Digital Health Competencies Among Health Care Professionals: Systematic Review

Digital health competences and AI beliefs as conditions for the practice of evidence-based medicine: a study of prospective physicians in Canada

BACKGROUND

The practice of evidence-based medicine (EBM) has become pivotal in enhancing medical care and patient outcomes. With the diffusion of innovation in healthcare organizations, EBM can be expected to depend on medical professionals' competences with digital health (dHealth) and artificial intelligence (AI) technologies.

OBJECTIVE

We aim to investigate the effect of dHealth competences and perceptions of AI on the adoption of EBM among prospective physicians. By focusing on dHealth and AI technologies, the study seeks to inform the redesign of medical curricula to better prepare students for the demands of evidence-based medical practice.

METHODS

A cross-sectional survey was administered online to students at the University of Montreal's medical school, which has approximately 1,400 enrolled students. The survey included questions on students' dHealth competences, perceptions of AI, and their practice of EBM. Using structural equation modeling (SEM), we analyzed data from 177 respondents to test our research model.

RESULTS

Our analysis indicates that medical students possess foundational knowledge competences of dHealth technologies and perceive AI to play an important role in the future of medicine. Yet, their experiential competences with dHealth technologies are limited. Our findings reveal that experiential dHealth competences are significantly related to the practice of EBM (β = 0.42, p < 0.001), as well as students' perceptions of the role of AI in the future of medicine (β = 0.39, p < 0.001), which, in turn, also affect EBM (β = 0.19, p < 0.05).

CONCLUSIONS

The study underscores the necessity of enhancing students' competences related to dHealth and considering their perceptions of the role of AI in the medical profession. In particular, the low levels of experiential dHealth competences highlight a promising starting point for training future physicians while simultaneously strengthening their practice of EBM. Accordingly, we suggest revising medical curricula to focus on providing students with practical experiences with dHealth and AI technologies.

Health care professionals intention to use digital health data hub working in East Gojjam Hospitals, Northwest Ethiopia: Technology acceptance modeling

BACKGROUND

Digital health data hubs contribute significantly to finding the right solutions to health problems, which forms the basis for achieving sustainable development goals. However, in Ethiopia, the health system has been coming to one central hub for all data, there is limited evidence of health professionals' intentions to use these systems. Understanding their intentions is crucial, as this can significantly improve the advancement of digital health in healthcare organizations. This study assessed health professionals' intention to use digital health data hubs in hospitals in East Gojjam, northwest Ethiopia, in 2024.

METHODS

A cross-sectional study design was used to conduct the study. Eleven hospitals were included in the study area. Using an a priori structural equation modeling sample size calculator, the total sample size was 616. Stratified proportional allocation sampling was performed. The study participants were selected using a systematic sample. Structural equation modeling (SEM) was used for the analysis. Because it is a more powerful multivariate technique for testing and evaluating multivariate causal relationships. The assumptions of SEM-like normality, average variance extracted (AVE), composite reliability (CR), Cronbach's alpha, confirmatory factor analysis (CFA), and model specifications were checked using Amos and Stata version 16.

RESULTS

This study was conducted with a sample size of 616 healthcare professionals; 591 (95.94%) responded to the survey. The results showed that 57.69% (n = 341) of the healthcare professionals intended to use the digital health data hub. Further analysis showed that perceived usefulness (PU: β = 0.576, p = 0.000), perceived trust (PT: β = 0.116, p = 0.022), and attitude (β = 0.143, p = 0.043) significantly and positively influenced health professionals' intention to use digital health data hubs.

CONCLUSION

Overall, the findings showed that 42.31% of health professionals have low intention to use digital health data hubs. These shall be needed to improve their intentions to use digital health data hubs through targeted interventions. Therefore, focusing on critical factors, such as perceived usefulness, trust, and attitude are crucial factors to reinforce their intention to use the system. Additionally, overcoming implementation challenges and building trust is critical to the successful integration and use of digital health data hubs.

Professionals' Perceptions of the Management of Digital Competence Sharing in Healthcare and Associated Background Factors: A Cross-Sectional Study

AIMS

To describe professionals' perceptions of the management of digital competence sharing in healthcare and associated background factors.

DESIGN

A descriptive cross-sectional study.

METHODS

The study used an online survey involving 227 healthcare professionals from three public and one private healthcare organisation in Finland. Data was collected using the management of digital competence sharing (MDCS) instrument and analysed using descriptive statistics, independent sample t-tests and one-way ANOVA.

RESULTS

Based on the professionals' perceptions, the overall management of digital competence sharing was weak. They perceived the highest level of creation of a friendly and safe digital organisational atmosphere while the lowest level of provision of resources and opportunities for digital competence sharing. Background factors, including gender, age, work experience in healthcare, organisation and clinical environment, showed statistically significant differences in how professionals perceived the management of digital competence sharing.

CONCLUSION

The results emphasised the need for increased managers' attention to digital competence development, prioritising and supporting digital competence sharing among healthcare professionals.

IMPLICATIONS

The results can be utilised in healthcare management to enhance the digital competence sharing among healthcare professionals and the use of existing digital competence to benefit the work community.

IMPACT

The importance of digital competence is increasing among healthcare professionals, but at the same time, they perceive inadequate management support in this area. This study revealed limited management of digital competence sharing in healthcare organisations, particularly among older professionals and those in inpatient and primary care settings. These results can be applied in managers' training to support and promote digital competence among healthcare professionals.

REPORTING METHOD

The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist.

PATIENT OR PUBLIC CONTRIBUTION

There is no patient or public contribution.

Use and Acceptance of Innovative Digital Health Solutions Among Patients and Professionals: Survey Study

Background

Digital solutions are gaining increasing importance and present a challenge regarding their introduction and acceptance into professional medical environments. Significant advances have been made regarding the availability, safety, and ease of use of data generated by a multitude of devices and wearables. However, data security and data protection are delaying factors. The underlying analysis focuses on the use and acceptance of digital solutions, and their respective differences between health care professionals and patients.

Objective

This study examines the current use and acceptance of digital solutions among health care professionals and patients. In addition, it derives an outlook on future developments and expectations in the setting of innovative technologies able to penetrate the health market.

Methods

An anonymous web-based survey of 23 multiple-choice and 3 open-text questions was conducted among medical professionals and patients between April and September 2023. In this study, quantitative analysis was performed using Python, with Pandas for data processing and Matplotlib for visualization. Chi-square tests were used to analyze binary categorical data, while Mann-Whitney U tests were used to evaluate ordinal data. Additionally, a qualitative analysis was conducted to summarize the results of the open-ended questions.

Results

During 178 days, the survey garnered 2058 clicks, resulting in 1389 participants (67.5% response rate). A total of 1002 participants completed the entire questionnaire, while 387 (27.9%) did not finish. Incomplete responses were excluded from the comprehensive analysis. The sample comprised 271 (27%) physicians and 731 (73%) patients. The study found significant agreement between both groups in adopting and foreseeing the use of digital health tools and telemedicine. Both groups recognized the future importance of digital health without substantial differences.

Conclusions

Overall, attitudes toward digital health and telemedicine were consistent, reflecting a uniform acceptance and expectation of these technologies among health care professionals and patients. The consensus on telemedicine's future role over the next 5 years indicates a unified vision for digital health paradigms. These consistencies between the 2 groups might be future drivers for improvements in accessibility, convenience, and efficiency in health care delivery.

Financial management, efficiency, and care quality: A systematic review in the context of Health 4.0

This article investigates the intersection between innovation, Health 4.0, and financial management in the healthcare industry, emphasizing the importance of operational efficiency and quality of care. The study aims to analyze how financial management processes in healthcare relate to Health 4.0 and enhance care quality. It begins with a thorough theoretical grounding, proposing a framework that connects Health 4.0 with financial management practices. A systematic review of the literature was conducted, identifying trends, challenges, and opportunities in the financial management of Health 4.0. The results highlight selected articles on responsible innovation, Health 4.0 technologies, investments in health, hospital efficiency, performance forecasting, and high-cost patient management. These articles were clustered into "Data Analysis and Machine Learning in Healthcare" and "Health Management and Sustainability," providing a categorized understanding of the topics. The study reveals that Health 4.0 offers significant opportunities for process efficiency and cost reduction without compromising service quality. It highlights strategic advantages in addressing contemporary healthcare challenges by optimizing processes, improving financial projections, and incorporating advanced technologies efficiently. The successful implementation of Health 4.0 can lead to substantial improvements in service quality, adding value to patients and driving local economic development. This article offers valuable insights for healthcare professionals and managers, emphasizing the transformative potential of Health 4.0 and outlining strategies for its effective implementation. The clustering of articles provides a clearer understanding of current research in Health 4.0, contributing significantly to the field and guiding future research directions.

Translation, adaptation and psychometric testing of the Digital Health Technology Literacy Assessment Questionnaire (DHTL-AQ) in the Serbian language

BACKGROUND

The use of digital health technologies (DHTs), systems that use computing platforms, connectivity, software, and/or sensors for health care and related uses, is rapidly increasing. Assessing literacy in this area may be challenging given the absence of comprehensive instruments, especially those dedicated to health care professionals. The digital health technology literacy assessment questionnaire (DHTL-AQ) is a 34-item instrument that assesses an individual's ability to use DHTs, services, and data.

AIM

To translate and culturally adapt the DHTL-AQ and to evaluate the psychometric properties of the Serbian version.

METHOD

The DHTL-AQ English version was translated into Serbian, back-translated, and adapted via expert consensus discussion. Pilot testing was conducted among a population of community pharmacists. To gather evidence of initial validity, the culturally adapted version was tested in the same population as the pilot. Reliability was examined using Cronbach's alpha (Cα), and a test-retest methodology for temporary stability. Validity was explored through factor analysis.

RESULTS

A pilot study (n = 22) included linguistic and cultural adjustments, confirming the item comprehensibility. The final Serbian DHTL-AQ consists of 5 questions and 25 items. The psychometric analysis (n = 162) indicated, satisfactory internal consistency (Cα = 0.822) and temporal stability (ICC = 0.981). Factor analysis identified 3 factors that explained 52% of the total variance, reducing the number of factors to 3 compared with 4 into the original questionnaire.

CONCLUSION

The culturally adapted DHTL-AQ Serbian version demonstrated strong psychometric properties. Practical application can support the development and implementation of customized education and training programs and new DHT-related services that pharmacists can offer patients.

The Chinese Version of the DigiHealthCom (Digital Health Competence) Instrument for Assessing Digital Health Competence of Health Care Professionals: Translation, Adaptation, and Validation Study

Background

Digital health competence is increasingly recognized as a core competence for health care professionals. A comprehensive evaluation of knowledge, skills, performance, values, and attitudes necessary to adapt to evolving digital health technologies is essential. DigiHealthCom (Digital Health Competence) is a well-established instrument designed to assess digital health competence across diverse health care professionals.

Objective

This study aimed to translate and culturally adapt DigiHealthCom into simplified Chinese (Mandarin) and verify its reliability and validity in assessing digital health competence of Chinese health care professionals.

Methods

DigiHealthCom was translated into Chinese following the guideline proposed by its original developers. The cultural adaptation involved expert review and cognitive interviewing. Internal consistency, test-retest reliability, content validity, convergent validity, discriminant validity, and factor structure were examined. Item analysis tested item discrimination, item correlation, and item homogeneity. Internal consistency was assessed using Cronbach α, and test-retest reliability was measured using the intraclass correlation coefficient. Content validity was assessed through both item and scale content validity indices. Convergent validity was measured by the Average Variance Extracted and Composite Reliability, while discriminant validity was measured by the heterotrait-monotrait ratio. A five-dimension model of DigiHealthCom was confirmed using confirmatory factor analysis.

Results

The finalized Chinese version of the DigiHealthCom was completed after addressing differences between the back-translations and the original version. No discrepancies affecting item clarity were reported during cognitive interviewing. The validation process involved 398 eligible health care professionals from 36 cities across 15 provinces in China, with 43 participants undergoing a retest after a 2-week interval. Critical ratio values (range 16.05-23.77, P<.001), item-total correlation coefficients (range 0.69-0.89), and Cronbach α if the item deleted (range 0.91-0.96) indicated satisfactory item discrimination, item correlation, and item homogeneity. Cronbach α for dimensions and the scale ranged from 0.94 to 0.98, indicating good internal consistency. The intraclass correlation coefficient was 0.90 (95% CI 0.81-0.95), indicating good test-retest reliability. Item content validity index ranged from 0.82 to 1.00, and the scale content validity index was 0.97, indicating satisfactory content validity. Convergent validity (average variance extracted: 0.60-0.79; composite reliability: 0.94-0.95) and divergent validity (heterotrait-monotrait ratio: 0.72-0.89) were satisfactory. Confirmatory factor analysis confirmed a well-fit five-dimension model (robust chi-square to df ratio=3.10, comparative fit index=0.91, Tucker-Lewis index=0.90, incremental fit index=0.91, root-mean-square error of approximation=0.07, standardized root-mean-square residual=0.05), with each item having a factor loading exceeding 0.40.

Conclusions

The Chinese version of DigiHealthCom has been proved to be reliable and valid. It is now available for assessing digital health competence among Chinese health care professionals. This assessment can be used to guide health care policy makers and educators in designing comprehensive and implementable educational programs and interventions.

Beyond carrots and sticks. Exploring faculty motivation to join a digital health professions educator program

Introduction

Faculty development programs in the health professions are essential in addressing the evolving and expanding roles of educators. These programs have become a cornerstone of organizational development and contribute significantly to improving student learning. However, the motivation of faculty to engage in such programs is often challenged by the significant demands of their clinical responsibilities and already busy schedules. This study aims to explore the motivation of teaching health professionals to voluntarily participate in the Digital Health Professions Education (d-HPE) program, a 200-h certification program at the Charité - Universitätsmedizin Berlin to train digital teaching skills and competencies.

Methods

In this qualitative study, we analyzed the motivation letters from faculty members who volunteered to participate in the d-HPE program. We used coding based on Self-Determination Theory (SDT) as a framework for analysis with three main themes: autonomy, competence and relatedness. Within autonomy, the sub-themes were intrinsic motivation and self-directed choices. Competence included the sub-themes of mastery of teaching practices and digital skill development. Relatedness included the sub-themes of interprofessional collaboration and mentorship.

Results

A total of 21 motivational letters were analyzed from two d-HPE cohorts, representing diverse health professional backgrounds and career stages. Analysis of the autonomy theme revealed an intrinsic motivation shaped by early teaching experiences and a self-directed decision to pursue advanced qualifications. The competence theme reflected the need to master evidence-based teaching practices and to develop advanced digital skills, with the COVID-19 pandemic as a driving factor. The relatedness theme demonstrated the importance of inter-professional collaboration and mentorship in promoting educational innovation across disciplines and institutions.

Discussion

The motivation of health professions educators to participate in faculty development programs goes beyond the traditional 'carrots and sticks' of external rewards or punishments constellation; it is rooted in their intrinsic motivation to improve teaching qualifications and fulfill their role in digital education. Despite the demands of a busy clinical and professional work schedule, active engagement in intensive faculty development programs is aligned with the need for interprofessional networking and the evolving demands of digital education.

Teaching clinical reasoning in gerontological physiotherapy: Experiences and perceptions of clinical supervisors

INTRODUCTION

Teaching clinical reasoning to physiotherapy students is essential for preparing them to work effectively with patients.

OBJECTIVE

This qualitative study aimed to explore the experiences and perceptions of clinical supervisors of teaching clinical reasoning in gerontological physiotherapy.

METHODS

Australian-based clinical supervisors for student placements in gerontological physiotherapy (n = 9) participated in individual semi-structured interviews via videoconferencing. Data were analyzed using Braun and Clark's reflexive thematic analysis.

RESULTS

Four themes were developed from the data: 1) Preparedness for placement: students and supervisors; 2) Dynamic placement adaptations to meet individual learning needs; 3) Negotiating clinically complex and variable patient needs; and 4) Crafting learning opportunities amidst complexities. Clinical supervisors perceive that teaching clinical reasoning is influenced by student and supervisor preparedness and the complexity of gerontological practice. Supervisors engage in planning prior to placements, adapt tasks, discussions and feedback throughout the placement, and promote multi-disciplinary learning experiences to highlight person-centered and collaborative care.

CONCLUSION

This research enhances physiotherapy academics,' clinical supervisors' and students' understanding of the factors influencing teaching clinical reasoning to students in gerontological settings. The challenges and strategies identified can improve students' and supervisors' preparedness for placements, assist them to negotiate complexity and create opportunities to strengthen the learning experience.

Revolutionizing public health through digital health technology

The aging population and increasing chronic diseases strain public health systems. Advancements in digital health promise to tackle these challenges and enhance public health outcomes. Digital health integrates digital health technology (DHT) across healthcare, including smart consumer devices. This article examines the application of DHT in public health and its significant impact on revolutionizing the field. Historically, DHT has not only enhanced the efficiency of disease prevention, diagnosis, and treatment but also facilitated the equitable distribution of global health resources. Looking ahead, DHT holds vast potential in areas such as personalized medicine, telemedicine, and intelligent health management. However, it also encounters challenges such as ethics, privacy, and data security. To further advance DHT, concerted efforts are essential, including policy support, investment in research and development, involvement of medical institutions, and improvement of public digital health literacy.

Considerations for adapting digital competencies and training approaches to the public health workforce: an interpretive description of practitioners' perspectives in Canada

BACKGROUND

Widespread digital transformation necessitates developing digital competencies for public health practice. Given work in 2024 to update Canada's public health core competencies, there are opportunities to consider digital competencies. In our previous research, we identified digital competency and training recommendations within the literature. In this study, we explored public health practitioners' experiences and perspectives on adapting identified digital competencies and training recommendations for Canada.

METHODS

Between November and December 2023, we conducted an interpretive description using four focus groups with 19 public health practitioners working in regional and federal health authorities across Canada, with at least 3 years' experience in current roles and experience using digital technologies in practice. We explored practitioners' experiences using digital technologies and sought their opinions on how digital competency recommendations previously identified could be adapted to Canada's context. To generate deep insights of practitioners' subjective experiences and perspectives, we analyzed verbatim transcripts using Braun and Clarke's reflexive thematic analysis.

RESULTS

We identified three main themes: a) public health systems must evolve to support new digital competencies; b) strengthen the basics before extending towards digital competencies; and c) focus on building general digital competencies with options for specialization where necessary. Findings emphasized matching workforce digital competencies to public health system capabilities and meaningfully integrating digital competencies within existing curricula. Such integration can consider how digital technologies change current public health practice to ensure practitioners are better able to address contemporary public health problems. Findings demonstrated roles for specialized digital programs as resources for learning within health systems and emphasized hands-on real-world training approaches.

CONCLUSION

We need integrated, systems-focused approaches to digital competencies cutting across the current public health curriculum, while creating space for specialized digital public health competencies and roles. Further research is needed to understand requirements for enacting these recommendations in practice.

Digital Dentists: A Curriculum for the 21st Century

Unlabelled

Future health professionals, including dentists, must critically engage with digital health technologies to enhance patient care. While digital health is increasingly being integrated into the curricula of health professions, its interpretation varies widely depending on the discipline, health care setting, and local factors. This viewpoint proposes a structured set of domains to guide the designing of a digital health curriculum tailored to the unique needs of dentistry in Australia. The paper aims to share a premise for curriculum development that aligns with the current evidence and the national digital health strategy, serving as a foundation for further discussion and implementation in dental programs.

Factors Associated With Digital Capacity for Health Promotion Among Primary Care Workers: Cross-Sectional Survey Study

BACKGROUND

Health education and promotion are recognized as effective strategies for fostering healthy ageing, reducing the disease burden, and addressing health inequalities, particularly when delivered through digital media. Primary care workers are often regarded as the key providers of these interventions. Despite the strong practical significance and substantial individual demand, the use of digital media for delivering health promotion practices was not widespread in China. One of the main challenges identified is the providers' inadequate capacities. However, little is known about the digital capacity for health promotion among primary care workers.

OBJECTIVE

This study aimed to investigate the levels of digital capacity for health promotion and its associated factors among community health workers.

METHODS

A total of 1346 community health workers were recruited from across 47 communities in Shanghai, China, through cluster-stratified random sampling. The digital capacity for health promotion was measured using the revised version of the Digital Capabilities Framework. Web-based questionnaires were distributed to collect data from March 20 to March 29, 2024. Data were analyzed using descriptive statistics, independent t tests, one-way ANOVA, and linear hierarchical regression using Stata MP (version 17.0; StataCorp).

RESULTS

We included 1199 participants. Among them, 47.5% (570/1199) had high digital media use for more than 19.6 hours per week, whereas 31.8% (381/1199) demonstrated high digital media trust. The average level of digital capacity for health promotion was 16.71 (SD 2.94) out of 25 points. Demographics, digital media usage-related characteristics, perceived usefulness and usability, attitudes, and behaviors were significant predictors of the capacities, explaining 44.4% of the total variance. Master's degree or above (β=.077; P=.013), perceived usability (β=.235; P<.001), attitudes toward digital media health promotion (β=.095; P=.002), and past digital media health promotion practices (β=.377; P<.001) had significantly positive associations with digital capacities for health promotion. However, senior (β=-.076; P=.008) or median (β=-.074; P=.01) titles had a significant negative association with capacity levels.

CONCLUSIONS

A digitally capable workforce is required for primary health care systems to take full advantage of digital media health promotion. Therefore, solutions are necessary to achieve enhanced capacities among health professionals, including public health policy making, community empowerment, and individual practices.

Digitalization in the operating theatre- an interview study of operating room nurses' and nurse anesthetists' experiences in Norway

BACKGROUND

Digitalization in the health sector requires adaptive change in human attitudes and skills. The operating theatres have been introduced to digital innovations through centuries. The aim of this study was to explore operating room (OR) nurses' and Nurse Anesthetists' (NAs) experiences with digitalization in the operating theatre.

METHODS

The study had a qualitative design, using individual interviews with OR nurses and NAs at a Norwegian hospital. Data were analyzed using reflexive thematic analysis in-line with recommendations from Braun & Clarke.

RESULTS

Two themes were identified, namely (1) Impacting the work processes, and (2) Implications for patient safety. The OR nurses and NAs experienced that digitalization impacted on their work processes positively through making these smoother, but also negatively making the work processes vulnerable for disruptions, leading to a need for parallel actions. Digitalization was experienced to positively impact patient safety for example through making information more accessible. However, digital tools reduced focus on the patient, and then represented a risk to patient safety.

CONCLUSION

OR nurses and NAs perceive that digitalization on one side may facilitate work processes and information flow. However, on the other side digitalization may steel focus on the patient. These aspects should be taken into consideration in quality improvement initiatives and when introducing new digital tools.

Evaluating the Transformative Impact of Online Education on Medical Student Learning Outcomes

Introduction

The COVID-19 pandemic forced educational institutions worldwide to shift to online learning as a means to continue education during lockdowns and social distancing measures. This study investigates the effectiveness of online learning in comparison to traditional on-campus learning, specifically within the context of medical education.

Methods

Two hundred and three first- and second-year medical students at King Saud University participated in this randomized experimental study. The research employed written exams to evaluate learning outcomes, with a focus on the understanding of lecture content. Data analysis was performed using the Statistical Package for Social Studies (SPSS 22).

Results

The findings reveal that while online learning attained similar learning outcomes to on-campus learning for content related to the early parts of the lecture, significantly lower outcomes were achieved by the online learners as the lecture progressed. Moreover, a smaller percentage of online students demonstrated a full understanding of the lecture material compared to on-campus students.

Conclusion

This study emphasizes the importance of assessing the effectiveness of online learning methods, particularly in medical education, to address students' needs better and improve the quality of online learning systems.

Capabilities for Using Telemonitoring in Physiotherapy Treatment: Exploratory Qualitative Study

Background

Telemonitoring (TM), as part of telehealth, allows physiotherapists to monitor and coach their patients using remotely collected data. The use of TM requires a different approach compared with face-to-face treatment. Although a telehealth capability framework exists for health care professionals, it remains unclear what specific capabilities are required to use TM during physiotherapy treatments.

Objective

This study aims to identify the capabilities required to use TM in physiotherapy treatment.

Methods

An exploratory qualitative study was conducted following a constructivist semistructured grounded theory approach. Three heterogeneous focus groups were conducted with 15 lecturers of the School of Physiotherapy (Bachelor of Science Physiotherapy program) from the Amsterdam University of Applied Sciences. Focus group discussions were audiotaped and transcribed verbatim. Capabilities for using TM in physiotherapy treatment were identified during an iterative process of data collection and analysis, based on an existing framework with 4 different domains. Team discussions supported further conceptualization of the findings.

Results

Sixteen capabilities for the use of TM in physiotherapy treatment were found addressing 3 different domains. Four capabilities were identified in the "digital health technologies, systems, and policies" domain, 7 capabilities in the "clinical practice and application" domain, and 5 capabilities in the "data analysis and knowledge creation" domain. No capabilities were identified in the "system and technology implementation" domain.

Conclusions

The use of TM in physiotherapy treatment requires specific skills from physiotherapists. To best use TM in physiotherapy treatment, it is important to integrate these capabilities into the education of current and future physiotherapists.

Design, Implementation, and Analysis of an Assessment and Accreditation Model to Evaluate a Digital Competence Framework for Health Professionals: Mixed Methods Study

BACKGROUND

Although digital health is essential for improving health care, its adoption remains slow due to the lack of literacy in this area. Therefore, it is crucial for health professionals to acquire digital skills and for a digital competence assessment and accreditation model to be implemented to make advances in this field.

OBJECTIVE

This study had two objectives: (1) to create a specific map of digital competences for health professionals and (2) to define and test a digital competence assessment and accreditation model for health professionals.

METHODS

We took an iterative mixed methods approach, which included a review of the gray literature and consultation with local experts. We used the arithmetic mean and SD in descriptive statistics, P values in hypothesis testing and subgroup comparisons, the greatest lower bound in test diagnosis, and the discrimination index in study instrument analysis.

RESULTS

The assessment model designed in accordance with the competence content defined in the map of digital competences and based on scenarios had excellent internal consistency overall (greatest lower bound=0.91). Although most study participants (110/122, 90.2%) reported an intermediate self-perceived digital competence level, we found that the vast majority would not attain a level-2 Accreditation of Competence in Information and Communication Technologies.

CONCLUSIONS

Knowing the digital competence level of health professionals based on a defined competence framework should enable such professionals to be trained and updated to meet real needs in their specific professional contexts and, consequently, take full advantage of the potential of digital technologies. These results have informed the Health Plan for Catalonia 2021-2025, thus laying the foundations for creating and offering specific training to assess and certify the digital competence of such professionals.

Needed competence for registered nurses working at a patient-centred telehealth service aimed to engage and empower people living with COPD: A five-month participatory observational study

BACKGROUND

The global population of older aged 65 and over is increasing, which means an increase in people living with long-term health conditions and multimorbidity. Implementing new digital health technologies enables increased patient empowerment and responsibility, and the ability to respond to changes in their condition themselves, with less involvement of healthcare professionals. Important parameters need to be addressed for this digitally enabled empowerment to be successful, these include increased individual and organizational health literacy, the establishment of joint decision-making activities among patients and healthcare professionals, and efforts that target the individual's ability to manage their condition, which include education to increase skills and providing technology for self-monitoring.

OBJECTIVE

To identify needed competencies of digital healthcare professionals to be able to provide the needed services to service users with chronic obstructive pulmonary disease in a 24/7 digital healthcare service.

METHOD

Five registered nurses' work was observed weekly for five months. In total 13 participatory observations were conducted. Data from the observations was transcribed and analysed through inductive content analysis.

RESULTS

Five main categories were identified in the analysis; 1) tasks, 2) communication, 3) the relationships between the registered nurses, 4) service users, and 5) technology. These categories contain different competencies needed for registered nurses working in a digitalized healthcare system.

CONCLUSIONS

Future digital healthcare professionals will require several competencies, to be able to deliver proper care in a digital health community that goes beyond traditional healthcare competencies, including social, technological, and communication skills.

A landscape analysis of digital health technology in medical schools: preparing students for the future of health care

Although Digital Health Technology is increasingly implemented in hospitals and clinics, physicians are not sufficiently equipped with the competencies needed to optimize technology utilization. Medical schools seem to be the most appropriate channel to better prepare future physicians for this development. The purpose of this research study is to investigate the extent to which top-ranked medical schools equip future physicians with the competencies necessary for them to leverage Digital Health Technology in the provision of care. This research work relied on a descriptive landscape analysis, and was composed of two phases: Phase I aimed at investigating the articulation of the direction of the selected universities and medical schools to identify any expressed inclination towards teaching innovation or Digital Health Technology. In phase II, medical schools' websites were analyzed to discover how innovation and Digital Health Technology are integrated in their curricula. Among the 60 medical schools that were analyzed, none mentioned any type of Digital Health Technology in their mission statements (that of the universities, in general, and medical schools, specifically). When investigating the medical schools' curricula to determine how universities nurture their learners in relation to Digital Health Technology, four universities covering different Digital Health Technology areas were identified. The results of the current study shed light on the untapped potential of working towards better equipping medical students with competencies that will enable them to leverage Digital Health Technology in their future practice and in turn enhance the quality of care.

Digital Competencies and Training Approaches to Enhance the Capacity of Practitioners to Support the Digital Transformation of Public Health: Rapid Review of Current Recommendations

Background

The COVID-19 pandemic highlighted gaps in the public health workforce's capacity to deploy digital technologies while upholding ethical, social justice, and health equity principles. Existing public health competency frameworks have not been updated to reflect the prominent role digital technologies play in contemporary public health, and public health training institutions are seeking to integrate digital technologies in their curricula.

Objective

As a first step in a multiphase study exploring recommendations for updates to public health competency frameworks within the Canadian public health context, we conducted a rapid review of literature aiming to identify recommendations for digital competencies, training approaches, and inter- or transdisciplinary partnerships that can enhance public health practitioners' capacity to support the digital transformation of public health.

Methods

Following the World Health Organization's (2017) guidelines for rapid reviews, a systematic search was conducted on Ovid MEDLINE, Ovid Embase, ERIC (Education Resources Information Center), and Web of Science for peer-reviewed articles. We also searched Google Scholar and various public health agency and public health association websites for gray literature using search terms related to public health, digital health, practice competencies, and training approaches. We included articles with explicit practice competencies and training recommendations related to digital technologies among public health practitioners published between January 2010 and December 2022. We excluded articles describing these concepts in passing or from a solely clinical perspective.

Results

Our search returned 2023 titles and abstracts, of which only 12 studies met the inclusion criteria. We found recommendations for new competencies to enable public health practitioners to appropriately use digital technologies that cut across all existing categories of the core competencies for public health framework of the Public Health Agency of Canada. We also identified a new competency category related to data, data systems management, and governance. Training approaches identified include adapted degree-awarding programs like combined public health and informatics or data science degree programs and ongoing professional certifications with integration of practice-based learning in multi- and interdisciplinary training. Disciplines suggested as important to facilitate practice competency and training recommendations included public health, public health informatics, data, information and computer sciences, biostatistics, health communication, and business.

Conclusions

Despite the growth of digital technologies in public health, recommendations about practice competencies and training approaches necessary to effectively support the digital transformation of public health remain limited in the literature. Where available, evidence suggests the workforce requires new competencies that cut across and extend existing public health competencies, including new competencies related to the use and protection of new digital data sources, alongside facilitating health communication and promotion functions using digital media. Recommendations also emphasize the need for training approaches that focus on interdisciplinarity through adapted degree-awarding public health training programs and ongoing professional development.

Developing competencies relating to information science and technology in Japanese undergraduate medical education

In response to the growing expectation and recognized potential for integrating information and communication technology (ICT) into medicine, the Model Core Curriculum for Medical Education in Japan incorporated 'the ability to use information science and technology' as a new competency in its 2022 revision. This study aimed to identify specific learning objectives that medical students should achieve to acquire this competency. The research team developed an initial list of 107 learning objectives through a literature survey. Subsequently, two rounds of expert panel surveys were conducted to refine these objectives. Seventy-four medical education stakeholders participated in the expert panel, including medical and non-medical faculty, medical students, graduate students, and university staff. Through the expert panel surveys, 13 learning objectives were finally established from the initial list, consisting of three categories: 'Ethics and rules for dealing with information science and technology,' 'Principles of information science and technology necessary for medical care and surrounding society,' and 'Application of information science and technology in clinical practice.' Our investigation effectively identified essential components of competencies for integrating ICT into medical education. The identified learning objectives would provide valuable insights for designing curricula for undergraduates in the new era of information and artificial intelligence.

The Digital Determinants of Health: A Guide for Competency Development in Digital Care Delivery for Health Professions Trainees

Unlabelled

Health care delivery is undergoing an accelerated period of digital transformation, spurred in part by the COVID-19 pandemic and the use of "virtual-first" care delivery models such as telemedicine. Medical education has responded to this shift with calls for improved digital health training, but there is as yet no universal understanding of the needed competencies, domains, and best practices for teaching these skills. In this paper, we argue that a "digital determinants of health" (DDoH) framework for understanding the intersections of health outcomes, technology, and training is critical to the development of comprehensive digital health competencies in medical education. Much like current social determinants of health models, the DDoH framework can be integrated into undergraduate, graduate, and professional education to guide training interventions as well as competency development and evaluation. We provide possible approaches to integrating this framework into training programs and explore priorities for future research in digitally-competent medical education.

Competencies required to make use of Information Science and Technology among Japanese medical students: a cross-sectional study

BACKGROUND

Competency in the use of information science and technology (IST) is essential for medical students. This study identified learning objectives and competencies that correspond with low self-assessment related to use of IST and factors that improve such self-assessment among medical students.

METHODS

A questionnaire was administered to sixth-year medical students across 82 medical schools in Japan between November 2022 and February 2023.

RESULTS

Three learning objectives were identified as difficult for the students to achieve: (1) provide an overview of the regulations, laws, and guidelines related to IST in medicine; (2) discuss ethical issues, such as social disparities caused by the digital divide that may arise in the use of IST in medicine; and (3) understand IST related to medical care. Further, problem-based learning, engaging with IST beyond class, and learning approach impacted the students' acquisition of competencies related to IST. Furthermore, it was recognized that the competencies required by medical students may change over the course of an updated medical school curriculum.

CONCLUSIONS

It is important for medical students to recognize the significance of learning, establishing active learning methods, and gaining experience in practically applying these competencies.

Digital Competence among Healthcare Leaders: A Mixed-Methods Systematic Review

Background

New evidence on the digital competencies of healthcare leaders can provide essential knowledge for building training for the leaders to ensure high-quality patient care.

Objective

The aim of this mixed-methods systematic review was to identify the current best evidence from qualitative, quantitative, and mixed-methods studies on healthcare leaders' digital competence experiences and perceptions and factors associated with it.

Methods

A mixed-methods systematic review was conducted following the Joanna Briggs Institute guidelines for mixed-methods systematic reviews by including original qualitative and quantitative observational studies and mixed-methods studies published in English or Finnish between January 2012 and January 2024. The studies were retrieved from four databases (CINAHL, PubMed, Scopus, and Medic). In total, 4470 articles were screened, 122 were eligible for full-text screening, and 19 articles were included in the review according to the established inclusion and exclusion criteria. Data Extraction and Synthesis. Data tabulation and narrative synthesis for quantitative studies and content analysis for qualitative studies.

Results

The synthesis of qualitative data identified five main categories that describe healthcare leaders' experiences with digital competencies: (1) the need for developing leader's own, professionals', and patients' competence in the digitalisation of healthcare, (2) the need for expertise in the health IT implementation process, (3) positive perceptions towards technology, (4) negative perceptions towards technology, and (5) ability to act as an advocate to implement technology into practice. Data from the selected quantitative studies presents that factors associated with the digital competence of healthcare leaders include individual characteristics, career characteristics, training, and other factors.

Conclusion

This review suggests that developing and supporting healthcare leaders' digital competencies should be considered in healthcare organizations, research, and education to make their digital competencies meet the demands of increasingly digitalising healthcare development work.

Digital Health Education and Training for Undergraduate and Graduate Nursing Students: Scoping Review

BACKGROUND

As technology will continue to play a pivotal role in modern-day health care and given the potential impact on the nursing profession, it is vitally important to examine the types and features of digital health education in nursing so that graduates are better equipped with the necessary knowledge and skills needed to provide safe and quality nursing care and to keep abreast of the rapidly evolving technological revolution.

OBJECTIVE

In this scoping review, we aimed to examine and report on available evidence about digital health education and training interventions for nursing students at the undergraduate and graduate levels.

METHODS

This scoping review was conducted using the Joanna Briggs Institute methodological framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A comprehensive search strategy was developed and applied to identified bibliographic databases including MEDLINE (Ovid; 1946 to present), Embase (Ovid; 1974 to present), CINAHL (EBSCOhost; 1936 to present), ERIC (EBSCOhost; 1966 to present), Education Research Complete (EBSCOhost; inception to present), and Scopus (1976 to present). The initial search was conducted on March 3, 2022, and updated searches were completed on January 11, 2023, and October 31, 2023. For gray literature sources, the websites of select professional organizations were searched to identify relevant digital health educational programs or courses available to support the health workforce development. Two reviewers screened and undertook the data extraction process. The review included studies focused on the digital health education of students at the undergraduate or graduate levels or both in a nursing program. Studies that discussed instructional strategies, delivery processes, pedagogical theory and frameworks, and evaluation strategies for digital health education; applied quantitative, qualitative, and mixed methods; and were descriptive or discussion papers, with the exception of review studies, were included. Opinion pieces, editorials, and conference proceedings were excluded.

RESULTS

A total of 100 records were included in this review. Of these, 94 records were identified from database searches, and 6 sources were identified from the gray literature. Despite improvements, there are significant gaps and limitations in the scope of digital health education at the undergraduate and graduate levels, consequently posing challenges for nursing students to develop competencies needed in modern-day nursing practice.

CONCLUSIONS

There is an urgent need to expand the understanding of digital health in the context of nursing education and practice and to better articulate its scope in nursing curricula and enforce its application across professional nursing practice roles at all levels and career trajectories. Further research is also needed to examine the impact of digital health education on improving patient outcomes, the quality of nursing care, and professional nursing role advancement.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.11124/JBIES-22-00266.

Translation and Validation of Digital Competence Indicators in Greek for Health Professionals: A Cross-Sectional Study

BACKGROUND

it is widely accepted that living in the digital transformation era, the need to develop and update new professional skills and tools in health sectors is crucially important. Therefore, this study aimed to explore the reliability and validity of the Digital Competence Indicators tool in assessing the digital skills of Greek health professionals.

METHODS

in this cross-sectional study, 494 health professionals, including doctors (175) and registered nurses (319) working in four Greek hospitals were recruited and willingly participated using a convenience-sampling method. The original framework of Digital Competence Indicators was translated from English to Greek based on guidelines for cross-cultural adaptation of questionnaires. The validity of the tool was explored using confirmatory factor analysis (CFA) to verify the fit of the model using inductive techniques. The instrument reliability was confirmed using Cronbach's alpha (α) and McDonald's Omega coefficients.

RESULTS

the reliability was estimated at 0.826 (Cronbach's-α) and 0.850 (McDonald's Omega-ω). The indicators of CFA were all calculated within an ideal range of acceptance. Specifically, the CFA comparative fit index produced the following adjustment indices: x2/df = 1.152 (p = 0.037), CFI = 0.997, Lewis index (TLI) = 0.966, and root mean square error of approximation (RMSEA) = 0.018.

CONCLUSIONS

The present study demonstrated that the Digital Competence Indicator instrument has high reliability, internal consistency, and construct validity and, therefore, it is suitable for measuring digital skills of health professionals.

Assessing digital health knowledge, attitudes and practices among nurses in Naples: a survey study protocol

INTRODUCTION

Digital competencies are essential for nurses to actively participate in the digitisation of healthcare systems. Therefore, it is important to assess their skill levels to identify strengths and areas for improvement.

METHOD AND ANALYSIS

This study aims to investigate nurses' knowledge, attitudes, behaviours, subjective norms and behavioural control regarding digital health. A knowledge-attitude-practice model guided the development of a structured questionnaire divided into six sections. A sample of 480 registered nurses of Naples will be involved in the study. After conducting a pretest, an invitation will be publicised through the institutional communication channels of Nurses Provincial Order of Naples. Nurses will respond via a unique link or quick response code sent through a PEC email system (a legally valid email system, which guarantees delivery and receipt). They will have 30 days to complete the survey, scheduled between May and July 2024.

ETHICS AND DISSEMINATION

No ethics committee approval was required, as the study does not involve minors, direct or indirect physical or physiological harm to participants, or clinical trials. Anonymity will be guaranteed at all data collection and processing levels. The results will be broadly distributed through conference presentations and peer-reviewed publications. The effective use of digital technologies by healthcare professionals can bring significant improvements to healthcare services and help improve the health of individuals and community health. The study's findings will serve as a foundation for developing and implementing educational programmes related to eHealth and telemedicine, promoting the harmonisation of such programmes.

Preferences, Needs, and Values of Patients With Chronic Obstructive Pulmonary Disease Attending a Telehealth Service: Qualitative Interview Study

BACKGROUND

Digitally assisted health care services and technologies are gaining popularity. They assist patients in managing their conditions, thereby reducing the burden on health care staff. Digital health care enables individuals to receive care that is more tailored to their needs and preferences. When implemented properly, it can promote equity by considering each person's opportunities and limitations in the context of health care needs, preferences, values, and capabilities.

OBJECTIVE

This study aims to understand the needs, values, and preferences of individuals with chronic obstructive pulmonary disease (COPD) who are provided with a 24/7 digital health care service. Furthermore, we aim to understand the dynamics of the communities to which they belong and how these communities intersect. This will provide us with the essential knowledge to establish new methods of providing education, including the development of educational activities for health professionals to engage, train, and empower people living with COPD.

METHODS

The study included 7 informants diagnosed with COPD who received 24/7 digital health care service support from a regional project in Region Zealand, Denmark. The informants were visited 4 times during 2 months, including a "Hello" visit, a day with a semistructured interview, and 2 days with field observations. The informants participated in a semistructured interview, following participant observation and an ethnographic approach. The interview content was analyzed using an inductive methodology to categorize the empirical data.

RESULTS

Using the inductive approach, we identified 3 main categories related to the informants' needs, values, and preferences: (1) Health, (2) Value Creation, and (3) Resources. These 3 main categories were based on 9 subcategories: (1) health and barriers, (2) self-monitoring, (3) medication, (4) behavior, (5) motivation, (6) hobbies, (7) social networks, (8) health professionals, and (9) technology. These findings revealed that the informants placed value on maintaining their daily activities and preserving their sense of identity before the onset of COPD. Furthermore, they expressed a desire not to be defined by their COPD, as conversations about COPD often shifted away from the topic.

CONCLUSIONS

Digital health solutions and the health care professionals who offer them should prioritize the individuals they serve, considering their needs, values, and preferences rather than solely focusing on the medical condition. This approach ensures the highest level of daily living and empowerment for those living with long-term health conditions. The communities surrounding individuals must engage in constant interaction and collaboration. They should work together to incorporate people's needs, values, and preferences into future digital health services, thereby promoting empowerment and self-management. New educational programs aimed at developing the digital health service competencies of registered nurses should facilitate collaboration between the 2 communities. This collaboration is essential for supporting patients with long-term health conditions in their daily activities.

Enhancing neurosurgical navigation operation flow management through personal digital assistant technology: a prospective cohort study

Purpose

This prospective cohort study aims to evaluate the impact of digital health technology especially Personal Digital Assistants (PDA) in neurosurgical procedure management, focusing on surgical safety check accuracy, efficiency, and patient satisfaction.

Methods

The study included 211 neurosurgical cases from January to December 2022. The control group of 106 patients followed traditional verification methods, while the experimental group of 105 patients used PDA. The PDA system facilitated real-time data collection, verification, and transmission. The study compared both groups in terms of check times, accuracy rates, and patient satisfaction, and used multivariate regression to assess the impact of baseline parameters on these outcomes.

Results

The study found that the experimental group using the PDA system reduced the average verification time by approximately 8 min, achieving 100.0% accuracy in preoperative and postoperative checks, significantly better than the control group (91.5% pre- and post-operation). Multivariate regression confirmed a 48.1% reduction in postoperative verification time due to the PDA system (p < 0.001), with the model showing high explanatory power (R2 = 0.911). Other examined factors, including patient age and nurse experience, had no significant effects. Similarly, the PDA's introduction markedly improved verification accuracy, with no significant impact from other variables (p = 0.010).

Conclusion

The application of the PDA system in neurosurgical operations significantly enhanced the accuracy and efficiency of surgical safety checks, reduced nursing errors, optimized nursing workflows, and improved patient satisfaction. These results provide valuable insights for the application of PDA technology in high-risk medical fields, demonstrating potential of digital health tools in enhancing surgical safety and efficiency.

Evaluating digital literacy of health professionals in Ethiopian health sectors: A systematic review and meta-analysis

BACKGROUND

Digital literacy refers to the capacity to critically assess digital content, use digital tools in professional settings, and operate digital devices with proficiency. The healthcare sector has rapidly digitized in the last few decades. This systematic review and meta-analysis aimed to assess the digital literacy level of health professionals in the Ethiopian health sector and identify associated factors. The study reviewed relevant literature and analyzed the data to provide a comprehensive understanding of the current state of digital literacy among health professionals in Ethiopia.

METHODS

The study was examined by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Evidence was gathered from the databases of Google Scholar, Pub Med, Cochrane Library, Hinari, CINAHL, and Global Health. Consequently, five articles met the eligible criteria for inclusion. The analysis was carried out using STATA version 11. The heterogeneity was evaluated using the I2 test, while the funnel plot and Egger's regression test statistic were used to examine for potential publication bias. The pooled effect size of each trial is evaluated using a random effect model meta-analysis, which provides a 95% confidence interval.

RESULT

A total of five articles were included in this meta-analysis and the overall pooled prevalence of this study was 49.85% (95% CI: 37.22-62.47). six variables, Monthly incomes AOR = 3.89 (95% CI: 1.03-14.66), computer literacy 2.93 (95% CI: 1.27-6.74), perceived usefulness 1.68 (95% CI: 1.59-4.52), educational status 2.56 (95% CI: 1.59-4.13), attitude 2.23 (95% CI: 1.49-3.35), perceived ease of use 2.22 (95% CI: 1.52-3.23) were significantly associated with the outcome variable.

CONCLUSION

The findings of the study revealed that the overall digital literacy level among health professionals in Ethiopia was relatively low. The study highlights the importance of addressing the digital literacy gap among health professionals in Ethiopia. It suggests the need for targeted interventions, such as increasing monthly incomes, giving computer training, creating a positive attitude, and educational initiatives, to enhance digital literacy skills among health professionals. By improving digital literacy, health professionals can effectively utilize digital technologies and contribute to the advancement of healthcare services in Ethiopia.

Sustainable integration of digitalisation in nursing education-an international scoping review

Introduction

Trainees and teachers at nursing schools as well as nursing professionals are increasingly facing new challenges as a result of the digital transformation. Opportunities for the entire care system exist in the improvement of care quality and communication between those involved. However, this change also harbours risks, such as the use of immature digital applications in the care sector, data theft and industrial espionage. In order to be able to exploit the potential of digitalisation despite these risks, it is necessary to integrate relevant aspects such as digital skills into nursing training. The aim of this study is to investigate the extent to which the sustainable integration of digitalisation in nursing education is discussed.

Methods

The methods of the systematic literature and database search were carried out in the form of a scoping review according to the PRISMA scheme. The PubMed and CINAHL databases were used for this purpose. The search period covered the years 2017-2023.

Findings

After screening the titles and abstracts using inclusion and exclusion criteria, 13 studies were included in the synthesis of findings. The international literature focuses on content areas that highlight trends in digitalisation-related training in nursing. These focal points include concept development, considering the heterogeneity of demand constellations, as well as the reflexive reorientation of existing competences, whereby the technological competence of teachers is not disregarded. Other focal points relate to the initiation of digital skills in training and maintaining the employability of older nursing staff through professional development.

Discussion

The literature research shows that there is a rudimentary discussion about digitalisation and curricular developments in nursing training in an international context, while the discourse in the German-language literature is less advanced. Among the sustainability desiderata derived from the literature is the involvement of nursing professionals in the development, testing and implementation of digital technologies. Only through active cooperation between nursing professionals and nursing sciences can the topic of digitalisation be integrated into the education and training of professional nursing in a targeted and future-oriented manner, whereby the focus should always be on the ability to deal with digital technologies and the associated change.

Measuring the Digital Competence of Health Professionals: Scoping Review

BACKGROUND

Digital competence is listed as one of the key competences for lifelong learning and is increasing in importance not only in private life but also in professional life. There is consensus within the health care sector that digital competence (or digital literacy) is needed in various professional fields. However, it is still unclear what exactly the digital competence of health professionals should include and how it can be measured.

OBJECTIVE

This scoping review aims to provide an overview of the common definitions of digital literacy in scientific literature in the field of health care and the existing measurement instruments.

METHODS

Peer-reviewed scientific papers from the last 10 years (2013-2023) in English or German that deal with the digital competence of health care workers in both outpatient and inpatient care were included. The databases ScienceDirect, Scopus, PubMed, EBSCOhost, MEDLINE, OpenAIRE, ERIC, OAIster, Cochrane Library, CAMbase, APA PsycNet, and Psyndex were searched for literature. The review follows the JBI methodology for scoping reviews, and the description of the results is based on the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist.

RESULTS

The initial search identified 1682 papers, of which 46 (2.73%) were included in the synthesis. The review results show that there is a strong focus on technical skills and knowledge with regard to both the definitions of digital competence and the measurement tools. A wide range of competences were identified within the analyzed works and integrated into a validated competence model in the areas of technical, methodological, social, and personal competences. The measurement instruments mainly used self-assessment of skills and knowledge as an indicator of competence and differed greatly in their statistical quality.

CONCLUSIONS

The identified multitude of subcompetences illustrates the complexity of digital competence in health care, and existing measuring instruments are not yet able to reflect this complexity.

A Delphi Study on Identifying Competencies in Virtual Healthcare for Healthcare Professionals

BACKGROUND

Virtual care adoption accelerated during the COVID-19 pandemic, highlighting the need for healthcare professionals to develop relevant competencies. However, limited evidence exists on the core competencies required for quality virtual care delivery.

OBJECTIVE

This study aimed to identify the critical competencies physicians, nurses, and other health professionals need for adequate virtual care provision in Saudi Arabia using a Delphi method.

METHODS

A 3-round Delphi technique was applied with a panel of 42 experts, including policymakers, healthcare professionals, academicians, and telehealth specialists. In Round 1, an open-ended questionnaire elicited competencies needed for virtual care. The competencies were distilled and rated for importance in Rounds 2 and 3 until consensus was achieved.

RESULTS

Consensus emerged on 151 competencies across 33 domains. The most prominent domains were communication (15 competencies), professionalism (13), leadership (12), health informatics (5), digital literacy (5), and clinical expertise (11).

A Virtual Case Presentation Platform: Protocol Study

Gaining practical experience is indispensable for medical students. Therefore, when medical students were prevented access to hospitals during the COVID-19 pandemic in Romania, there was an urgent need to find a solution that would allow medical students to develop the skills they would usually develop in hospitals but without the need to be physically present in a hospital. This was the reason behind the idea of developing a Virtual Case Presentation Platform. The platform offers the possibility for medical students to reproduce virtually, in clinically valid scenarios, the diagnostic process and treatment recommendation, as well as the interactions with patients that usually take place in hospitals using natural language through speech and text. On the platform, the students receive valuable feedback from the professors about their performance. In order to reproduce the whole targeted experience for students, without missing anything, before starting the development of the platform, it was mandatory to identify and understand all the aspects that should be covered by the platform. The proposed platform covers the different aspects that have been identified for the diagnostic process and treatment recommendation. It enables medical students to develop essential skills for their future careers as doctors.

[How much digital public health is in public health degree programs? A systematic analysis of module handbooks in German full-time study programs at public colleges and universities]

BACKGROUND

Professionals, especially in the field of digital public health (DiPH), are crucial for a successful digital transformation in social and health care. However, it is still unclear to what extent academic professionals are taught DiPH-related content in their public health (PH) studies.

METHODS

This study used a systematic module handbook analysis to analyze accredited full-time PH-oriented degree programs at public colleges and universities in Germany for DiPH-related module content. Through the "Hochschulkompass" platform and the member programs of the German Public Health Association (DGPH), 422 programs were identified. Included module handbooks were evaluated by content analysis using MAXQDA.

RESULTS

Only 10 bachelor and 6 master programs contain DiPH. They are heterogeneous in their focus and belong to different subfields of public health ("methods, definition, history, and social medicine" = 5; "health management" = 5; "digital health" = 3; "health services research" = 2; "health communication" = 1). Differences were found between the common understanding of DiPH in academia and the content in the module handbooks. The content identified in the analysis focuses mainly on technical areas. Social and health science content is only marginally present.

DISCUSSION

The heterogeneous study programs with a connection to DiPH allow academic PH specialists to develop specific profiles. To achieve comprehensive competencies in DiPH, there is a need for further development of modules with relevance to the respective degree program. The results could be used for the (further) development of relevant modules and a core curriculum in DiPH.

Empowering the digital health workforce in Latin America in the context of the COVID-19 pandemic: the Peruvian case

The COVID-19 pandemic has exposed significant gaps in healthcare access, quality, and the urgent need for enhancing the capacity of digital health human resources, particularly in Latin America. During the pandemic, online courses and telehealth initiatives supported by governmental agencies, the Pan American Health Organization, and other public and private resources, have played a crucial role in meeting training demands. This article discusses the role of capacity building programs in digital health within the context of Latin America, with a specific focus on the Peruvian case. We highlight the development of digital health competencies and related policies, while also describing selected experiences related to capacity building in this field. Additionally, we discuss the pivotal role of collaborative partnerships among institutions and countries, emphasizing the importance of culturally relevant training programs in digital health. These initiatives have the potential to accelerate training and research opportunities in Latin America, drawing on the involvement of government agencies, non-governmental organizations, industry, universities, professional societies, and communities.

Exploring physiotherapists' perceptions of telerehabilitation for musculoskeletal disorders: Insights from focus groups

Objective

This study explored the perceived benefits, barriers, and recommendations of telerehabilitation for musculoskeletal disorders among physiotherapists in Malaysia.

Methods

This study employed an exploratory qualitative methodology to gather the perceptions of government-employed physiotherapists in Malaysia regarding the benefits, barriers, and recommendations for telerehabilitation in treating musculoskeletal disorders. The researchers conducted semistructured focus group discussions (FGDs) via Google Meet, which were recorded, transcribed, and analyzed using thematic analysis.

Results

Five FGDs were conducted with 24 participants, 37.5% of whom had prior experience with telerehabilitation. The data analysis returned three main themes: (1) perceived benefits, (2) barriers, and (3) recommendations. Four subthemes were derived from perceived benefits: (1a) saving time and money, (1b) convenience, (1c) clients responsible for their treatment, and (1d) alternatives for infectious diseases. Perceived barriers revealed three subthemes: (2a) technology, (2b) organization, and (2c) personal barriers. Finally, participants provided recommendations for improving telerehabilitation services, including training programs to facilitate greater acceptance of this modality.

Conclusion

The findings of this study offer crucial insights into the evolving landscape of telerehabilitation in Malaysia. These findings revealed a greater prevalence of barriers to enablers among Malaysian physiotherapists, potentially influenced by varying experience levels. Despite the prevailing lack of experience among participants, this research underscores the significance of identifying barriers and enablers in implementing telerehabilitation with participants offering recommendations for integrating telerehabilitation into their practices. This study provides clear insights and a roadmap for stakeholders aiming to shape the future of telerehabilitation among physiotherapists in Malaysia.

Development of an eLearning intervention for enhancing health professionals' skills for addressing COVID-19 vaccine hesitancy

Like many countries, Greece has faced resistance to coronavirus disease 2019 (COVID-19) vaccination among residents for both the initial and booster doses. Supporting healthcare professionals with delivering brief advice on COVID-19 vaccination may assist with reaching national vaccination targets. We sought to rapidly develop, pilot test, and deploy an eLearning intervention on skills training on effective techniques for addressing COVID-19 vaccine hesitancy for primary health and social care professionals in Greece. A five-part, 1.5-h eLearning was produced in Greek which featured two behavior change techniques, Very Brief Advice (VBA) and Motivational Interviewing (MI) adapted for use in addressing COVID-19 vaccine hesitancy. Six-film-based case studies modeling the use of VBA and MI in the context of challenging scenarios typically seen in Greek health and social settings were produced for the eLearning. The CME was pilot tested using a pre-post design in a small convenience sample (n = 17) of health care professionals. Pilot study results found the training provided new knowledge (80%), improved provider skills (80%), and was useful to provider's clinical practice (90%). There was a mixed effect in provider capability, motivation, and opportunity. Ninety percent of providers strongly agreed or agreed that they planned to use the information and skills provided by the training in their clinical practice. This project has resulted in new training assets for use by health and social professional tailored to the nationally context in Greece including supporting uptake of booster doses of the COVID-19 vaccine.

Content Validation of a Questionnaire to Measure Digital Competence of Nurses in Clinical Practice

Clinical practice nurses need adequate digital competence to use technologies appropriately at work. Questionnaires measuring clinical practice nurses' digital competence lack content validity because attitude is not included as a measure of digital competence. The aim of the current study was to identify items for an item pool of a questionnaire to measure clinical practice nurses' digital competence and to evaluate the content validity. A normative Delphi study was conducted, and the content validity index on item and scale levels was calculated. In each round, 21 to 24 panelists (medical informatics specialists, nurse informatics specialists, digital managers, and researchers) were asked to rate the items on a 4-point Likert scale ranging from "not relevant" to "very relevant." Within three rounds, the panelists reached high consensus and rated 26 items of the initial 37 items as relevant. The average content validity index of 0.95 (SD, 0.07) demonstrates that the item pool showed high content validity. The final item pool included items to measure knowledge, skills, and attitude. The items included represent the international recommendations of core competences for clinical nursing. Future research should conduct psychometric testing for construct validity and internal consistency of the generated item pool.

eHealth literacy among hospital health care providers: a systematic review

BACKGROUND

eHealth literacy is a key concept in the implementation of eHealth resources. However, most eHealth literacy definitions and frameworks are designed from the perceptive of the individual receiving eHealth care, which do not include health care providers' eHealth literacy or acceptance of delivering eHealth resources.

AIMS

To identify existing research on eHealth literacy domains and measurements and identify eHealth literacy scores and associated factors among hospital health care providers.

METHODS

This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. A systematic literature search was conducted in MEDLINE, Cinahl, Embase, Scopus, PEDro, AMED and Web of Science. Quantitative studies assessing eHealth literacy with original research, targeting hospital health care providers were included. Three eHealth literacy domains based on the eHealth literacy framework were defined a priori; (1) Individual eHealth literacy, (2) Interaction with the eHealth system, and (3) Access to the system. Pairs of authors independently assessed eligibility, appraised methodological quality and extracted data.

RESULTS

Fourteen publications, of which twelve publications were conducted in non-Western countries, were included. In total, 3,666 health care providers within eleven different professions were included, with nurses being the largest group. Nine of the included studies used the eHealth literacy scale (eHEALS) to measure eHealth literacy, representing the domain of individual eHealth literacy. A minority of the studies covered domains such as interaction with the eHealth system and access to the system. The mean eHEALS score in the studies ranged from 27.8 to 31.7 (8-40), indicating a higher eHealth literacy. One study reported desirable eHealth literacy based on the Digital Health Literacy Instrument. Another study reported a relatively high score on the Staff eHealth literacy questionnaire. eHealth literacy was associated with socio-demographic factors, experience of technology, health behaviour and work-related factors.

CONCLUSIONS

Health care providers have good individual eHealth literacy. However, more research is needed on the eHealth literacy domains dependent on interaction with the eHealth system and access to the system. Furthermore, most studies were conducted in Eastern and Central-Africa, and more research is thus needed in a Western context.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews (CRD42022363039).

Escape to the future - a qualitative study of physicians' views on the work environment, education, and support in a digital context

BACKGROUND

The use of remote services such as video consultations (VCs) has increased significantly in the wake of the COVID-19 pandemic. In Sweden, private healthcare providers offering VCs have grown substantially since 2016 and have been controversial. Few studies have focused on physicians' experiences providing care in this context. Our aim was to study physicians' experiences of VCs, focusing on the work environment, quality of care, and educational needs.

METHODS

Twenty-two semi-structured interviews were performed with physicians working with VCs in Sweden, and analyzed through inductive content analysis.

RESULTS

We identified five categories; flexibility, social work environment, impact on care and society, continuous learning and career development, and organizational support. Flexibility and accessibility were considered positive features of working digitally by giving physicians control over their time and workplace and increasing patients' timely access to healthcare. Regarding collegial contact and social activities in a digital context, the majority of the participants did not experience any significant difference compared to the physical context. Access to technical support services, educational support, and collegial support in decision-making, guidance, and consultations were described as well-functioning. Satisfied patients positively impacted the work environment, and participants felt that VCs have a positive socio-economic effect. Continuity of care was considered supported, but patients did not always prioritize this. Privacy risks were considered a challenge, as were poor development of clinical skills due to the low variation of patient cases. Working for an online healthcare provider was contributing to career advancements for junior clinicians.

CONCLUSIONS

Physicians appreciate the flexibility of the digital context and seem satisfied with a work environment where they have a high level of control, but few consider this a full-time career option. The pandemic year 2020 has led to a significant increase in the implementation of VCs in traditional care systems. How this affects the work environment and continuous education needs and career development remains to be seen.

Pedagogical impact of integration of musculoskeletal anatomy blended learning on physiotherapy education

Background

In physiotherapy education, blended learning is recognized to be more effective compared to traditional teaching. The aim of this study was to assess the consequences of a musculoskeletal anatomy blended learning program on skills developed by students.

Methods

We conducted an observational retrospective monocentric study in a French physiotherapy school named "X." Ninety-two first-year students in the 2017-18 baseline group (students with traditional face-to-face learning), and ninety-eight first-year students and ninety-five second-year students in the 2018-19 and 2019-20 blended learning experimental groups was included. A success rate of the anatomy final written exam, defined by the percentage of students scoring 50% or above, was analyzed between 2017 and 2020. We also evaluated the pedagogical value of musculoskeletal e-learning and its usefulness for preparing the student for their anatomy final written exam at «X».

Results

We observed an improvement in the success rate of the anatomy final written exam between the 2017-18 baseline group, 2018-19 and 2019-2020 experimental groups during first (Kruskal-Wallis = 74.06, df = 2, p < 0.001) and second semester (Kruskal-Wallis = 173.6, df = 2, p < 0.001). We obtained a data survey and questionnaire response rate of 74% (n = 89/120) for the 2018-19 and 62% (n = 72/116) for the 2019-20 experimental groups. Concerning questionnaire response, they were no significant statistical difference between 2018-19 and 2019-20 experimental groups.

Conclusion

Blended learning could improve student success rate of the anatomy final written exam and learning of professional physiotherapy skills.

Comparing Online and Face-to-Face Performance in Scientific Courses: A Retrospective Comparative Gender Study of Year-1 Students

Purpose

As a result of COVID-19 pandemic, medical education at the Arabian Gulf University was instructed to apply online teaching instead of face-to-face for all phases of teaching at the University. Phase-1 is concerned with basic science courses delivered to year 1 students. We conducted this study to detect if there are any differences in the performance of medical students between online and face-to-face ways of learning. Also, a comparison between male and female performance in scientific courses was carried out in pre and during COVID-19 periods.

Methods

The participant were first year students for pre COVID-19 period from 2018 to 2019 and during COVID-19 period from 2020 to 2021. The university used Moodle and Zoom as an online way of teaching. The students' performance in the year 1 (three-semester) -online period of teaching were compared with a three-semester-performance of conventional teaching prior to COVID-19. This is a retrospective study that attempts to shed some light on the efficiency of AGU experience in online learning for year 1 (Phase I) students. This study evaluates the outcome of both, online and face-to-face examinations for scientific courses.

Results

The results showed that the mean performance of year one medical students in all basic scientific courses (Phase I) during the coronavirus pandemic was greater than the mean performance before the pandemic with the exception of the Biostatistics course. The results by gender showed that the mean performance of females was better than males across all scientific courses before coronavirus. Also, during the COVID pandemic, the mean performance of females was better than males in all basic science courses.

Conclusion

Year -1 students' performance in science courses during the coronavirus period seems better than pre COVID19 era. Females' performance was better than males' in both periods; pre and during COVID -19 periods.

Medical, Dental, and Nursing Students' Experience with Virtual Practical Sessions: A Cross-Sectional Study in a Developing Country

Background

The COVID-19 pandemic has disrupted the scope of healthcare education and shifted the teaching methods from on-campus to virtual. The impact of such a shift has rarely been investigated, and limited evidence exists about students' experience in terms of effort made and time spent, especially for laboratory sessions. Assessing students' experiences will provide paramount evidence to fine-tune laboratory virtual learning sessions.

Objective

To assess students' experience of virtual (online) laboratory sessions versus on-campus laboratory sessions, including preference, time spent, the effort made, ability to remember instructions, and preference for future teaching.

Methods

A cross-sectional study was utilized. A Google Forms questionnaire was prepared and sent to medicine, dentistry, and nursing school students registered at Jordan University of Science and Technology (JUST) during the 2019/2020 academic year. Self-reported preference, time spent, efforts made, ability to remember instructions and preference for future teaching were assessed for virtual versus on-campus anatomy, pathology, microbiology, histology, and physiology laboratory sessions.

Results

A total of 455 students participated in this questionnaire. More students in histology (55.2%), pathology (57.4%), and microbiology (55.3%) laboratories, but not anatomy (39.6%) physiology (443.95), reported preferring virtual sessions over on-campus sessions. More students from histology (35.6%) and microbiology (37.0%) reported spending less effort than on-campus sessions. More than half of the participants agreed that virtual laboratory sessions consumed less time than on-campus sessions. Participants reported that they cannot remember the instruction given during virtual teaching compared to on-campus teaching. Differences in students' experiences were detected by gender, major, and year of study.

Conclusion

The COVID-19 pandemic has the potential to change the future of healthcare education, and preparation for future crises is paramount. Effort made, time spent, ability to remember, and preference for virtual education should be considered in terms of gender, major of study, and year. These differences should also be reflected in the planning of virtual sessions for effective implementation.

The role of digital transformation in addressing health inequalities in coastal communities: barriers and enablers

Healthcare systems worldwide are striving for the "quadruple aim" of better population health and well-being, improved experience of care, healthcare team well-being (including that of carers) and lower system costs. By shifting the balance of care from reactive to preventive by facilitating the integration of data between patients and clinicians to support prevention, early diagnosis and care at home, many technological solutions exist to support this ambition. Yet few have been mainstreamed in the NHS. This is particularly the case in English coastal areas which, despite having a substantially higher burden of physical and mental health conditions and poorer health outcomes, also experience inequalities with respect to digital maturity. In this paper, we suggest ways in which digital health technologies (DHTs) can support a greater shift towards prevention; discuss barriers to digital transformation in coastal communities; and highlight ways in which central, regional and local bodes can enable transformation. Given a real risk that variations in digital maturity may be exacerbating coastal health inequalities, we call on health and care policy leaders and service managers to understands the potential benefits of a digital future and the risks of failing to address the digital divide.

The Widening Gap between the Digital Capability of the Care Workforce and Technology-Enabled Healthcare Delivery: A Nursing and Allied Health Analysis

There is a need to ensure that healthcare organisations enable their workforces to use digital methods in service delivery. This study aimed to evaluate the current level of digital understanding and ability in nursing, midwifery, and allied health workforces and identify some of the training requirements to improve digital literacy in these health professionals. Representatives from eight healthcare organizations in Victoria, Australia participated in focus groups. Three digital frameworks informed the focus group topic guide that sought to examine the barriers and enablers to adopting digital healthcare along with training requirements to improve digital literacy. Twenty-three participants self-rated digital knowledge and skills using Likert scales and attended the focus groups. Mid-range scores were given for digital ability in nursing, midwifery, and allied health professionals. Focus group participants expressed concern over the gap between their organizations’ adoption of digital methods relative to their digital ability, and there were concerns about cyber security. Participants also saw a need for the inclusion of consumers in digital design. Given the widening gap between digital innovation and health workforce digital capability, there is a need to accelerate digital literacy by rapidly deploying education and training and policies and procedures for digital service delivery.

Telerehabilitation Delivery in Canada and the Netherlands: Results of a Survey Study

BACKGROUND

Following the onset of the COVID-19 pandemic, telerehabilitation (TR) has been expanding to address the challenges and risks of in-person delivery. It is likely that a level of TR delivery will continue after the pandemic because of its advantages, such as reducing geographical barriers to service. Many pandemic-related TR initiatives were put in place quickly. Therefore, we have little understanding of current TR delivery, barriers and facilitators, and how therapists anticipate integrating TR into current practice. Knowing this information will allow the incorporation of competencies specifically related to the use and provision of TR into professional profiles and entry-to-practice education, thereby promoting high-quality TR care.

OBJECTIVE

This study aimed to obtain a descriptive overview of current TR practice among rehabilitation therapists in Canada and the Netherlands and identify perceived barriers to and facilitators of practice.

METHODS

A web-based cross-sectional survey was conducted with occupational, physical, and respiratory therapists and dietitians in Canada (in French and English) and the Netherlands (in Dutch and English) between November 2021 and March 2022. Recruitment was conducted through advertisements on social media platforms and email invitations facilitated by regulatory and professional bodies. The survey included demographic and practice setting information; whether respondents delivered TR, and if so, components of delivery; confidence and satisfaction ratings with delivery; and barriers to and facilitators of use. TR satisfaction and uptake were measured using the Telehealth Usability Questionnaire and modified Technology Acceptance Model. Data were first summarized descriptively, and then, comparisons were conducted between professions.

RESULTS

Overall, 723 survey responses were received, mostly from Canada (n=666, 92.1%) and occupational therapists (n=434, 60%). Only 28.1% (203/723) reported receiving specific training in TR, with 1.2% (9/723) indicating that it was part of their professional education. Approximately 19.5% (139/712) reported not using TR at all, whereas most participants (366/712, 51.4%) had been using this approach for 1 to 2 years. Services delivered were primarily teleconsultation and teletreatment with individuals. Respondents offering TR were moderately satisfied with their service delivery and found it to be effective; 90.1% (498/553) indicated that they were likely to continue offering TR after the pandemic. Technology access, confidence, and setup were rated the highest as facilitators, whereas technology issues and the clinical need for physical contact were the most common barriers.

CONCLUSIONS

Professional practice and experience with TR were similar in both countries, suggesting the potential for common strategic approaches. The high prevalence of current practice and strong indicators of TR uptake suggest that therapists are likely to continue TR delivery after the pandemic; however, most therapists (461/712, 64.7%) felt ill prepared for practice, and the need to target TR competencies during professional and postprofessional education is critical. Future studies should explore best practice for preparatory and continuing education.

A perspective of massive open online courses (MOOCs) and public health

Massive open online courses (MOOCs) have emerged as an innovative educational technology relevant to and affecting higher education, professional development, and lifelong learning. This paper introduces the principles of MOOCs and reviews the development of these platforms over time. We reflect upon the considerable investment by institutions to develop, deliver and promote such courses, particularly in public health. While open to interpretation, the inherent power, influence, and effectiveness of MOOCs is unquestionable. The potential contribution of MOOCs to public health education is immense, with almost universal reach and access. However, apart from research into participant engagement and knowledge, MOOC-related research and evaluation continue to lag with the rapid proliferation of these courses in response to emerging challenges, as seen with the Coronavirus Disease 19 (COVID-19) pandemic. This makes analyzing the contribution of MOOCs to public health education, health promotion and community programs challenging. This perspective article provides a robust rationale for the necessity of MOOCs and their utility in upskilling health professionals and the general public. It builds on current knowledge to comprehensively explore the factors influencing the development, and application of MOOCs.