36 journals monthly for impactful articles and reviewed 113 articles during 2019 according to Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria.

RESULTS

Articles with a 1A grade, including three clinical practice guidelines, six meta-analyses, and five original research trials are reviewed here from those included in the monthly CCPLU. Clinical practice guidelines on the use of polymyxins and antiarrhythmic drugs in cardiac arrest as well as meta-analyses on antipsychotic use in delirium, stress ulcer prophylaxis (SUP), and vasoactive medications in septic shock and cardiac arrest were summarized. Original research trials evaluated delirium, sedation, neuromuscular blockade, SUP, anticoagulation reversal, and hemostasis.

CONCLUSION

This clinical review and expert opinion provides summary and perspectives of clinical practice impact on influential critical care pharmacotherapy publications in 2019.

The efficacy of microlearning in improving self-care capability: a systematic review of the literature

OBJECTIVE

To determine the effectiveness of microlearning in improving an individual's capability for self-care.

STUDY DESIGN

Systematic review of the literature.

BACKGROUND

The routine adoption of health seeking self-care behaviours can prevent or delay the appearance of various lifestyle diseases including type 2 diabetes and cardiovascular disease. Microlearning delivers complex knowledge in fragments or bite-size 'nuggets' of information and has been applied as a novel intervention to improve individual's self-care capabilities. The aim of this research was to systematically review the literature to determine the effectiveness of microlearning in improving individual self-care capability.

METHODS

A search was conducted on 15 July 2019 across five electronic bibliographic databases: EMBASE, MEDLINE, PsycINFO, CINAHL and Scopus. Randomised and non-randomised controlled trials, controlled before-after studies and interrupted time series studies, published between 1 January 1990 and 15 July 2019 and looking at individuals of all ages were included in the search. The search strategy included a keyword search and a string of "(modality) AND (learning) AND (micro)", which broadly described microlearning to cover all available articles that have used microformat learning interventions. The search was combined with keywords and Medical Subject Headings (MeSH) terms for self-care to identify studies of interests. Studies were screened by two reviewers independently and reported using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. Data from included articles were extracted using Cochran Data Collection Form. Risk of bias was assessed using Version 2 of the Cochrane Risk-of-bias or Risk Of Bias In Non-Randomised Studies of Interventions (ROBINS-I).

RESULTS

1310 articles were identified in the initial search. A total of 26 manuscripts were included in the narrative synthesis after title and abstract and full text screening was performed by two reviewers. Outcomes of studies were categorised. A total of 23 studies measured cognitive level self-care capabilities-related changes, and 91% showed statistically significant improvements. Only 11 studies measured actual self-care behaviour changes, from which only 36% showed statistically significant results. From the 26 manuscripts included, 25 articles were evaluated as having moderate-to-high risk of bias.

CONCLUSION

Under certain conditions, or when combined with monitoring such as tracking daily medicine intake, microlearning can be effective in improving actual self-care behaviours. Microlearning can also positively influence individuals' cognitive self-care capabilities but was largely ineffective in triggering actual self-care behaviour change. More studies are needed to investigate the effectiveness of microlearning in improving self-care capabilities amongst the general population at scale.

Quality of information on YouTube about artificial intelligence in dental radiology

OBJECTIVES

This study was designed to investigate Artificial Intelligence in Dental Radiology (AIDR) videos on YouTube in terms of popularity, content, reliability, and educational quality.

METHODS

Two researchers systematically searched about AIDR on YouTube on January 27, 2020, by using the terms "artificial intelligence in dental radiology," "machine learning in dental radiology," and "deep learning in dental radiology." The search was performed in English, and 60 videos for each keyword were assessed. Video source, content type, time since upload, duration, and number of views, likes, and dislikes were recorded. Video popularity was reported using Video Power Index (VPI). The accuracy and reliability of the source of information were measured using the adapted DISCERN score. The quality of the videos was measured using JAMAS and modified Global Quality Score (mGQS) and content via Total Concent Evaluation (TCE).

RESULTS

There was high interobserver agreement for DISCERN (intraclass correlation coefficient [ICC]: 0.975; 95% confidence interval [CI]: 0.957-0.985; P: 0.000; P < 0.05) and mGQS (ICC: 0.904; 95% CI: 0.841-0.943; P: 0.000; P < 0.05). Academic source videos had higher DISCERN, GQS, and TCE, revealing both reliability and quality. Also, positive relationship of VPI with mGQS (30.1%) (P: 0.035) and DISCERN (38.1%) (P: 0.007) is detected. The scores revealed 51.9% relationship between mGQS and DISCERN (P: 0.001); and educational quality predictor scores revealed 62.5% relationship between TCE and GQS (P: 0.000).

CONCLUSION

Despite the limited number of relevant videos, YouTube involves reliable and quality videos that can be used by dentists about learning AIDR.

Social Media Guidelines for Anatomists

Social Media has changed the way that individuals interact with each other - it has brought considerable benefits, yet also some challenges. Social media in anatomy has enabled anatomists all over the world to engage, interact and form new collaborations that otherwise would not have been possible. In a relatively small discipline where individuals may be working as the only anatomist in an institution, having such a virtual community can be important. Social media is also being used as a means for anatomists to communicate with the current generation of students as well as members of the public. Posting appropriate content is one of the challenges raised by social media use in anatomy. Human cadaveric material is frequently shared on social media and there is divided opinion among anatomists on whether or not such content is appropriate. This article explores the uses and challenges of social media use in the field of anatomy and outlines guidelines on how social media can be used by anatomists globally, while maintaining professional and ethical standards. Creating global guidelines has shown to be difficult due to the differences in international law for the use of human tissue and also the irregularities in acquiring informed consent for capturing and sharing cadaveric images. These nuances may explain why cadaveric images are frequently shared on social media. This article proposes that as standard practice, anatomists obtain informed consent from donors before sharing images of cadaveric material on social media and ensure posts include a statement stating the same.

Use of Social Media to Teach Global Reconstructive Surgery: Initiation of a Secret Facebook Group

The ReSurge Global Training Program (RGTP) is a model for building reconstructive surgery capacity in low- and middle-income countries.¹ The aim of this study is to assess attitudes toward social media, to develop an initial RGTP Facebook Education Group, and to assess the early results of the group’s implementation.

The Role of Digital Devices in Dentistry: Clinical Trends and Scientific Evidences

In recent years, digital technologies have significantlychanged the clinical approach to medicine and dentistry. Innovative operative techniques and restorative materials have paved the way to a significant active boost towards full digital workflows. Particularly, novel dental materials offer undeniable advantages such as optimal mechanical resistance, excellent esthetic and optical properties, and reliable accuracy and precision, widening the clinical scenario and allowing for innovative and less invasive restorative solutions.

A Literature Review on the Foundations and Potentials of Digital Teaching Scenarios for Interprofessional Health Care Education

The health care system is increasingly complex and specialized, but it presents the actors involved with the challenge of working together in interprofessional teams. One way to meet this challenge is through interprofessional training approaches, where representatives of different professions learn together with learners of other professions. This article contributes to the question of how interprofessional teaching in health care education can be designed with a low threshold by using digital media. We focus on learning with digital learning platforms and learning with videos. Based on existing empirical findings, these approaches are discussed in terms of their potential and limitations for interprofessional teaching. In particular, we examine how these approaches influence the core competence domains of interprofessional collaborative practice. Digital collaborative learning platforms are suitable for teaching interprofessional competences, since they enable social and professional exchange among learners of different professions. Videos are suitable for imparting medical declarative and procedural knowledge. Based on these considerations, the use of videos in combination with interaction possibilities is presented as a didactic approach that can combine the aspect of knowledge transfer with the possibility of interprofessional computer-based collaboration.

Effect of a rapid e-learning module and brief interprofessional simulation event on medical and nursing student collaborative attitudes and behaviors

Objectives Undergraduate nursing and first-year medical students participated in a brief, scenario-based, interprofessional event. The experimental group only was provided an innovative, rapid e-learning instructional module focused on interprofessional roles/responsibilities and communication prior to the event. Methods Pre-post attitudes toward physician-nurse collaboration were surveyed, and collaborative behaviors were observed during the event. Results For the experimental group, a statistically significant (p<0.05) attitude improvement was found between pre-post e-learning module scores as well as pre-e-learning module and post-simulation event scores. For the control group, a statistically significant (p=0.001) attitude improvement was found between pre-post simulation event scores. No statistically significant differences in team collaborative behaviors were observed between experimental and control. Conclusions The combination of module and simulation event was not a more effective option than the event alone. As both interventions present unique challenges in regards to technology and facility requirements, having multiple effective intervention options will be of benefit to educational institutions.

Mobile community learning programme's effectiveness in case management for psychiatric nurses: A preliminary randomised controlled trial

BACKGROUND

The global health care system has applied case management (CM) as a care delivery service provided by nurses. Nurses require continuing education in CM to enhance their professional knowledge and competence. Mobile communities have been used to promote continuing education for medical professionals. However, limited studies have examined the effectiveness of such learning programmes in CM for psychiatric nurses.

OBJECTIVE

To evaluate the effectiveness of a mobile community learning (MCL) programme in CM for psychiatric nurses.

DESIGN

This study used an experimental two-group pre- and post-test design.

SETTINGS AND PARTICIPANTS

Psychiatric nurses employed in a psychiatric teaching hospital situated in northern Taiwan were recruited.

METHODS

Nurses were randomly allocated to the experimental or comparison group. The former participated in the learning intervention in CM. The CM knowledge index and a competence scale were used to determine outcomes. Pre-tests and 2-month post-tests were conducted. The MCL programme comprised five simulated learning modules, self-assessment questions, learning cases, learning resources and experience sharing. A two-way repeated-measures analysis of variance was performed to evaluate the effect of the intervention on target outcomes.

RESULTS

The questionnaires were completed by 48 participants. The two groups possessed high homogeneity with regard to characteristics and pre-test outcomes. Differences between the two groups regarding CM knowledge (F = 22.99, p < .01) and competence (F = 6.33, p = .015) were significant. The programme had a positive benefit on the learning experience in the experimental group; the mean satisfaction score for the programme reached 4.27 (range, 1-5).

CONCLUSIONS

MCL programmes for psychiatric nurses can effectively enhance CM knowledge and competence. However, these methods cannot completely replace the continuing education approach for achieving CM competence.

As mídias e as plataformas digitais no campo da Educação Permanente em Saúde: debates e propostas

RESUMO Este ensaio buscou debater a relevância das mídias e das plataformas digitais como ferramentas para o desenvolvimento e gestão de ações de Educação Permanente em Saúde. Defende-se que as mídias sociais e as plataformas digitais são uma chave para a gestão da educação e do trabalho em saúde se (e somente se) considerados e respeitados os usos tácitos daquelas já existentes e utilizadas pela comunidade de usuários, gestores e trabalhadores. Inicialmente, discute-se o já estabelecido reconhecimento das tecnologias de informação e comunicação como elemento importante para a educação na saúde, a despeito das dificuldades de sua utilização crítica nos cenários. Em seguida, a partir da perspectiva dos estudos digitais, introduzem-se algumas noções correntes sobre redes sociais, cyber e digital, fenômenos que vão além da adoção de certos dispositivos e tecnologias como mediadores, reconhecendo-os como elemento central de diversos grupos e atividades humanas na cultura contemporânea. Por fim, sugere-se a ampliação da proposta de adoção dessas tecnologias para uma de reconhecimento das plataformas e das mídias digitais e seu uso corrente como ferramentas estratégicas para a gestão da educação e do trabalho na saúde.

Adoption and Use of Mobile Learning in Continuing Professional Development by Health and Human Services Professionals

INTRODUCTION

Health and human services professionals are increasingly using mobile devices to support clinical decision-making and evidence-based practice. However, research on self-directed learning in an era of growing digital technology utilization is underdeveloped. This study explored the adoption and use of mobile learning as a continuing professional development (CPD) activity.

METHODS

A mixed-methods case study using semistructured interviews and a web-based questionnaire was conducted with health and human services professionals in Newfoundland and Labrador, Canada.

RESULTS

Respondents reported using a smartphone (53.8%), tablets (50.4%), YouTube (43.0%), and mobile apps (35.8%) for CPD. The highest-rated benefits of mobile learning included improved access to information (M = 3.51); potential for enhanced knowledge acquisition (M = 3.45); staying up to date (M = 3.44); and verifying information (M = 3.40). The greatest barriers included cost of some apps and resources (M = 3.07); websites/programs not functional on mobile devices (M = 2.84); workplace barriers preventing access to digital resources (M = 2.82); and social media use linked to negative perceptions of professionalism (M = 2.65). Interview respondents described the flexibility and convenience of mobile learning, the level of autonomy it offered, and the advantages of learning on their own time. Technical issues, particularly for rural and remote practitioners, and digital professionalism also emerged as potential barriers.

DISCUSSION

A systems model organizes the factors influencing the adoption and use of mobile devices and resources to support "just-in-time" learning. Addressing policies, practices, and regulations that enable or inhibit adoption of mobile learning for CPD may foster enhanced use to support better clinical decision-making, improved accuracy, and greater patient safety.

Smartphone Use and Professional Communication Among Medical Residents in Primary Care

Introduction

The rapid integration and evolution of technology has impacted remote data access, dissemination of medical information, and use of applications (apps) for patient care and treatment. The aims of this study were to (1) describe patterns of smartphone use by residents in a rural clinical setting (both clinical and communicative patterns), (2) examine residents' perceptions of benefits of smartphone use, and (3) determine whether there is an association between smartphone use and organizational attributes.

Methods

Self-report surveys were administered to family medicine and internal medicine residents (N=39).

Results

Descriptive analyses indicated that primary care residents used their pagers more often for communication, but also believed smartphones were more efficient, and increased accessibility and timeliness of attending physicians. Additional analyses suggested that smartphone use was not associated with chaos, and was negatively correlated with history of culture change within the organization.

Conclusion

Overall, use of smartphones among medical residents is relatively common, and residents believe there are numerous benefits of use. Future research might consider causal reasons why there is reduced communication among primary care practices with a history of change.

Major publications in the critical care pharmacotherapy literature: January-December 2017

PURPOSE

To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2017. The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 32 journals monthly for impactful articles and reviewed 115 during 2017. Two meta-analyses and eight original research trials were reviewed here from those included in the monthly CCPLU. Meta-analyses on early, goal-directed therapy for septic shock and statin therapy for acute respiratory distress syndrome were summarized. Original research trials that were included evaluate thrombolytic therapy in severe stroke, hyperoxia and hypertonic saline in septic shock, intraoperative ketamine for prevention of post-operative delirium, intravenous ketorolac dosing regimens for acute pain, angiotensin II for vasodilatory shock, dabigatran reversal with idarucizumab, bivalirudin versus heparin monotherapy for myocardial infarction, and balanced crystalloids versus saline fluid resuscitation.

CONCLUSION

This clinical review provides perspectives on impactful critical care pharmacotherapy publications in 2017.