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Horiuchi S, Soller T, Bykersma C, Huang S, Smith R, Vogel JP. Use of digital technologies for staff education and training programmes on newborn resuscitation and complication management: a scoping review. BMJ Paediatr Open 2024; 8:e002105. [PMID: 38754893 PMCID: PMC11097833 DOI: 10.1136/bmjpo-2023-002105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 04/09/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Poor-quality care is linked to higher rates of neonatal mortality in low-income and middle-income countries (LMICs). Limited educational and upskilling opportunities for healthcare professionals, particularly those who work in remote areas, are key barriers to providing quality neonatal care. Novel digital technologies, including mobile applications and virtual reality, can help bridge this gap. This scoping review aims to identify, analyse and compare available digital technologies for staff education and training to improve newborn care. METHODS We conducted a structured search of seven databases (MEDLINE (Ovid), EMBASE (Ovid), EMCARE (Ovid), Global Health (CABI), CINAHL (EBSCO), Global Index Medicus (WHO) and Cochrane Central Register of Controlled Trials on 1 June 2023. Eligible studies were those that aimed to improve healthcare providers' competency in newborn resuscitation and management of sepsis or respiratory distress during the early postnatal period. Studies published in English from 1 January 2000 onwards were included. Data were extracted using a predefined data extraction format. RESULTS The review identified 93 eligible studies, of which 35 were conducted in LMICs. E-learning platforms and mobile applications were common technologies used in LMICs for neonatal resuscitation training. Digital technologies were generally well accepted by trainees. Few studies reported on the long-term effects of these tools on healthcare providers' education or on neonatal health outcomes. Limited studies reported on costs and other necessary resources to maintain the educational intervention. CONCLUSIONS Lower-cost digital methods such as mobile applications, simulation games and/or mobile mentoring that engage healthcare providers in continuous skills practice are feasible methods for improving neonatal resuscitation skills in LMICs. To further consider the use of these digital technologies in resource-limited settings, assessments of the resources to sustain the intervention and the effectiveness of the digital technologies on long-term health provider performance and neonatal health outcomes are required.
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Affiliation(s)
- Sayaka Horiuchi
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Environmental Medicine, University of Yamanashi Graduate School of Medicine, Chuo, Yamanashi, Japan
| | - Tasmyn Soller
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Chloe Bykersma
- Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Shan Huang
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Rachel Smith
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Joshua P Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
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Bucher SL, Young A, Dolan M, Padmanaban GP, Chandnani K, Purkayastha S. The NeoRoo mobile app: Initial design and prototyping of an Android-based digital health tool to support Kangaroo Mother Care in low/middle-income countries (LMICs). PLOS DIGITAL HEALTH 2023; 2:e0000216. [PMID: 37878575 PMCID: PMC10599536 DOI: 10.1371/journal.pdig.0000216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/12/2023] [Indexed: 10/27/2023]
Abstract
Premature birth and neonatal mortality are significant global health challenges, with 15 million premature births annually and an estimated 2.5 million neonatal deaths. Approximately 90% of preterm births occur in low/middle income countries, particularly within the global regions of sub-Saharan Africa and South Asia. Neonatal hypothermia is a common and significant cause of morbidity and mortality among premature and low birth weight infants, particularly in low/middle-income countries where rates of premature delivery are high, and access to health workers, medical commodities, and other resources is limited. Kangaroo Mother Care/Skin-to-Skin care has been shown to significantly reduce the incidence of neonatal hypothermia and improve survival rates among premature infants, but there are significant barriers to its implementation, especially in low/middle-income countries (LMICs). The paper proposes the use of a multidisciplinary approach to develop an integrated mHealth solution to overcome the barriers and challenges to the implementation of Kangaroo Mother Care/Skin-to-skin care (KMC/STS) in LMICs. The innovation is an integrated mHealth platform that features a wearable biomedical device (NeoWarm) and an Android-based mobile application (NeoRoo) with customized user interfaces that are targeted specifically to parents/family stakeholders and healthcare providers, respectively. This publication describes the iterative, human-centered design and participatory development of a high-fidelity prototype of the NeoRoo mobile application. The aim of this study was to design and develop an initial ("A") version of the Android-based NeoRoo mobile app specifically to support the use case of KMC/STS in health facilities in Kenya. Key functions and features are highlighted. The proposed solution leverages the promise of digital health to overcome identified barriers and challenges to the implementation of KMC/STS in LMICs and aims to equip parents and healthcare providers of prematurely born infants with the tools and resources needed to improve the care provided to premature and low birthweight babies. It is hoped that, when implemented and scaled as part of a thoughtful, strategic, cross-disciplinary approach to reduction of global rates of neonatal mortality, NeoRoo will prove to be a useful tool within the toolkit of parents, health workers, and program implementors.
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Affiliation(s)
- Sherri Lynn Bucher
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Department of Community and Global Health, Richard M. Fairbanks School of Public Health, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
| | - Allison Young
- Scholarly Concentration in Public Health Certificate Program, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
| | - Madison Dolan
- Scholarly Concentration in Public Health Certificate Program, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
| | - Geetha Priya Padmanaban
- Department of Human Centered Computing, Human-Computer Interaction, Luddy School of Informatics, Computing, and Engineering, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
| | - Khushboo Chandnani
- Department of Human Centered Computing, Human-Computer Interaction, Luddy School of Informatics, Computing, and Engineering, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
| | - Saptarshi Purkayastha
- Department of BioHealth Informatics, Data Science and Health Informatics, Luddy School of Informatics, Computing, and Engineering, Indiana University–Indianapolis, Indianapolis, Indiana, United States of America
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Meaney PA, Hokororo A, Masenge T, Mwanga J, Kalabamu FS, Berg M, Rozenfeld B, Smith Z, Chami N, Mkopi N, Mwanga C, Agweyu A. Development of pediatric acute care education (PACE): An adaptive electronic learning (e-learning) environment for healthcare providers in Tanzania. Digit Health 2023; 9:20552076231180471. [PMID: 37529543 PMCID: PMC10387696 DOI: 10.1177/20552076231180471] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 05/19/2023] [Indexed: 08/03/2023] Open
Abstract
Globally, inadequate healthcare provider (HCP) proficiency with evidence-based guidelines contributes to millions of newborn, infant, and child deaths each year. HCP guideline proficiency would improve patient outcomes. Conventional (in person) HCP in-service education is limited in 4 ways: reach, scalability, adaptability, and the ability to contextualize. Adaptive e-learning environments (AEE), a subdomain of e-learning, incorporate artificial intelligence technology to create a unique cognitive model of each HCP to improve education effectiveness. AEEs that use existing internet access and personal mobile devices may overcome limits of conventional education. This paper provides an overview of the development of our AEE HCP in-service education, Pediatric Acute Care Education (PACE). PACE uses an innovative approach to address HCPs' proficiency in evidence-based guidelines for care of newborns, infants, and children. PACE is novel in 2 ways: 1) its patient-centric approach using clinical audit data or frontline provider input to determine content and 2) its ability to incorporate refresher learning over time to solidify knowledge gains. We describe PACE's integration into the Pediatric Association of Tanzania's (PAT) Clinical Learning Network (CLN), a multifaceted intervention to improve facility-based care along a single referral chain. Using principles of co-design, stakeholder meetings modified PACE's characteristics and optimized integration with CLN. We plan to use three-phase, mixed-methods, implementation process. Phase I will examine the feasibility of PACE and refine its components and protocol. Lessons gained from this initial phase will guide the design of Phase II proof of concept studies which will generate insights into the appropriate empirical framework for (Phase III) implementation at scale to examine effectiveness.
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Key Words
- eHealth, general, digital health, general education, lifestyle, smartphone, media paediatrics, medicine, mHealth, psychology, mixed methods, studies
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Affiliation(s)
- Peter Andrew Meaney
- Department of Pediatrics, Stanford University School of Medicine, Pediatrics, Palo Alto, CA, USA
| | - Adolfine Hokororo
- Department of Pediatrics, Catholic University of Health and Allied Sciences Bugando, Pediatrics, Mwanza, Tanzania
| | | | - Joseph Mwanga
- Catholic University of Health and Allied Sciences School of Public Health, Mwanza, Tanzania
| | | | - Marc Berg
- Department of Pediatrics, Stanford University School of Medicine, Pediatrics, Palo Alto, CA, USA
| | | | - Zachary Smith
- Department of Pediatrics, Stanford University School of Medicine, Pediatrics, Palo Alto, CA, USA
| | - Neema Chami
- Department of Pediatrics, Catholic University of Health and Allied Sciences Bugando, Pediatrics, Mwanza, Tanzania
| | - Namala Mkopi
- Department of Pediatrics, Muhimbili University of Health and Allied Sciences School of Medicine, Pediatrics, Dar Es Salaam, Tanzania
| | - Castory Mwanga
- Department of Pediatrics, Simiyu District Hospital, Pediatrics, Simiyu, Tanzania
| | - Ambrose Agweyu
- Department of Infectious Disease and Epidemiology, London School of Hygiene and Tropical Medicine, Infectious Disease Epidemiology, Nairobi, Kenya
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Fuller R, Goddard VCT, Nadarajah VD, Treasure-Jones T, Yeates P, Scott K, Webb A, Valter K, Pyorala E. Technology enhanced assessment: Ottawa consensus statement and recommendations. MEDICAL TEACHER 2022; 44:836-850. [PMID: 35771684 DOI: 10.1080/0142159x.2022.2083489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION In 2011, a consensus report was produced on technology-enhanced assessment (TEA), its good practices, and future perspectives. Since then, technological advances have enabled innovative practices and tools that have revolutionised how learners are assessed. In this updated consensus, we bring together the potential of technology and the ultimate goals of assessment on learner attainment, faculty development, and improved healthcare practices. METHODS As a material for the report, we used the scholarly publications on TEA in both HPE and general higher education, feedback from 2020 Ottawa Conference workshops, and scholarly publications on assessment technology practices during the Covid-19 pandemic. RESULTS AND CONCLUSION The group identified areas of consensus that remained to be resolved and issues that arose in the evolution of TEA. We adopted a three-stage approach (readiness to adopt technology, application of assessment technology, and evaluation/dissemination). The application stage adopted an assessment 'lifecycle' approach and targeted five key foci: (1) Advancing authenticity of assessment, (2) Engaging learners with assessment, (3) Enhancing design and scheduling, (4) Optimising assessment delivery and recording learner achievement, and (5) Tracking learner progress and faculty activity and thereby supporting longitudinal learning and continuous assessment.
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Affiliation(s)
- Richard Fuller
- Christie Education, The Christie NHS Foundation Trust, Manchester, UK
| | | | | | | | - Peter Yeates
- School of Medicine, University of Keele, Keele, UK
| | - Karen Scott
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Alexandra Webb
- College of Health and Medicine, Australian National University, Canberra, Australia
| | - Krisztina Valter
- John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Eeva Pyorala
- Center for University Teaching and Learning, University of Helsinki, Helsinki, Finland
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Wanyama C, Nagraj S, Muinga N, Tuti T, Edgcombe H, Geniets A, Winters N, English M, Rossner J, Paton C. Lessons from the design, development and implementation of a three-dimensional (3D) neonatal resuscitation training smartphone application: Life-saving Instruction for Emergencies (LIFE app). Adv Simul (Lond) 2022; 7:2. [PMID: 35012665 PMCID: PMC8744048 DOI: 10.1186/s41077-021-00197-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022] Open
Abstract
Neonatal mortality remains disproportionately high in sub-Saharan Africa partly due to insufficient numbers of adequately trained and skilled front-line health workers. Opportunities for improving neonatal care may result from upskilling frontline health workers using innovative technological approaches. This practice paper describes the key steps involved in the design, development and implementation of an innovative smartphone-based training application using an agile, human-centred design approach. The Life-saving Instruction for Emergencies (LIFE) app is a three-dimension (3D) scenario-based mobile app for smartphones and is free to download. Two clinical modules are currently included with further scenarios planned. Whilst the focus of the practice paper is on the lessons learned during the design and development process, we also share key learning related to project management and sustainability plans, which we hope will help researchers working on similar projects.
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Affiliation(s)
- Conrad Wanyama
- KEMRI/Wellcome Trust Research Programme, Kenya Medical Research Institute, 197 Lenana Place, P.O Box 43640-00100, Nairobi, Kenya.
| | - Shobhana Nagraj
- Nuffield Department of Women's & Reproductive Health, Oxford, England
- The George Institute for Global Health, London, UK
| | - Naomi Muinga
- KEMRI/Wellcome Trust Research Programme, Kenya Medical Research Institute, 197 Lenana Place, P.O Box 43640-00100, Nairobi, Kenya
| | - Timothy Tuti
- KEMRI/Wellcome Trust Research Programme, Kenya Medical Research Institute, 197 Lenana Place, P.O Box 43640-00100, Nairobi, Kenya
| | | | - Anne Geniets
- Department of Education, University of Oxford, Oxford, UK
| | - Niall Winters
- Department of Education, University of Oxford, Oxford, UK
| | - Mike English
- KEMRI/Wellcome Trust Research Programme, Kenya Medical Research Institute, 197 Lenana Place, P.O Box 43640-00100, Nairobi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Jakob Rossner
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Chris Paton
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Warsinsky S, Schmidt-Kraepelin M, Rank S, Thiebes S, Sunyaev A. Conceptual Ambiguity Surrounding Gamification and Serious Games in Health Care: Literature Review and Development of Game-Based Intervention Reporting Guidelines (GAMING). J Med Internet Res 2021; 23:e30390. [PMID: 34505840 PMCID: PMC8463952 DOI: 10.2196/30390] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND In health care, the use of game-based interventions to increase motivation, engagement, and overall sustainability of health behaviors is steadily becoming more common. The most prevalent types of game-based interventions in health care research are gamification and serious games. Various researchers have discussed substantial conceptual differences between these 2 concepts, supported by empirical studies showing differences in the effects on specific health behaviors. However, researchers also frequently report cases in which terms related to these 2 concepts are used ambiguously or even interchangeably. It remains unclear to what extent existing health care research explicitly distinguishes between gamification and serious games and whether it draws on existing conceptual considerations to do so. OBJECTIVE This study aims to address this lack of knowledge by capturing the current state of conceptualizations of gamification and serious games in health care research. Furthermore, we aim to provide tools for researchers to disambiguate the reporting of game-based interventions. METHODS We used a 2-step research approach. First, we conducted a systematic literature review of 206 studies, published in the Journal of Medical Internet Research and its sister journals, containing terms related to gamification, serious games, or both. We analyzed their conceptualizations of gamification and serious games, as well as the distinctions between the two concepts. Second, based on the literature review findings, we developed a set of guidelines for researchers reporting on game-based interventions and evaluated them with a group of 9 experts from the field. RESULTS Our results show that less than half of the concept mentions are accompanied by an explicit definition. To distinguish between the 2 concepts, we identified four common approaches: implicit distinction, synonymous use of terms, serious games as a type of gamified system, and distinction based on the full game dimension. Our Game-Based Intervention Reporting Guidelines (GAMING) consist of 25 items grouped into four topics: conceptual focus, contribution, mindfulness about related concepts, and individual concept definitions. CONCLUSIONS Conceptualizations of gamification and serious games in health care literature are strongly heterogeneous, leading to conceptual ambiguity. Following the GAMING can support authors in rigorous reporting on study results of game-based interventions.
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Affiliation(s)
- Simon Warsinsky
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | | | - Sascha Rank
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Scott Thiebes
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Ali Sunyaev
- Department of Economics and Management, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Kobayashi S, Falcón L, Fraser H, Braa J, Amarakoon P, Marcelo A, Paton C. Using Open Source, Open Data, and Civic Technology to Address the COVID-19 Pandemic and Infodemic. Yearb Med Inform 2021; 30:38-43. [PMID: 33882602 PMCID: PMC8416191 DOI: 10.1055/s-0041-1726488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES The emerging COVID-19 pandemic has caused one of the world's worst health disasters compounded by social confusion with misinformation, the so-called "Infodemic". In this paper, we discuss how open technology approaches - including data sharing, visualization, and tooling - can address the COVID-19 pandemic and infodemic. METHODS In response to the call for participation in the 2020 International Medical Informatics Association (IMIA) Yearbook theme issue on Medical Informatics and the Pandemic, the IMIA Open Source Working Group surveyed recent works related to the use of Free/Libre/Open Source Software (FLOSS) for this pandemic. RESULTS FLOSS health care projects including GNU Health, OpenMRS, DHIS2, and others, have responded from the early phase of this pandemic. Data related to COVID-19 have been published from health organizations all over the world. Civic Technology, and the collaborative work of FLOSS and open data groups were considered to support collective intelligence on approaches to managing the pandemic. CONCLUSION FLOSS and open data have been effectively used to contribute to managing the COVID-19 pandemic, and open approaches to collaboration can improve trust in data.
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Affiliation(s)
| | - Luis Falcón
- GNU Solidario, GNU Health, Las Palmas de Gran Canaria, Spain
| | - Hamish Fraser
- Brown Center for Biomedical Informatics, Brown University, Providence, USA
| | | | | | - Alvin Marcelo
- Asia eHealth Information Network, Manilla, Philippines
| | - Chris Paton
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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