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  • 1.
    Ahmady, Soleiman
    et al.
    Shahid Beheshti University of Medical Sciences, Iran;Karolinska Institutet, Sweden.
    Changiz, Tahereh
    Isfahan University of Medical Sciences, Iran.
    Masiello, Italo
    Karolinska Institutet, Sweden.
    Hamadanchi, Arya
    University of Social and Rehabilitation Sciences, Iran.
    Development and psychometrics properties of an instrument for assessing faculty development programs from a broader perspective2016In: Biosciences Biotechnology Research Asia, ISSN 0973-1245, Vol. 13, no 1, p. 319-325Article in journal (Refereed)
    Abstract [en]

    The present study proposed a new instrument for the assessment of the current faculty development programs at Iranian medical universities. Although the literature concerning the subject of faculty development activities has already identified strengths and weakness of such programs, it is still questionable whether these activities can be assessed using a pedagogical and managerial comprehensive approach. Therefore, it was determined to develop an instrument to examine faculty development activities that address all components of programs from planning and implementing to evaluating phases, with the possibility of utilizing this instrument as a tool to assess faculty development activities.

  • 2.
    Bikmoradi, Ali
    et al.
    Hamadan Univ Med Sci, Iran.
    Masmouei, Behnam
    Hamadan Univ Med Sci, Iran.
    Ghomeisi, Mohammad
    Kermanshah Univ Med Sci, Iran.
    Roshanaei, Ghodratollah
    Hamadan Univ Med Sci, Iran.
    Masiello, Italo
    Karolinska Institutet;Södersjukhuset.
    Impact of telephone counseling on the quality of life of patients discharged after coronary artery bypass grafts2017In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 100, no 12, p. 2290-2296Article in journal (Refereed)
    Abstract [en]

    Background: This study aimed to assess the impact of telephone counseling on quality of life in patients with coronary artery bypass graft. Methods: A quasi-experimental study was conducted with 71 discharged patients after coronary artery bypass graft surgery at Ekbatan Edcuational hospital in Hamadan, Iran, in 2014. The patients were randomly allocated into intervention (n = 36) and control group (n = 35). The intervention group received education and counseling about therapeutic plan via telephone after discharge. Patients in the control group received only routines. All patients completed the quality of life questionnaire before and after the intervention period of five weeks. Results: There was no significant difference between intervention and control group about quality of life before intervention (p = 0.696). However, there was significant and positive deference between the two groups in favor of the telephone counseling after the intervention (P = 0.01) and control group (P = 0.04). Quality of life in the intervention group was significantly better compared to control group (P = 0.01). Conclusions: Telephone counseling could be a cost-effective patient counseling plan for therapeutic adherence after coronary artery bypass surgery in order to improve the patients' quality of life. Practice implications: Telephone counseling is feasible to implement and well accepted for patient counseling for many diseases. (C) 2017 Elsevier B.V. All rights reserved.

  • 3.
    Ericson, Anne
    et al.
    Karolinska University Hospital.
    Löfgren, Susanne
    Karolinska Institutet.
    Bolinder, Gunilla
    Karolinska University Hospital.
    Reeves, Scott
    Univ Kingston, UK;St Georges Univ London, UK.
    Kitto, Simon
    Univ Ottawa, Canada.
    Masiello, Italo
    Karolinska Institutet;Södersjukhuset.
    Interprofessional education in a student-led emergency department: A realist evaluation2017In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 31, no 2, p. 199-206Article in journal (Refereed)
    Abstract [en]

    This article reports a realist evaluation undertaken to identify factors that facilitated or hindered the successful implementation of interprofessional clinical training for undergraduate students in an emergency department. A realist evaluation provides a framework for understanding how the context and underlying mechanisms affect the outcome patterns of an intervention. The researchers gathered both qualitative and quantitative data from internal documents, semi-structured interviews, observations, and questionnaires to study what worked, for whom, and under what circumstances in this specific interprofessional setting. The study participants were medical, nursing, and physiotherapy students, their supervisors, and two members of the emergency department's management staff. The data analysis indicated that the emergency ward provided an excellent environment for interprofessional education (IPE), as attested by the students, supervisors, and the clinical managers. An essential prerequisite is that the students have obtained adequate skills to work independently. Exemplary conditions for IPE to work well in an emergency department demand the continuity of effective and encouraging supervision throughout the training period and supervisors who are knowledgeable about developing a team.

  • 4.
    Ericson, Anne
    et al.
    Karolinska Institutet;Karolinska University Hospital.
    Masiello, Italo
    Karolinska Institutet.
    Bolinder, Gunilla
    Karolinska University Hospital;Karolinska Institutet.
    Interprofessional clinical training for undergraduate students in an emergency department setting2012In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 26, no 4, p. 319-325Article in journal (Refereed)
    Abstract [en]

    Interprofessional education (IPE) for teams of undergraduate students has since 1999 been carried out at the orthopedic emergency department at the Karolinska University Hospital. During a 2-week period, teams of medical, nursing and physiotherapy students practice together. With the aim of training professional and collaboration skills, the teams take care of patients with varying acute complaints, under the guidance of supervisors from each profession. This study describes the educational model and compares the attitudes of the different student categories participating in this unique IPE model. All students who participated in this experience during the period 2008-2010 were asked to fill in a questionnaire on completion of their training period. Results showed that all three categories, with no significant difference, highly appreciated the setting and the team training. Results also showed that the training significantly increased the students' knowledge of their own professional role as well as their knowledge of the other professions. We conclude that training at an emergency department can provide excellent opportunities for interprofessional team training for undergraduate students. The teamwork enhances the students' understanding of the professional roles and can contribute to a more holistic approach to patient care.

  • 5.
    Hadadgar, Arash
    et al.
    Karolinska Institutet;Isfahan Univ Med Sci, Iran.
    Changiz, Tahereh
    Isfahan Univ Med Sci, Iran.
    Dehghani, Zahra
    Isfahan Univ Med Sci, Iran.
    Backheden, Magnus
    Karolinska Institutet.
    Mirshahzadeh, Nahidalsadat
    Isfahan Univ Med Sci, Iran.
    Zary, Nabil
    Karolinska Institutet.
    Masiello, Italo
    Karolinska Institutet;Södersjukhuset.
    A Theory-Based Study of Factors Explaining General Practitioners' Intention to Use and Participation in Electronic Continuing Medical Education2016In: Journal of Continuing Education in the Health Professions, ISSN 0894-1912, E-ISSN 1554-558X, Vol. 36, no 4, p. 290-294Article in journal (Refereed)
    Abstract [en]

    Introduction: Electronic modes of continuing medical education (eCME) can provide an appropriate and scalable way of updating the knowledge and skills of general practitioners (GPs). To optimize the adoption of eCME and develop efficient and cost-effective eCME programs, factors explaining GPs' intention to use eCME must first be elucidated. Methods: Using the Theory of Planned Behavior as a framework, we developed a questionnaire and administered it to GPs in seven CME seminars in Isfahan, Iran, in 2014. Three domains of GPs' intention to use eCME were measured: attitudes, perceived behavioral control, and subjective norms. We used linear and logistic regression to identify the main predictors of intention and behavior. Results: GPs who had high score in perceived behavioral control and a more positive attitude toward e-learning had a higher intention to adopt it for CME. In contrast, subjective norms (eg, social pressures to use eCME) were not a predictor. Attitude toward usefulness of eCME was the main predictor of being an actual eCME user. Discussion: Perceived behavioral control and attitude constitute the main predictors of the intention to use eCME. Establishing discussions forums and strengthening organizational support for eCME through an increased awareness among clinical superiors and CME managers would be expected to increase GPs' intention to use eCME.

  • 6.
    Hadadgar, Arash
    et al.
    Isfahan Univ Med Sci, Iran;Karolinska Institutet, Sweden.
    Changiz, Tahereh
    Isfahan Univ Med Sci, Iran.
    Kononowicz, Andrzej A.
    Jagiellonian Univ, Poland.
    Safaeian, Leila
    Isfahan Univ Med Sci, Iran.
    Mirshahzadeh, Nahidossadat
    Isfahan Univ Med Sci, Iran.
    Najimi, Arash
    Isfahan Univ Med Sci, Iran.
    Ahmadi, Fatemeh
    Joundishapour Univ Med Sci, Iran.
    Mostafavizadeh, Kamyar
    Isfahan Univ Med Sci, Iran.
    Zary, Nabil
    Karolinska Institutet, Sweden.
    Masiello, Italo
    Karolinska Institutet, Sweden;Södersjukhuset, Sweden.
    Creating and validating e-cases as educational tools in general practitioners' continuing medical education context2018In: Bio-Algorithms and Med-Systems, ISSN 1895-9091, Vol. 14, no 1, article id UNSP 20170027Article in journal (Refereed)
    Abstract [en]

    Objective: This study aimed at creating electronic cases (e-cases) and analyzing their validity as a diagnostic assessment tool within the context of continuing medical education (CME) to measure general practitioners' (GPs) knowledge of common infectious disease. Methods: We designed assessment e-cases in an electronic CME platform. The e-cases were designed to measure GPs' knowledge about diagnosis and treatment of common infectious disease in outpatient settings. The data collected were analyzed for five forms of evidence: content, response process, internal structure, relations with other variables and consequences. Results: A total of 46 GPs participated in the study. Among them, 87% perceived the e-cases as resembling the patients whom they visit in their everyday practice. Although attendance in this activity made 85% of the participants more cautious about prescription of antibiotics, we could not detect any statistically significant association between the assessment scores and the physicians' previous antibiotic prescription. The diagnos- e tic assessment with e-cases was supported by most of the elements of validity evidence, including content, response process, internal structure and consequences. Conclusions: Overall, evidence suggests that using e-cases might be a valid diagnostic assessment CME activity to measure GPs' knowledge of common infectious disease, but more research is necessary.

  • 7.
    Hadadgar, Arash
    et al.
    Karolinska Institutet, Sweden;Isfahan Univ Med Sci, Iran.
    Changiz, Tahereh
    Isfahan Univ Med Sci, Iran.
    Masiello, Italo
    Karolinska Institutet, Sweden.
    Dehghani, Zahra
    Isfahan Univ Med Sci, Iran.
    Mirshahzadeh, Nahidossadat
    Isfahan Univ Med Sci, Iran.
    Zary, Nabil
    Karolinska Institutet, Sweden.
    Applicability of the theory of planned behavior in explaining the general practitioners eLearning use in continuing medical education2016In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, article id 215Article in journal (Refereed)
    Abstract [en]

    Background: General practitioners (GP) update their knowledge and skills by participating in continuing medical education (CME) programs either in a traditional or an e-Learning format. GPs' beliefs about electronic format of CME have been studied but without an explicit theoretical framework which makes the findings difficult to interpret. In other health disciplines, researchers used theory of planned behavior (TPB) to predict user's behavior. Methods: In this study, an instrument was developed to investigate GPs' intention to use e-Learning in CME based on TPB. The goodness of fit of TPB was measured using confirmatory factor analysis and the relationship between latent variables was assessed using structural equation modeling. Results: A total of 148 GPs participated in the study. Most of the items in the questionnaire related well to the TPB theoretical constructs, and the model had good fitness. The perceived behavioral control and attitudinal constructs were included, and the subjective norms construct was excluded from the structural model. The developed questionnaire could explain 66 % of the GPs' intention variance. Conclusions: The TPB could be used as a model to construct instruments that investigate GPs' intention to participate in e-Learning programs in CME. The findings from the study will encourage CME managers and researchers to explore the developed instrument as a mean to explain and improve the GPs' intentions to use eLearning in CME.

  • 8.
    Husebø, Sissel Eikeland
    et al.
    University of Stavanger, Norway;Stavanger University Hospital, Norway;University of Southeast Norway, Norway.
    Silvennoinen, Minna
    JAMK University of Applied Sciences, Finland;University of Jyväskylä, Finland.
    Rosqvist, Eerika
    Central Finland Healthcare District, Finland.
    Masiello, Italo
    Karolinska Institutet;Södersjukhuset.
    Status of Nordic research on simulation-based learning in healthcare: an integrative review.2018In: Advances in Science and Technology Research Journal, ISSN 2364-3277, E-ISSN 2059-0628, Vol. 3, article id 12Article in journal (Refereed)
    Abstract [en]

    Background: Based on common geography, sociopolitics, epidemiology, and healthcare services, the Nordic countries could benefit from increased collaboration and uniformity in the development of simulation-based learning (SBL). To date, only a limited overview exists on the Nordic research literature on SBL and its progress in healthcare education. Therefore, the aim of this study is to fill that gap and suggest directions for future research.

    Methods: An integrative review design was used. A search was conducted for relevant research published during the period spanning from 1966 to June 2016. Thirty-seven studies met the inclusion criteria. All included studies were appraised for quality and were analyzed using thematic analysis.

    Results: The Nordic research literature on SBL in healthcare revealed that Finland has published the greatest number of qualitative studies, and only Sweden and Norway have published randomized control trials. The studies included interprofessional or uniprofessional teams of healthcare professionals and students. An assessment of the research design revealed that most studies used a qualitative or a descriptive design. The five themes that emerged from the thematic analysis comprised technical skills, non-technical skills, user experience, educational aspects, and patient safety.

    Conclusion: This review has identified the research relating to the progress of SBL in the Nordic countries. Most Nordic research on SBL employs a qualitative or a descriptive design. Shortcomings in simulation research in the Nordic countries include a lack of well-designed randomized control trials or robust evidence that supports simulation as an effective educational method. In addition, there is also a shortage of studies focusing on patient safety, the primary care setting, or a combination of specialized and primary care settings. Suggested directions for future research include strengthening the design and methodology of SBL studies, incorporating a cross-country comparison of studies using simulation in the Nordic countries, and studies combining specialized and primary care settings.

  • 9.
    Iversen, Maura D.
    et al.
    Northeastern University, Boston, USA;Harvard Medical School, USA;Karolinska Institutet, Sweden.
    Kiami, Sheri
    Northeastern University, Boston, USA.
    Singh, Karandeep
    Harvard Medical School, USA.
    Masiello, Italo
    Södersjukhuset, Sweden;Karolinska Institutet, Sweden.
    von Heideken, Johan
    Northeastern University, Boston, USA;Karolinska Institutet, Sweden.
    Prospective, randomised controlled trial to evaluate the effect of smart glasses on vestibular examination skills2016In: BMJ Innovations, ISSN 2055-8074, Vol. 2, no 2, p. 99-105Article in journal (Refereed)
    Abstract [en]

    This proof-of-concept trial explored whether using Google Glass to augment instruction of vestibular assessment and treatment skills increased student competence. In 2015, 103 physiotherapy students with no prior vestibular examination training participated in a lab for adults with vestibular dysfunction led by experienced clinicians. Half were randomised (blocked on gender and self-efficacy) to standard lab instruction and half to the experiential lab wherein the instructor used the Google Glass video function in real time, along with verbal instruction. Students completed a pretest questionnaire to establish self-reported skill level in vestibular dysfunction assessment and treatment. Another faculty member assessed students' competence in these clinical skills after 7 days. A student evaluation of teaching was completed after the teaching session. No between-group differences existed regarding change in self-efficacy scores for vestibular assessment and treatment skills preintervention and postintervention. Students in the Google Glass group scored slightly better on the clinical skills check (median score of 19 (range 16–20) versus 18 (range 16–20); p=0.03). 40 students (77%) in the Google Glass group performed the assessment satisfactorily versus 30 (59%) (p=0.049) in the standard lab group. The majority of students evaluated the video quality as unacceptable. This novel study demonstrated that using Google Glass to live stream vestibular assessment and treatment techniques in first-person view had a significant but small impact on acquisition of these clinical skills.

  • 10.
    Jafari, J.
    et al.
    Karolinska Institute, Sweden;Mashhad University of Medical sciences, Iran.
    Moonaghi, H. K.
    Mashhad University of Medical sciences, Iran.
    Ahmady, S.
    Shahid Beheshti University of Medical Sciences, Iran.
    Zary, N.
    Karolinska Institute, Sweden.
    Masiello, Italo
    Karolinska Institute, Sweden;Södersjukhuset, Sweden.
    Readiness of diabetics to use the internet and mobile services: The case of a large city in a middle-income country2015In: Journal of Community Medicine & Health Education, E-ISSN 2161-0711, Vol. 5, p. 1-6, article id 380Article in journal (Refereed)
    Abstract [en]

    Objective: To determine the potential of providing health-related services on the Internet or via mobile phones to diabetic patients in a large city in Iran, a middle-income country. Background: Diabetes mellitus (DM) is increasing worldwide, especially in developing countries, as a consequence of urbanisation, which is associated with risk factors for diabetes such as physical inactivity and high sugar and fat diets. The use of the Internet and mobile services is increasing worldwide. Independent use of the Internet and mobile technologies by patients could be a key step towards self-care management of DM. Methods: A two-part validated questionnaire was completed by patients who attended one of two diabetic clinics for a routine check-up. The first part consisted of 16 demographic-related items. The second part contained 26 items about the specific use of the Internet and mobile services to access information. Results: In total, 407 questionnaires were completed. The results showed that 108 (26.5%) of the respondents had routine access to the Internet, of which 95.4% had routine access to mobile services and 77.8% were positive about using an official Iranian website for medical information. However, 55% of the respondents preferred to obtain health-related information from television, radio, and educational films. Conclusions: The data suggest that the diabetic patients who used the Internet in this study were willing to receive educational material via the Internet. However, many still preferred traditional sources of health-related information. The findings indicated that our future effort in self-care management should focus on early technology adopters to increase the penetration rate of technology in the field of health care.

  • 11.
    Jafari, Javad
    et al.
    Karolinska Institutet, Sweden.
    Karimi Moonaghi, Hosein
    Mashhad University of Medical Sciences, Iran.
    Zary, Nabil
    Karolinska Institutet, Sweden;Nanyang Technological University, Singapore.
    Masiello, Italo
    Södersjukhuset, Sweden;Karolinska Institutet, Sweden.
    Exploring educational needs and design aspects of internet-enabled patient education for persons with diabetes: a qualitative interview study.2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, p. 1-7, article id e013282Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of this article is to explorethe educational needs and design aspects ofpersonalised internet-enabled education for patientswith diabetes in Iran.Design: Data were collected using semistructuredinterviews and then qualitatively analysed usinginductive content analysis.Participants: 9 patients with type 2 diabetes wereincluded. Inclusion criteria were access to andknowledge on how to use the internet. The selectionensured representation based on gender, age,occupation and educational background.Setting: The sample population was patients withdiabetes who were admitted to an outpatient diabetesclinic in Mashhad, a large city of Iran with about 3million inhabitants.Results: 4 core categories emerged from the data: (1)seeking knowledge about diabetes, including specificknowledge acquisition, patient’s interactions andlearning requirements; (2) teaching and learning,including using different teaching methods anddifferent ways to learn about the disease; (3)facilitators, including internet and mobile phone use tolearn about the disease; and (4) barriers, including lackof internet access, uncertainty of access to the internetand lack of website in the local language and alsoperceived cultural barriers, such as patients’ fears ofthe internet, lack of time and awareness.Conclusions: This study provides a betterunderstanding of the patient’s educational expectationsand technical needs in relation to internet-enablededucation. This knowledge will inform the developmentof functional mock-ups in the next research phaseusing a design-based research approach in order todesign internet-enabled patient education for selfmanagementof diabetes.

  • 12.
    Keshmiri, F.
    et al.
    Tehran University of Medical Sciences, Iran.
    Ponzer, S.
    Södersjukhuset, Sweden;Karolinska Institutet, Sweden.
    Sohrabpour, A.
    Tehran University of Medical Sciences, Iran.
    Farahmand, S
    Imam Khomeini Hospital, Iran;Tehran University of Medical Sciences, Iran.
    Shahi, F
    Tehran University of Medical Sciences, Iran.
    Bagheri-Hariri, S.
    Imam Khomeini Hospital, Iran;Tehran University of Medical Sciences, Iran.
    Soltani-Arabshahi, K.
    Iran University of Medical Sciences, Iran.
    Shirazi, M.
    Södersjukhuset, Sweden;Karolinska Institutet, Sweden;Tehran University of Medical Sciences, Iran.
    Masiello, Italo
    Södersjukhuset, Sweden;Karolinska Institutet, Sweden.
    Contextualization and validation of the interprofessional collaborator assessment rubric (ICAR) through simulation: Pilot investigation.2016In: Medical journal of the Islamic Republic of Iran, ISSN 1016-1430, Vol. 30, p. 742-749, article id 403Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Simulation can be used for educating, evaluating and assessing psychometric properties of an instrument. The aim of this study was to contextualize and assess the validity and reliability of the Interprofessional Collaborative Assessment tool (ICAR) in an Iranian context using simulation.

    METHODS:

    In this descriptive study, contextualization of the ICAR was assessed through several steps. Firstly, validity assessment was approved through expert panels and Delphi rounds. Secondly, reliability assessment was done by arranging a simulation video and assessing reproducibility, test-retest (ICC), internal consistency (Cronbach's Alpha) and inter-rater reliability (Kappa).The participants included 26 experts, 27 students and 6 staff of the Standardized Simulation Office of Teheran University of Medical Sciences.

    RESULTS:

    Contextualization and validity of the ICAR were approved in an Iranian context. The reliability of the tool was computed to be 0.71 according to Cronbach´s Alpha. The test-retest was calculated to be 0.76.

    CONCLUSION:

    The Iranian ICAR can be a useful tool for evaluating interprofessional collaborative competencies. The development of the instrument through a simulation scenario has been a positive prospect for researchers.

  • 13. Kononowicz, A. A.
    et al.
    Woodham, L.
    Georg, C.
    Edelbring, S.
    Stathakarou, N.
    Davies, D.
    Masiello, Italo
    Karolinska institutet.
    Saxena, N.
    Tudor Car, L.
    Car, J.
    Zary, N.
    Virtual patient simulations for health professional education2016In: Cochrane Database of Systematic Reviews, ISSN 1469-493X, E-ISSN 1469-493X, no 5, article id CD012194Article, review/survey (Refereed)
    Abstract [en]

    The objective of this review is to evaluate the effectiveness of virtual patient simulation as an educational intervention versus traditional learning, other types of e‐Learning interventions and other forms of virtual patient simulation interventions for delivering pre‐registration and post‐registration healthcare professional education. We will primarily assess the impact of these interventions on learners’ knowledge, skills and attitudes. Our secondary objective is to assess the cost‐effectiveness of these interventions.

  • 14.
    Kyaw, Bhone Myint
    et al.
    Nanyang Technol Univ Singapore, Singapore.
    Saxena, Nakul
    Natl Healthcare Grp Singapore, Singapore.
    Posadzki, Pawel
    Nanyang Technol Univ Singapore, Singapore.
    Vseteckova, Jitka
    Open Univ, UK.
    Nikolaou, Charoula Konstantia
    Catholic Univ Louvain, Belgium.
    George, Pradeep Paul
    Natl Healthcare Grp Singapore, Singapore.
    Divakar, Ushashree
    Nanyang Technol Univ Singapore, Singapore.
    Masiello, Italo
    Linnaeus University, Faculty of Social Sciences, Department of Pedagogy and Learning. Karolinska Institutet, Sweden.
    Kononowicz, Andrzej A.
    Jagiellonian Univ, Poland.
    Zary, Nabil
    Nanyang Technol Univ Singapore, Singapore;Karolinska Institutet;Mohammed VI Univ Hlth Sci, Morocco.
    Car, Lorainne Tudor
    Nanyang Technol Univ Singapore, Singapore;Imperial Coll London, UK.
    Virtual Reality for Health Professions Education: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration2019In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 21, no 1, article id e12959Article, review/survey (Refereed)
    Abstract [en]

    Background: Virtual reality (VR) is a technology that allows the user to explore and manipulate computer-generated real or artificial three-dimensional multimedia sensory environments in real time to gain practical knowledge that can be used in clinical practice. Objective: The aim of this systematic review was to evaluate the effectiveness of VR for educating health professionals and improving their knowledge, cognitive skills, attitudes, and satisfaction. Methods: We performed a systematic review of the effectiveness of VR in pre- and postregistration health professions education following the gold standard Cochrane methodology. We searched 7 databases from the year 1990 to August 2017. No language restrictions were applied. We included randomized controlled trials and cluster-randomized trials. We independently selected studies, extracted data, and assessed risk of bias, and then, we compared the information in pairs. We contacted authors of the studies for additional information if necessary. All pooled analyses were based on random-effects models. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to rate the quality of the body of evidence. Results: A total of 31 studies (2407 participants) were included. Meta-analysis of 8 studies found that VR slightly improves postintervention knowledge scores when compared with traditional learning (standardized mean difference [SMD]=0.44; 95% CI 0.18-0.69; I-2=49%; 603 participants; moderate certainty evidence) or other types of digital education such as online or offline digital education (SMD=0.43; 95% CI 0.07-0.79; I-2=78%; 608 participants [8 studies]; low certainty evidence). Another meta-analysis of 4 studies found that VR improves health professionals' cognitive skills when compared with traditional learning (SMD=1.12; 95% CI 0.81-1.43; I-2=0%; 235 participants; large effect size; moderate certainty evidence). Two studies compared the effect of VR with other forms of digital education on skills, favoring the VR group (SMD=0.5; 95% CI 0.32-0.69; I-2=0%; 467 participants; moderate effect size; low certainty evidence). The findings for attitudes and satisfaction were mixed and inconclusive. None of the studies reported any patient-related outcomes, behavior change, as well as unintended or adverse effects of VR. Overall, the certainty of evidence according to the GRADE criteria ranged from low to moderate. We downgraded our certainty of evidence primarily because of the risk of bias and/or inconsistency. Conclusions: We found evidence suggesting that VR improves postintervention knowledge and skills outcomes of health professionals when compared with traditional education or other types of digital education such as online or offline digital education. The findings on other outcomes are limited. Future research should evaluate the effectiveness of immersive and interactive forms of VR and evaluate other outcomes such as attitude, satisfaction, cost-effectiveness, and clinical practice or behavior change.

  • 15. Lazzari, Carlo
    et al.
    Masiello, Italo
    Karolinska institutet, Sweden.
    Communication Neurosciences for Interprofessional Teams in Health Care2016In: Communication Skills: Challenges, Importance for Health Care Professionals and Strategies for Improvement / [ed] Bridget L. Wright, Nova Science Publishers, Inc., 2016Chapter in book (Other academic)
  • 16. Lazzari, Carlo
    et al.
    Masiello, Italo
    Karolinska Institutet, Sweden.
    Shoka, Ahmed
    Theoretical Models of Social Mind and Social Thinking in Interprofessional Education2017In: Progress in Education: Volume 48 / [ed] Roberta V. Nata, New York: Nova Science Publishers, Inc., 2017Chapter in book (Other academic)
  • 17. Lazzari, Carlo
    et al.
    Shoka, Ahmed
    Masiello, Italo
    Karolinska Institutet.
    Maladaptive Behaviors in Inpatients with Borderline Personality Disorder: A Behavioral Game Theory Explanation2016In: Borderline Personality Disorder (BPD): Prevalence, Management Options and Challenges / [ed] Raymond Anderson, Nova Science Publishers, Inc., 2016Chapter in book (Other academic)
  • 18.
    Liu, Jenny
    et al.
    Karolinska Institutet;Södersjukhuset.
    Masiello, Italo
    Karolinska Institutet;Södersjukhuset.
    Ponzer, Sari
    Karolinska Institutet;Södersjukhuset.
    Farrokhnia, Nasim
    Karolinska Institutet;Södersjukhuset.
    Can interprofessional teamwork reduce patient throughput times?: A longitudinal single-centre study of three different triage processes at a Swedish emergency department2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 4, article id e019744Article in journal (Refereed)
    Abstract [en]

    Objective To determine the impact on emergency department (ED) throughput times and proportion of patients who leave without being seen by a physician (LWBS) of two triage interventions, where comprehensive nurse-led triage was first replaced by senior physician-led triage and then by interprofessional teamwork. Design Single-centre before-and-after study. Setting Adult ED of a Swedish urban hospital. Participants Patients arriving on weekdays 08: 00 to 21: 00 during three 1-year periods in the interval May 2012 to November 2015. A total of 185 806 arrivals were included. Interventions Senior physicians replaced triage nurses May 2013 to May 2014. Interprofessional teamwork replaced the triage process on weekdays 08: 00 to 21: 00 November 2014 to November 2015. Main outcome measures Primary outcomes were the median time to physician (TTP) and the median length of stay (LOS). Secondary outcome was the LWBS rate. Results The crude median LOS was shortest for teamwork, 228 min (95% Cl 226.4 to 230.5) compared with 232 min (95% Cl 230.8 to 233.9) for nurse-led and 250 min (95% Cl 248.5 to 252.6) for physician-led triage. The adjusted LOS for the teamwork period was 16 min shorter than for nurse-led triage and 23 min shorter than for physician-led triage. The median TTP was shortest for physician-led triage, 56 min (95% Cl 54.5 to 56.6) compared with 116 min (95% Cl 114.4 to 117.5) for nurse-led triage and 74 min (95% Cl 72.7 to 74.8) for teamwork. The LWBS rate was 1.9% for nurse-led triage, 1.2% for physician-led triage and 3.2% for teamwork. All outcome measure differences had two-tailed p values< 0.01. Conclusions Interprofessional teamwork had the shortest length of stay, a shorter time to physician than nurse-led triage, but a higher LWBS rate. Interprofessional teamwork may be a useful approach to reducing ED throughput times.

  • 19.
    Liu, Jenny
    et al.
    Karolinska Institutet, Sweden;Södersjukhuset, Sweden.
    Masiello, Italo
    Karolinska Institutet, Sweden;Södersjukhuset, Sweden.
    Ponzer, Sari
    Karolinska Institutet, Sweden;Södersjukhuset, Sweden.
    Farrokhnia, Nasim
    Karolinska Institutet, Sweden;Södersjukhuset, Sweden.
    Interprofessional teamwork versus fast track streaming in an emergency department - An observational cohort study of two strategies for enhancing the throughput of orthopedic patients presenting limb injuries or back pain2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 7, p. -16, article id e0220011Article in journal (Refereed)
    Abstract [en]

    Objective To compare two strategies, interprofessional teams versus fast track streaming, for orthopedic patients with limb injuries or back pain, the most frequent orthopedic complaints in an emergency department. Methods An observational before-and-after study at an adult emergency department from May 2012 to Nov 2015. Patients who arrived on weekdays from 8 am to 9 pm and presented limb injury or back pain during one year of each process were included, so that 11,573 orthopedic presentations were included in the fast track period and 10,978 in the teamwork period. Similarly, another 11,020 and 10,760 arrivals presenting the six most frequent non-orthopedic complaints were included in the respective periods, altogether 44,331 arrivals. The outcome measures were the time to physician (TTP) and length of stay (LOS). The LOS was adjusted for predictors, including imaging times, by using linear regression analysis. Results The overall median TTP was shorter in the teamwork period, 76.3 min versus 121.0 min in the fast track period (-44.7 min, 95% confidence interval (CI): -47.3 to -42.6). The crude median LOS for orthopedic presentations was also shorter in the teamwork period, 217.0 min versus 230.0 min (-13.0 min, 95% CI: -18.0 to -8.0), and the adjusted LOS was 22.8 min shorter (95% CI: -26.9 to -18.7). For non-orthopedic presentations, the crude median LOS did not differ significantly between the periods (2.0 min, 95% CI: -3.0 to 7.0). However, the adjusted LOS was shorter in the teamwork period (-20.1 min, 95% CI: -24.6 to -15.7). Conclusions The median TTP and LOS for orthopedic presentations were shorter in the teamwork period. For non-orthopedic presentations, the TTP and adjusted LOS were also shorter in the teamwork period. Therefore, interprofessional teamwork may be an alternative approach to improve the patient flow in emergency departments.

  • 20. Läkartidningen, Författarintervjun
    4 frågor till Italo Masiello2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114, no 43-44Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Italo Masiello, docent, universitetslektor och chef för Södersjukhusets Utbildnings- och innovationscenter, har tillsammans med Anna Mattsson, med dr, skrivit en artikel om medicinsk simuleringsträning.

  • 21.
    Masiello, Italo
    Karolinska Institutet, Sweden;Karolinska University Hospital, Sweden.
    Why simulation-based team training has not been used effectively and what can be done about it2012In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 17, no 2, p. 279-288Article in journal (Refereed)
    Abstract [en]

    Advanced medical education simulators are broadly used today to train both technical/procedural and team-based skills. While there is convincing evidence of the benefits of training technical skills, this is not the case for team-based skills. Research on medical expertise could drive the creation of a new regime of simulation-based team training. The new regime includes first the understanding of complex systems such as the hospital and the operating room; then the performance of work-place assessment; thirdly, the deliberate training of weaknesses and team performance skills; and lastly the understanding of the underlying mechanisms of team competence. A new regime of deliberate training proposed by the author, which would need to be evaluated and validated, could elucidate the underlying mechanisms of team competence while providing evidence of the effect of simulation-based team training.

  • 22.
    Masiello, Italo
    et al.
    Södersjukhuset, Sweden;Karolinska institutet, Sweden.
    Anna, Mattsson
    Simuleringsträning ger ökad kunskap och bättre färdigheter : Men osäkerhet råder avseende klinisk nytta då många studier brister i evidens: [ Medical simulation training – an overview of the evidence ]2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114, no 43-44, p. 1-5Article in journal (Refereed)
    Abstract [en]

    Medical simulation training has become an important model for training of technical and non-technical clinical skills, aiming at preventing avoidable mistakes. The evidence for effects of simulation training is increasing, and several systematic reviews on the effect of medical simulation training have been published. This article summarizes the evidence for medical simulation training based on systematic reviews of medical simulation published in the last three years. There is a consistent finding in all systematic reviews that simulation training has a positive effect on learning and skills transfer, and small positive effects on patient-related outcomes. However, there is considerable uncertainty about the strength of evidence of this research, and all systematic reviews reported serious weaknesses in research methods of the included studies. We hope that the newly published guidelines for study design and reporting of medical simulation research can help create a stronger evidence base.

  • 23.
    Reeves, Scott
    et al.
    Univ Calif San Francisco, USA.
    Kitto, Simon
    Univ Toronto, Canada.
    Masiello, Italo
    Karolinska Institutet;Södersjukhuset.
    Crew resource management: How well does it translate to an interprofessional healthcare context?2013In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 27, no 3, p. 207-209Article in journal (Other academic)
  • 24.
    Renée, Allvin
    et al.
    Örebro University, Sweden.
    Magnus, Berndtzon
    Region County Jönköping, Sweden.
    Liisa, Carlzon
    Sahlgrenska University Hospital, Sweden.
    Samuel, Edelbring
    Linköping University, Sweden;Karolinska Institutet, Sweden.
    Håkan, Hult
    Linköping University, Sweden.
    Magnus, Hultin
    Umeå University, Sweden.
    Klas, Karlgren
    Karolinska Institutet, Sweden;Södersjukhuset Hospital, Sweden.
    Masiello, Italo
    Karolinska Institutet, Sweden.
    Marie-Louise, Södersved Källestedt
    Uppsala University, Sweden.
    Éva, Tamás
    Linköping University, Sweden.
    Confident but not theoretically grounded: experienced simulation educators' perceptions of their own professional development2017In: Advances in Medical Education and Practice, ISSN 1179-7258, E-ISSN 1179-7258, Vol. 2017, no 8, p. 99-108Article in journal (Refereed)
    Abstract [en]

    Background: Medical simulation enables the design of learning activities for competency areas (eg, communication and leadership) identified as crucial for future health care professionals. Simulation educators and medical teachers follow different career paths, and their education backgrounds and teaching contexts may be very different in a simulation setting. Although they have a key role in facilitating learning, information on the continuing professional development (pedagogical development) of simulation educators is not available in the literature.

    Objectives: To explore changes in experienced simulation educators’ perceptions of their own teaching skills, practices, and understanding of teaching over time.

    Methods: A qualitative exploratory study. Fourteen experienced simulation educators participated in individual open-ended interviews focusing on their development as simulation educators. Data were analyzed using an inductive thematic analysis.

    Results: Marked educator development was discerned over time, expressed mainly in an altered way of thinking and acting. Five themes were identified: shifting focus, from following to utilizing a structure, setting goals, application of technology, and alignment with profession. Being confident in the role as an instructor seemed to constitute a foundation for the instructor’s pedagogical development.

    Conclusion: Experienced simulation educators’ pedagogical development was based on self-confidence in the educator role, and not on a deeper theoretical understanding of teaching and learning. This is the first clue to gain increased understanding regarding educational level and possible education needs among simulation educators, and it might generate several lines of research for further studies.

  • 25.
    Sarmasoğlu, Şenay
    et al.
    Hacettepe University, Turkey.
    Elçin, Melih
    Hacettepe University, Turkey.
    Masiello, Italo
    Karolinska institutet, Sweden.
    Eğiticilerin Başarılı Mesleklerarası Eğitim Programlarına İlişkin Deneyimleri: Karolinska Enstitüsü Örneği2018In: Hacettepe Universitesi Hemcsirelik Fakultesi Dergisi, ISSN 2148-3590, Vol. 5, no 1, p. 14-28Article in journal (Other academic)
    Abstract [tr]

    Amaç: Bu çalışmanın amacı günümüzde başarı ile sürdürülen mesleklerarası eğitim programlarının kurulma sürecine ilişkin anlayış geliştirmek ve ülkemizde mesleklerarası eğitim programlarını hayata geçirmek isteyen eğitimcilere, öncü eğitimcilerin deneyimlerden yararlanma fırsatı sunmaktır. Gereç ve Yöntem: Araştırma niteliksel desene sahip olup, verileri İsveç Stokholm’de mesleklerarası eğitim programının oluşturulmasında ve yürütülmesinde yer alan beş kurucu ile yapılandırılmış görüşmeler sonucunda elde edilmiştir. Çalışmadan elde edilen verilerin analizinde içerik analizi yönteminden yararlanılmıştır. Bulgular: Mesleklerarası eğitim programlarının başlatılmasında en önemli itici güçler, DSÖ’nün küresel boyuttaki çağrıları ve mesleklerarası eğitim etkinliklerinin sürdürüldüğü diğer üniversitelerin olumlu raporları olmuştur. Mesleklerarası eğitimin hayata geçirilmesi sürecinde; ortak bir anlayış geliştirme, değişime uyum sağlama, öğrenci programlarını planlanma, öğrenci izlemi ve finans konularında sorunlar yaşanmıştır. İstekli liderler ve savunucular ile öncü ekip, kurulum sürecinde hayati bir rol üstlenmiştir. Katılımcıların mesleklerarası eğitim programlarını kurmak isteyen eğiticilere ilişkin önerileri; ortak amaçların oluşturulması, yöneticilerin desteğinin alınması, başarılı mesleklerarası eğitim öncüleri ile işbirliği yapılması, iyi uygulama örneklerinin ziyaret edilmesi, mentörlerin eğitimine önem verilmesi ve sabırlı olunmasıdır.Sonuç: Mesleklerarası eğitim programlarının kurulması sürecinde pek çok sorun ile karşılaşmak kaçınılmazdır ancak bu programların kabul edilmesinde istekli liderler fark yaratabilmektedirler. Kurumun yöneticileri/karar vericileri sürecin sürdürülebilir olmasında oldukça önemli bir role sahiptir.

  • 26. Saxena, N.
    et al.
    Kyaw, B. M.
    Vseteckova, J.
    Dev, P.
    Paul, P.
    Lim, K. T. K.
    Kononowicz, A.
    Masiello, Italo
    Karolinska insitutet, Sweden.
    Tudor Car, L.
    Nikolaou, C. K.
    Zary, N.
    Car, J.
    Virtual reality environments for health professional education2016In: Cochrane Database of Systematic Reviews, ISSN 1469-493X, E-ISSN 1469-493X, no 19 FebruaryArticle, review/survey (Refereed)
  • 27.
    Shirazi, M.
    et al.
    Tehran University of Medical Sciences, Tehran, Iran;Karolinska Institutet, Sweden.
    Emami, A. H.
    Tehran University of Medical Sciences, Iran;Imam Khomeini Hospital, Iran.
    Mirmoosavi, S. J.
    Sabzevar University of Medical Sciences, Iran.
    Alavinia, S M
    Bojnord University, Iran.
    Zamanian, H.
    Qom University of Medical Sciences, Iran.
    Fathollahbeigi, F.
    Tehran University of Medical Sciences, Iran.
    Masiello, Italo
    Södersjukhuset, Sweden;Karolinska Institute, Sweden.
    Contextualization and standardization of the supportive leadership behavior questionnaire based on socio- cognitive theory in Iran2014In: Medical Journal of the Islamic Republic of Iran, ISSN 1016-1430, E-ISSN 2251-6840, Vol. 28, p. 829-838, article id 125Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Effective leadership is of prime importance in any organization and it goes through changes based on accepted health promotion and behavior change theory. Although there are many leadership styles, transformational leadership, which emphasizes supportive leadership behaviors, seems to be an appropriate style in many settings particularly in the health care and educational sectors which are pressured by high turnover and safety demands. Iran has been moving rapidly forward and its authorities have understood and recognized the importance of matching leadership styles with effective and competent care for success in health care organizations. This study aimed to develop the Supportive Leadership Behaviors Scale based on accepted health and educational theories and to psychometrically test it in the Iranian context.

    METHODS:

    The instrument was based on items from established questionnaires. A pilot study validated the instrument which was also cross-validated via re-translation. After validation, 731 participants answered the questionnaire.

    RESULTS:

    The instrument was finalized and resulted in a 20-item questionnaire using the exploratory factor analysis, which yielded four factors of support for development, integrity, sincerity and recognition and explaining the supportive leadership behaviors (all above 0.6). Mapping these four measures of leadership behaviors can be beneficial to determine whether effective leadership could support innovation and improvements in medical education and health care organizations on the national level. The reliability measured as Cronbach's alpha was 0.84.

    CONCLUSION:

    This new instrument yielded four factors of support for development, integrity, sincerity and recognition and explaining the supportive leadership behaviors which are applicable in health and educational settings and are helpful in improving self -efficacy among health and academic staff.

  • 28.
    Shirazi, M.
    et al.
    Univ Tehran Med Sci, Iran;Karolinska Institutet.
    Labaf, A.
    Univ Tehran Med Sci, Iran.
    Monjazebi, F.
    Univ Tehran Med Sci, Iran.
    Jalili, M.
    Univ Tehran Med Sci, Iran.
    Mirzazadeh, M.
    Univ Tehran Med Sci, Iran.
    Ponzer, S.
    Karolinska Institutet.
    Masiello, Italo
    Karolinska Institutet.
    Assessing Medical Students' Communication Skills by the Use of Standardized Patients: Emphasizing Standardized Patients' Quality Assurance2014In: Academic Psychiatry, ISSN 1042-9670, E-ISSN 1545-7230, Vol. 38, no 3, p. 354-360Article in journal (Refereed)
    Abstract [en]

    The objective structured examination is one of the most valid, reliable, and effective tools for assessing clinical and communication skills, often by use of standard patients (SPs). SPs can also be assessors of those skills. One of the crucial areas when utilizing SP-based assessment is the quality and consistency assurance of their portrayal of the case and their ability to fill in checklists in an adequate way. The aim of this study was to assess the validity and reliability of SPs' ability to assess students' communication skill via a Calgary-Cambridge checklist. This cross-sectional and correlational study was conducted at the Tehran University of Medical Science. We first analyzed validity; the criterion validity of the SPs' filling in the checklists was assessed through determining the correlation between the SPs' completed checklists and the checklists filled in by three physician raters individually and then reproducibility: it was assessed by a test-retest approach inter-rater reliability. The mean correlation for assessing the validity of SPs' completed checklists by individual SPs was 0.81. The inter-rater reliability was calculated by kappa coefficient, and the total correlation among the three raters was 0.85. The reliability of the test-retest approach showed no significant differences between the test and re-test results. The increased number of medical students and different faculties' responsibilities such as doing educational, research, and health services duties assessing medical student communication skills is a complex issue. The results of our study showed that trained SPs can be used as a valid tool to assess medical students' communication skills, which is also more cost effective and reduces work load of medical faculties.

  • 29.
    Shirazi, Mandana
    et al.
    Univ Tehran Med Sci, Iran;Karolinska Institutet.
    Emami, Amir Hossein
    Univ Tehran Med Sci, Iran.
    Mirmoosavi, Seyed Jamal
    Sabzevar Univ, Iran.
    Alavinia, Seyed Mohammad
    North Khorasan Univ Med Sci Bojnurd, Iran.
    Zamanian, Hadi
    Qom Univ Med Sci, Iran.
    Fathollahbeigi, Faezeh
    Univ Tehran Med Sci, Iran.
    Masiello, Italo
    Karolinska Institutet;Södersjukhuset.
    The effects of intervention based on supportive leadership behaviour on Iranian nursing leadership performance: a randomized controlled trial2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 3, p. 400-408Article in journal (Refereed)
    Abstract [en]

    Aims To assess the effects of a workshop on supportive leadership behaviour (SLB) on the performance of head nurses, using a randomized controlled trial design. Background The effect of transformational leadership on SLB in nursing management is emphasised. Methods A total of 110 head nurses working at university hospitals were included randomly in two control and intervention groups. The head nurses in the intervention group participated in supportive leadership training, but the control group did not. Performance in supportive leadership was assessed with a validated instrument, which six subordinates used to assess their head nurse (n=731). Results There was a significant difference in SLB scores from baseline to the 3month follow-up (P<0.0001). Moreover, the post-intervention scores were significantly higher in the intervention group, compared with the control group (P<0.0001). The results showed that in the intervention group, the effect sizes were greater for males (50%) than for females (36%) and greater for married participants (42%) than for single participants (37%). Conclusion The workshop on supportive leadership behaviour, particularly the interactive multifaceted training, improved the leadership performance of the head nurses who participated in this study. Implications for nursing managers Health policy decision makers should apply SLB, which is a significant leadership style, to improve the outcomes in other groups of health-care management, such as physicians. Future studies are needed to investigate the effects of such workshops in longer periods of follow up.

  • 30.
    Zhu, E
    et al.
    Karolinska Institutet, Sweden.
    Lilienthal, A
    Karolinska Institutet, Sweden.
    Shluzas, L. A.
    Stanford University, USA.
    Masiello, Italo
    Karolinska Institutet, Sweden.
    Zary, N
    Karolinska Institutet, Sweden;Mohammed VI University of Health Sciences, Morocco.
    Design of Mobile Augmented Reality in Health Care Education: A Theory-Driven Framework2015In: JMIR medical education, E-ISSN 2369-3762, Vol. 1, no 2, p. 1-18, article id e10Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Augmented reality (AR) is increasingly used across a range of subject areas in health care education as health care settings partner to bridge the gap between knowledge and practice. As the first contact with patients, general practitioners (GPs) are important in the battle against a global health threat, the spread of antibiotic resistance. AR has potential as a practical tool for GPs to combine learning and practice in the rational use of antibiotics.

    OBJECTIVE:

    This paper was driven by learning theory to develop a mobile augmented reality education (MARE) design framework. The primary goal of the framework is to guide the development of AR educational apps. This study focuses on (1) identifying suitable learning theories for guiding the design of AR education apps, (2) integrating learning outcomes and learning theories to support health care education through AR, and (3) applying the design framework in the context of improving GPs' rational use of antibiotics.

    METHODS:

    The design framework was first constructed with the conceptual framework analysis method. Data were collected from multidisciplinary publications and reference materials and were analyzed with directed content analysis to identify key concepts and their relationships. Then the design framework was applied to a health care educational challenge.

    RESULTS:

    The proposed MARE framework consists of three hierarchical layers: the foundation, function, and outcome layers. Three learning theories-situated, experiential, and transformative learning-provide foundational support based on differing views of the relationships among learning, practice, and the environment. The function layer depends upon the learners' personal paradigms and indicates how health care learning could be achieved with MARE. The outcome layer analyzes different learning abilities, from knowledge to the practice level, to clarify learning objectives and expectations and to avoid teaching pitched at the wrong level. Suggestions for learning activities and the requirements of the learning environment form the foundation for AR to fill the gap between learning outcomes and medical learners' personal paradigms. With the design framework, the expected rational use of antibiotics by GPs is described and is easy to execute and evaluate. The comparison of specific expected abilities with the GP personal paradigm helps solidify the GP practical learning objectives and helps design the learning environment and activities. The learning environment and activities were supported by learning theories.

    CONCLUSIONS:

    This paper describes a framework for guiding the design, development, and application of mobile AR for medical education in the health care setting. The framework is theory driven with an understanding of the characteristics of AR and specific medical disciplines toward helping medical education improve professional development from knowledge to practice. Future research will use the framework as a guide for developing AR apps in practice to validate and improve the design framework.

  • 31.
    Zhu, Egui
    et al.
    Karolinska Institutet;Hubei Univ, Peoples Republic of China.
    Hadadgar, Arash
    Karolinska Institutet.
    Masiello, Italo
    Karolinska Institutet.
    Zary, Nabil
    Karolinska Institutet.
    Augmented reality in healthcare education: an integrative review2014In: PeerJ, ISSN 2167-8359, E-ISSN 2167-8359, Vol. 2, article id e469Article in journal (Refereed)
    Abstract [en]

    Background. The effective development of healthcare competencies poses great educational challenges. A possible approach to provide learning opportunities is the use of augmented reality (AR) where virtual learning experiences can be embedded in a real physical context. The aim of this study was to provide a comprehensive overview of the current state of the art in terms of user acceptance, the AR applications developed and the effect of AR on the development of competencies in healthcare. Methods. We conducted an integrative review. Integrative reviews are the broadest type of research review methods allowing for the inclusion of various research designs to more fully understand a phenomenon of concern. Our review included multi-disciplinary research publications in English reported until 2012. Results. 2529 research papers were found from ERIC, CINAHL, Medline, PubMed, Web of Science and Springer-link. Three qualitative, 20 quantitative and 2 mixed studies were included. Using a thematic analysis, we've described three aspects related to the research, technology and education. This study showed that AR was applied in a wide range of topics in healthcare education. Furthermore acceptance for AR as a learning technology was reported among the learners and its potential for improving different types of competencies. Discussion. AR is still considered as a novelty in the literature. Most of the studies reported early prototypes. Also the designed AR applications lacked an explicit pedagogical theoretical framework. Finally the learning strategies adopted were of the traditional style 'see one, do one and teach one' and do not integrate clinical competencies to ensure patients' safety.

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