Equipping Learners to Evaluate Online Health Care Resources: Longitudinal Study of Learning Design Strategies in a Health Care Massive Open Online Course

Factors associated with COVID-19 misinformation rebuttal among college students: a descriptive study

Background

The deluge of COVID-19 misinformation makes people confused, and acting on such misinformation can kill, leading to the tragic outcome of death. This makes it necessary to identify significant factors associated with college students' susceptibility.

Objective

This descriptive study sought to ascertain factors significantly associated with college students' susceptibility to online COVID-19 misinformation.

Methods

To assess college students' susceptibility to COVID-19 misinformation, we first chose as independent variables some demographic information, some well-developed, validated literacy tools, and the Patient Health Questionnaire-9 Items. Second, we selected as the dependent variable COVID-19 myths from some authoritative, official websites. Third, we integrated the independent and dependent variables into an online questionnaire. Fourth, we recruited students from Nantong University in China to participate in an online questionnaire survey. Finally, based on the data collected, we conducted quantitative and qualitative analyses to relate the independent variables to the dependent variable.

Results

Five hundred forty-six students participated in the survey voluntarily, and all questionnaires they answered were valid. The participants had an average of 2.32 (SD = 0.99) years of higher education. They have a mean age of 20.44 (SD = 1.52) years. 434 (79.5%) of the 546 participants were females. The frequency of their Internet use averaged 3.91 (SD = 0.41), indicating that they logged onto the Internet almost every day. Their self-reported Internet skill was rated 3.79 (SD = 1.07), indicating that the participants rated their Internet skills as basically "good." The mean scores of the sub-constructs in the AAHLS were 6.14 (SD = 1.37) for functional health literacy, 5.10 (SD = 1.65) for communicative health literacy, and 11.13 (SD = 2.65) for critical health literacy. These mean scores indicated that the participants needed help to read health-related materials "sometimes," the frequency that they knew how to communicate effectively with professional health providers was between "often" and "sometimes," and the frequency that they were critical about health information was between "often" and "sometimes," respectively. The sum of their scores for eHealth literacy averaged 28.29 (SD = 5.31), showing that they had a relatively high eHealth literacy level. The mean score for each question in the GHNT was determined at 1.31 (SD = 0.46), 1.36 (SD = 0.48), 1.41 (SD = 0.49), 1.77 (SD = 0.42), 1.51 (SD = 0.50), and 1.54 (SD = 0.50), respectively. These mean scores showed that a high percentage of the participants answered the 6 questions wrongly, especially Questions 4-6. Similarly, participants performed unsatisfactorily in answering the 3 questions in the CRT, with a mean score of 1.75 (SD = 0.43), 1.55 (SD = 0.50), and 1.59 (SD = 0.49) for each question, respectively. In the PHQ-9, the participants reported that they never felt depressed or felt depressed only for 1-3 days in the past week. The mean score for myths 1-6 and 9-10 ranged from 1.15 (SD = 0.36) to 1.29 (SD = 0.46). This meant that the participants rated these myths false. However, most of the participants rated myths 7-8 true (1.54, SD = 0.50; 1.49, SD = 0.50), showing that they were highly susceptible to these 2 pieces of misinformation. Through data analysis via Logistic Regression (forward stepwise), we found that (1) at an average threshold of 0.5, Internet use frequency, functional health literacy, general health numeracy, reflective thinking tendency, and depression severity were significant predictors of susceptibility to misinformation for both male and female students, (2) at a higher threshold of 0.8, aggregated general health numeracy scores and functional health literacy scores, as well as depression severity were predictors of susceptibility to misinformation for both male and female students, (3) functional health literacy, general health literacy, and depression predicted resistance to misinformation for female students, and (4) internet use frequency and self-reported digital health literacy predicted resistance to misinformation for male students.

Conclusion

We revealed the complexity, dynamics, and differences in age, gender, education, Internet exposure, communicative health literacy, and cognitive skills concerning college students' susceptibility to online COVID-19 misinformation. Hopefully, this study can provide valuable implications for counteracting COVID-19 misinformation among Chinese college students.

Learning Design Strategies in MOOCs for Physicians' Training: A Scoping Review

In recent years, there has been an increased implementation of massive open online courses (MOOCs). This teaching model plays a pivotal role in online education because it can provide high-quality learning resources to numerous students with great feasibility, shaping training courses according to their different learning requirements. Although the widespread adoption of MOOCs in medical education has led to numerous benefits for undergraduate and graduate doctors, their role remains unclear, suggesting the need to analyze the key factors of such a learning method in this field. To achieve this aim, a scoping review, in line with the PRISMA method for qualitative synthesis, was performed by considering studies published from 2016 to 2021, written in English, and including the physician population. Through this literature analysis, the following main areas of interest came to light: (1) pedagogical approaches, (2) MOOC structure-related variables, (3) participant-related variables, and (4) MOOCs vs. traditional courses. The review provides valuable evidence on factors underlying MOOCs effectiveness, which might be helpful for academic and healthcare organizations in designing effective training courses for physicians.

A Comprehensive Analysis of E-Health Literacy Research Focuses and Trends

Objective: To sort out the research focuses in the field of e-health literacy, analyze its research topics and development trends, and provide a reference for relevant research in this field in the future. Methods: The literature search yielded a total of 431 articles retrieved from the core dataset of Web of Science using the keywords “ehealth literacy”, “E-health literacy” and “electronic health literacy”. A bibliometric analysis was performed by using CiteSpace to explore the development history, hot themes, and trends of future research in the field of e-health literacy. Results: The thematic evolution path in e-health literacy was divided into three stages. The research focuses were inspected from four aspects: evaluation, correlation with health-promotion behaviors, influencing factors, and intervention measures for improvement. Conclusion: E-health literacy research faces challenges such as the development of the connotation of the term, the objectivity of evaluation methods, and the long-term impact of interventions. Future research themes in e-health literacy will include the standardization of evaluation instruments and the individualization of therapeutic strategies.

Undergraduate Medical Competencies in Digital Health and Curricular Module Development: Mixed Methods Study

Background

Owing to an increase in digital technologies in health care, recently leveraged by the COVID-19 pandemic, physicians are required to use these technologies appropriately and to be familiar with their implications on patient care, the health system, and society. Therefore, medical students should be confronted with digital health during their medical education. However, corresponding teaching formats and concepts are still largely lacking in the medical curricula.

Objective

This study aims to introduce digital health as a curricular module at a German medical school and to identify undergraduate medical competencies in digital health and their suitable teaching methods.

Methods

We developed a 3-week curricular module on digital health for third-year medical students at a large German medical school, taking place for the first time in January 2020. Semistructured interviews with 5 digital health experts were recorded, transcribed, and analyzed using an abductive approach. We obtained feedback from the participating students and lecturers of the module through a 17-item survey questionnaire.

Results

The module received overall positive feedback from both students and lecturers who expressed the need for further digital health education and stated that the field is very important for clinical care and is underrepresented in the current medical curriculum. We extracted a detailed overview of digital health competencies, skills, and knowledge to teach the students from the expert interviews. They also contained suggestions for teaching methods and statements supporting the urgency of the implementation of digital health education in the mandatory curriculum.

Conclusions

An elective class seems to be a suitable format for the timely introduction of digital health education. However, a longitudinal implementation in the mandatory curriculum should be the goal. Beyond training future physicians in digital skills and teaching them digital health’s ethical, legal, and social implications, the experience-based development of a critical digital health mindset with openness to innovation and the ability to assess ever-changing health technologies through a broad transdisciplinary approach to translate research into clinical routine seem more important. Therefore, the teaching of digital health should be as practice-based as possible and involve the educational cooperation of different institutions and academic disciplines.