Ciclo de palestras online "de férias com o PET": um relato de experiência / Online lecture series on vacation with PET: an experience report

As constantes transformações tecnológicas dos últimos anos têm refletido diretamente sobre o cenário da educação, com a popularização do ensino em meio digital, especialmente após a pandemia do COVID-19. Diante disso, surgiu a proposta de um ciclo de palestras online pelo grupo que compõe o Programa de Educação Tutorial (PET) Odontologia, do Instituto de Saúde de Nova Friburgo. O objetivo do evento foi oferecer conteúdo atualizado, de interesse dos participantes, abordando temas nem sempre são contemplados na grade curricular, contando com convidados externos à instituição. Após a seleção dos temas e a escolha dos palestrantes, iniciou-se a organização e divulgação do evento, utilizando ferramentas online gratuitas. O ciclo de palestras contou com sete apresentações, abrangendo áreas como Odontogeriatria, Dentística, Harmonização Orofacial, Gestão e Empreendedorismo, Emergências Médicas e Estomatologia. Durante os cursos, os participantes tiveram a oportunidade de esclarecer suas dúvidas, tornando a experiência interativa. Como instrumento de feedback, os participantes foram convidados a preencher um formulário de avaliação. O evento teve uma média de 73 participantes, os quais demonstraram estar satisfeitos com a qualidade dos temas abordados. Pode-se concluir que a proposta de um ciclo de palestras online é viável, dissemina o conhecimento, proporciona oportunidades de aprendizado e contribui para a consolidação do senso crítico-reflexivo. Para os membros do PET Odontologia, a experiência destacou a importância do ensino-aprendizado de excelência, contínuo e permanente, bem como a utilização de métodos alternativos que podem inovar o processo de formação acadêmica.

The constant technological transformations in recent years have directly impacted the education landscape, with the popularization of online teaching, especially after the COVID-19 pandemic. In light of this, a proposal for an online lecture series emerged from the group that comprises the Tutorial Education Program (PET) at the Nova Friburgo Institute of Health (ISNF). The aim of the event was to offer updated content, of interest to participants, covering topics not always included in the curriculum and featuring external guests to the institution. After selecting the topics and choosing the speakers, the organization and promotion of the event began, using free online tools. The lecture series consisted of seven presentations, covering areas such as Geriatric Dentistry, Restorative Dentistry, Orofacial Harmonization, Management and Entrepreneurship, Medical Emergencies, and Stomatology. Throughout the courses, participants had the opportunity to clarify their doubts, making the experience interactive. As a feedback tool, participants were invited to fill out an evaluation form. The event had an average of 73 participants, who expressed satisfaction with the quality of the topics covered. It could be concluded that the proposal for an online lecture series is feasible, disseminates knowledge, provides learning opportunities, and contributes to the consolidation of critical-reflexive thinking. For PET Dentistry members, the experience highlighted the importance of continuous and excellent teaching and learning, as well as the use of alternative methods that can innovate the academic training process.

3D-printed tooth for caries excavation.

BACKGROUND: To date, no suitable model tooth has been available for all standard restorative and prosthodontic procedures. To fill this gap, a realistic multilayer tooth with enamel, dentin, integrated caries, pulp, and electrometric and X-ray imaging abilities was developed. The aim of this study was to test the printed tooth while focusing on caries excavation and pulp capping. METHODS: Based on micro-CT data, a tooth was designed and produced via 3D printing. A total of 396 teeth were tested and evaluated by 66 fourth- and fifth-year students experienced in caries excavation at standard typodonts, extracted teeth and patients. They excavated the caries and capped the pulp on six teeth and rated them in a questionnaire. RESULTS: Compared with natural teeth, the printed teeth were generally rated positively and significantly better in all criteria than typodonts used previously (p < .001). They were rated as a suitable training option (Ø 2.3 ± 0.9) with fair examination conditions (Ø 2.1 ± 0.8) and easy to use (Ø 2.0 ± 0.8). Subjective learning success was also significantly greater (Ø 2.3 ± 0.9) than that of standard typodonts (Ø 3.2 ± 1.1) (p < .001). In general, the students desired more exercises with 3D-printed teeth for their studies (Ø 1.8 ± 0.8). CONCLUSIONS: Multilayered 3D-printed teeth were successfully tested and can improve and extend the teaching methods used for caries excavation and pulp capping. Its other abilities will be tested in subsequent studies. YEAR OF THE STUDY: 2023.

The impact of pedagogical beliefs on the adoption of generative AI in higher education: predictive model from UTAUT2.

Artificial Intelligence in Education (AIEd) offers advanced tools that can personalize learning experiences and enhance teachers' research capabilities. This paper explores the beliefs of 425 university teachers regarding the integration of generative AI in educational settings, utilizing the UTAUT2 model to predict their acceptance and usage patterns through the Partial Least Squares (PLS) method. The findings indicate that performance expectations, effort expectancy, social influence, facilitating conditions, and hedonic motivation all positively impact the intention and behavior related to the use of AIEd. Notably, the study reveals that teachers with constructivist pedagogical beliefs are more inclined to adopt AIEd, underscoring the significance of considering teachers' attitudes and motivations for the effective integration of technology in education. This research provides valuable insights into the factors influencing teachers' decisions to embrace AIEd, thereby contributing to a deeper understanding of technology integration in educational contexts. Moreover, the study's results emphasize the critical role of teachers' pedagogical orientations in their acceptance and utilization of AI technologies. Constructivist educators, who emphasize student-centered learning and active engagement, are shown to be more receptive to incorporating AIEd tools compared to their transmissive counterparts, who focus on direct instruction and information dissemination. This distinction highlights the need for tailored professional development programs that address the specific beliefs and needs of different teaching philosophies. Furthermore, the study's comprehensive approach, considering various dimensions of the UTAUT2 model, offers a robust framework for analyzing technology acceptance in education.

Enhancing Lessons on the Internet of Things in Science, Technology, Engineering, and Medical Education with a Remote Lab.

Integrating remote Internet of Things (IoT) laboratories into project-based learning (PBL) in higher education institutions (HEIs) while exploiting the approach of technology-enhanced learning (TEL) is a challenging yet pivotal endeavor. Our proposed approach enables students to interact with an IoT-equipped lab locally and remotely, thereby bridging theoretical knowledge with practical application, creating a more immersive, adaptable, and effective learning experience. This study underscores the significance of combining hardware, software, and coding skills in PBL, emphasizing how IoTRemoteLab (the remote lab we developed) supports a customized educational experience that promotes innovation and safety. Moreover, we explore the potential of IoTRemoteLab as a TEL, facilitating and supporting the understanding and definition of the requirements of remote learning. Furthermore, we demonstrate how we incorporate generative artificial intelligence into IoTRemoteLab's settings, enabling personalized recommendations for students leveraging the lab locally or remotely. Our approach serves as a model for educators and researchers aiming to equip students with essential skills for the digital age while addressing broader issues related to access, engagement, and sustainability in HEIs. The practical findings following an in-class experiment reinforce the value of IoTRemoteLab and its features in preparing students for future technological demands and fostering a more inclusive, safe, and effective educational environment.

Evaluation of the Effect of a Mobile Application on Glycated Hemoglobin in Older Adults with Type 2 Diabetes Mellitus-Protocol of a Randomized Clinical Trial.

BACKGROUND: Digital educational technologies in health have been an important instrument for promoting learning, self-care, self-esteem, and security regarding prevention and health promotion actions that lead to changes in behavior, mainly for non-communicable disease patients, such as type 2 Diabetes Mellitus (DM 2). OBJECTIVE: This study aimed to describe a protocol for evaluating the effect of an app for cell phones and tablets on the blood glucose of older adults with DM 2. METHODS: The protocol will be used to compare the effectiveness of an application for mobile devices concerning the educational booklet in reducing Glycated Hemoglobin in older adults with DM 2 in Primary Health Care. This protocol is part of a Randomized Clinical Trial project entitled Effectiveness of a Mobile Device Application on Glycated Hemoglobin in Elderly People with Type 2 Diabetes Mellitus: a Randomized Clinical Trial. RESULTS: The protocol was structured in the following phases: (i) sample calculation, (ii) invitation to participate in the study according to the eligibility criteria; (iii) participant registration; (iv) randomization and allocation of participants into groups (double blinding); (v) application of the intervention; (vi) post-intervention procedures (post-test); (vii) data analysis. CONCLUSION: It is expected that encouraging studies on the impact of a mobile application will improve and enhance health education focused on self-care for older adults with DM 2, potentially influencing the local health system by reducing hospitalizations due to conditions that are sensitive to primary care, since health promotion and prevention of DM-related illnesses will be the main focus of the application and booklet developed.

Analysis of occlusal clearance of crown preparations in a predoctoral clinical setting.

PURPOSE: This study sought to assess the presence and location of inadequate tooth preparation performed by predoctoral dental students by scanning mounted casts submitted for monolithic zirconia crown fabrication METHODS: An intraoral scanner capable of volumetric measurements of crown preparations was used to analyze 56 crown preparations on mounted stone casts before submission to a lab for crown fabrication. The mounted casts were scanned individually and then a buccal bite was scanned to stitch the models together into virtual occlusion. The distance between the crown preparations and opposing dentition was displayed volumetrically, and the minimum clearance of each preparation was recorded for both the functional and non-functional cusps. Preparations were evaluated for adequate interocclusal clearance and comparisons were made using a Chi-square test with α = 0.05 with respect to tooth location, functional versus nonfunctional cusp, and or single versus multi-unit preparation. RESULTS: Over 47% of mounted casts with crown preparations analyzed for the study exhibited a lack of occlusal clearance in at least one area. Functional cusps were more often under-reduced than non-functional (p < 0.001). No other comparisons were statistically significant. CONCLUSIONS: The present study demonstrates a high percentage of under-reduced crown preparations in a predoctoral clinic and emphasizes the utility of quality control and analysis via digital scanning of crown preparations prior to crown fabrication.

Applying a Motivational Instructional Design Model to Stroke Rehabilitation: A Feasibility Study on Occupational and Swallowing Therapies.

Objective: To investigate the feasibility of poststroke interventions using a motivational instructional design model with occupational therapy (OT) and swallowing therapy (ST) and the model's potential physical and mental health effects. Design: An open-label, single-arm, feasibility study on the Attention, Relevance, Confidence, and Satisfaction model. Setting: Two convalescent rehabilitation wards. Participants: Twenty-five patients with stroke (N=25) (19 men; mean age, 62.4±11.9y; 61.9±36.8d from the first stroke) were recruited. Interventions: Twelve participants received a motivational approach based on the Attention, Relevance, Confidence, and Satisfaction model during OT (OT group), and 13 received it during ST (ST group). The intervention lasted 40-60 minutes daily, 5 days weekly, for 4 weeks. Main Outcome Measures: The primary outcomes included the dropout rate, an adverse event, and the participants' acceptability of the intervention. Paretic arm function was assessed in the OT group; swallowing ability was assessed in the ST group; and activities of daily living, depressive symptoms, and apathy were assessed in both groups. Results: No participants dropped out of the intervention or experienced an adverse event. Twenty-one participants (84%) were satisfied with the intervention, and 19 (76%) hoped to continue receiving it. The OT group showed statistically significant improvements in paretic arm function and activities of daily living (Cohen's r=0.68-0.77), whereas the ST group improved in swallowing ability, activities of daily living, and depressive symptoms (Cohen's r=0.62-0.85). Conclusions: The interventions using the motivational instructional model with OT and ST were feasible and could improve poststroke paretic arm function, swallowing ability, and activities of daily living after stroke.

Exploring global perspectives on the use of computer-based simulation in pharmacy education: a survey of students and educators.

Background: : Increasing student numbers and logistical challenges in pharmacy education limit patient counselling and clinical placement opportunities. Computer-based simulation (CBS) offers scalable, interactive learning but faces integration barriers. Objective: : To explore global perceptions of CBS implementation in pharmacy education among educators and students. Methods: An online cross-sectional survey was developed based on literature review and expert feedback. The survey was distributed globally through academic pharmacy organisations, social media, and the authors' networks. It included 20 questions targeting pharmacy educators and students. Results: : Responses from 152 educators across 38 countries and 392 students from 46 countries, spanning six WHO regions (AFRO, AMRO, EMRO, EURO, SEARO, and WPRO) were analysed using descriptive and inferential statistics. The majority of educators (90.1%, n = 137) and students (84.2%, n = 330) expressed comfort with using CBS and implementing it in their curriculum. Despite this, CBS was perceived as underutilised by 53.5% (n = 81) of educators and 63.7% (n = 250) of students. Students valued CBS for enhancing communication and problem-solving skills, while educators highlighted its relevance to community pharmacy practice. Both groups supported CBS use in assessments. All educators (100%) identified workload reduction as a key priority, hoped CBS could assist in this area. Educators also reported barriers such as financial constraints (56.6%, n = 86) and insufficient technical support (53.3%, n = 81). On the other hand, students were less optimistic about institutional support, with only a few (7.4%, n = 29) believed institutional leaders would actively support CBS adoption. Regional differences emerged, with SEARO (Southeast Asia) and AFRO (Africa) showing the lowest CBS usage rates. Educators in SEARO, AFRO, and EMRO (Eastern Mediterranean) raised concerns about technical support, while those in SEARO, AFRO, and WPRO (Western Pacific, including Australia, New Zealand, and Singapore) expressed financial concerns. Educators in AFRO and WPRO, however, reported being 100% comfortable with using CBS. Conclusion: : Both students and educators recognised the potential of CBS in pharmacy education, with strong support for its integration. Addressing barriers such as educator workload, financial constraints, and technical support is crucial for broader adoption. Improved resource allocation and targeted training for educators are essential to effectively incorporate CBS into the pharmacy curriculum.

A comparative analysis of game-based learning and conventional learning in dental education.

OBJECTIVES: To evaluate the efficacy of traditional teaching versus traditional teaching supplemented by serious gaming in imparting knowledge of periodontal indices among dentistry students. Additionally, the study seeks to measure the level of satisfaction among students engaging with the assessed teaching method. MATERIALS AND METHOD: This comparative study was approved by the ethics committee of the University of Valencia with file number: 2479311. A sample of 61 subjects was divided randomly into two groups: the test group (n = 36) and the control group (n = 25). Baseline knowledge of community index of periodontal treatment need was assessed through a questionnaire completed by both groups before receiving a comprehensive explanation of the topic. The test group, in addition to the conventional explanation, received supplementary training via an educational gaming experience. Both groups underwent a final evaluation and, subsequently, a satisfaction survey was completed by the test group. Descriptive and inferential analyses were performed using a non-parametric Brunner-Langer model. The relationship between scores was examined using Mann-Whitney and Wilcoxon tests, with a significance level set at α = 0.05. RESULTS: The training, in general, was effective as both the test group (p = 0.003) and the control group (p = 0.015) demonstrated an increase in scores with both teaching modalities, but no significant difference was observed between the groups. The test group expressed a high level of satisfaction with the instructional approach. CONCLUSION: No statistically significant difference in learning outcomes was identified between the traditional lecture teaching method and the approach supplemented by gaming. There was an elevated level of student satisfaction with the gaming method.

Resident Perceptions of Simulcast Teaching: A Qualitative Study.

OBJECTIVES: During the COVID-19 pandemic, medical education programs were challenged to optimize learning while balancing social interaction with exposure risk. In response, our internal medicine (IM) residency program transitioned to "simulcast" educational sessions. In simulcast sessions, multiple small groups of learners met in person in separate rooms and connected to the large-group session via videoconferencing. This qualitative study describes IM residents' perceptions regarding the advantages and disadvantages of learning in simulcast compared to virtual and in-person settings during the pandemic. METHODS: Categorical IM residents at Penn State during the academic year 2020-2021 were invited to participate. Eligible residents participated in one 30-min virtual, semistructured focus group. We used inductive thematic coding to analyze resident responses. RESULTS: Forty-eight percent (n = 29/60) of invited residents participated in focus groups. In the simulcast setting, participants felt more accountability to participate in their small groups compared to a larger group or virtual setting. Educational experiences varied based upon facilitator skill level. Overall, in-person settings were preferred to virtual, when possible, due to increased social connection. Respondents identified educator enthusiasm and presentation quality as key to engagement regardless of setting. CONCLUSION: Residents had variable responses to the simulcast setting based upon their comfort with participation by group size, desire for social connection, and perception of teaching strategies. The key identified pitfalls to simulcast teaching were resident discomfort in small groups, heterogeneous learning experience, lack of engagement, and technology challenges. These pitfalls can be mitigated through strategic distribution of learners in groups, trained facilitators, and interactive teaching modalities. Given that simulcast and mixed (simulcast, virtual, and in-person) teaching settings are here to stay postpandemic, anticipating pitfalls and creating adaptable educational content that translates in multiple settings is crucial.

Insights into enhanced learning through virtual reality.

INTRODUCTION: This study investigates the impact of Immersive Virtual Reality (VR) on learning outcomes in radiography training using Virtual Medical Coaching's X-Ray Pro VR software. VR offers immersive experiential learning that may enhance academic performance and professional preparedness. METHODS: The study involved 130 students from two consecutive cohorts: one using traditional training methods and the other using VR software. We employed a mixed-methods approach, integrating quantitative measures of academic performance and clinical competency with qualitative insights into student engagement, enjoyment, and stress levels. The VR group used Virtual Medical Coaching simulation software, while the traditional group used physical simulation machines (Siemens Healthineers) to practice positioning anthropomorphic manikins, adjusting exposure settings, and handling X-ray equipment. Data were collected at four points: immediately post-training and at 1 month, 3 months, and 8 months follow-up. RESULTS: The VR cohort showed significantly higher knowledge retention, work readiness, and lower stress levels compared to the traditional cohort. Among the participants trained in VR, a vast majority (59 out of 65) reported a high level of satisfaction with the immersive nature of the training, emphasizing its realism and direct applicability to clinical scenarios. Quantitative analysis revealed superior performance metrics for the VR group across all measured time points (p < 0.001). Qualitative feedback highlighted enhanced engagement and enjoyment among VR-trained students. CONCLUSION: The results of this study clearly indicate that VR training significantly enhances learning outcomes in radiography education. The VR cohort exhibited higher knowledge retention, work readiness, student engagement, and enjoyment, along with lower stress levels and higher confidence compared to the traditional cohort. These findings support the integration of VR into professional training curricula to improve student performance and engagement.

Smart Classrooms: How Sensors and AI Are Shaping Educational Paradigms.

The integration of advanced technologies is revolutionizing classrooms, significantly enhancing their intelligence, interactivity, and personalization. Central to this transformation are sensor technologies, which play pivotal roles. While numerous surveys summarize research progress in classrooms, few studies focus on the integration of sensor and AI technologies in developing smart classrooms. This systematic review classifies sensors used in smart classrooms and explores their current applications from both hardware and software perspectives. It delineates how different sensors enhance educational outcomes and the crucial role AI technologies play. The review highlights how sensor technology improves the physical classroom environment, monitors physiological and behavioral data, and is widely used to boost student engagements, manage attendance, and provide personalized learning experiences. Additionally, it shows that combining sensor software algorithms with AI technology not only enhances the data processing and analysis efficiency but also expands sensor capabilities, enriching their role in smart classrooms. The article also addresses challenges such as data privacy protection, cost, and algorithm optimization associated with emerging sensor technologies, proposing future research directions to advance educational sensor technologies.

Effect of Choose-Your-Own-Adventure (CYOA) Activities on Pharmacy Student Knowledge.

OBJECTIVE: Many strategies are used in pharmacy education to maintain student engagement through active learning. Gamification, such as the choose-your-own-adventure activity (CYOAA), is one such method. The purpose of this study was to assess improvement in clinical knowledge and retention after the implementation of CYOAA. METHODS: Two CYOAAs were designed and implemented within second-year pharmacy courses. One activity was on venous thromboembolism (VTE) and the other on chronic obstructive pulmonary disease (COPD). Students completed a six question prequiz and postquiz for both activities mapped to core learning objectives and four similar but more difficult questions on corresponding exams. After the CYOAAs, the students completed a reflection and perceptions survey. RESULTS: Seventy-five students completed the VTE CYOAA and 77 completed COPD CYOAA. Over the three time points, there was a significant decrease in the mean assessment scores on the VTE activity (68% to 65% to 40%) versus a significant and sustained increase in mean assessment scores on COPD (62% to 83% to 85%). Of the 36 and 33 students who completed the postsurvey, the majority agreed or strongly agreed that they preferred CYOAA to traditional cases and that the activities improved their knowledge, critical thinking skills, and confidence in clinical decision-making. CONCLUSION: There was a mixed result in the mean assessment scores, with an increase seen with the COPD CYOAA and a decrease with VTE, as well as positive perceptions for VTE and COPD, indicating that this classroom innovation is well-liked and may improve knowledge outcomes.

Exploring barriers to the effective use of computer-based simulation in pharmacy education: a mixed-methods case study.

Background: At the University of Tasmania (UTAS), pharmacy education traditionally relies on placements to provide students with hands-on experience. However, these placements have become increasingly limited due to logistical challenges and growing student numbers. Computer-based simulation (CBS) has the potential to offer a scalable, effective alternative to enhance learning and critical thinking. However, integrating CBS in pharmacy education faces several barriers that must be addressed for successful implementation. Objective: To gain insight into pharmacy educators' and students' views regarding the barriers, and potential solutions, to integrating CBS in pharmacy practice education. Methods: This mixed-methods case study involved semi-structured interviews with pharmacy educators and quantitative surveys with pharmacy students. The data underwent thematic coding for interview transcripts and statistical analysis for survey responses. The findings were integrated by examining convergence, complementarity, and discrepancy, revealing insights into how pharmacy students and educators perceive implementation barriers and improvement strategies for CBS. Results: Ten interviews were conducted, and 75 survey responses were collected, with a 62.5% response rate. Key barriers to CBS integration included educators' heavy workload, scepticism about CBS's educational value, and general integration challenges. Students, however, showed high acceptance of CBS, with 70.7% agreeing that CBS could assess their knowledge, 69.3% emphasising its role in developing problem-solving skills, and 80% viewing CBS as a complement to classroom study. Proposed solutions for enhancing CBS uptake included additional institutional support by appointing dedicated simulation technicians, leveraging champions to advocate for CBS, and aligning CBS with educational objectives. Conclusion: A significant gap between students' readiness and educators' hesitancy to use CBS in pharmacy education was identified. While students are eager to adopt new technologies, educators expressed reservations, primarily due to workload concerns and uncertainties about the efficacy of CBS. The feedback from educators suggests that institutions may see improved uptake by employing dedicated support personnel and initiating targeted training programs. Future research should focus on exploring barriers and facilitators, using larger and more diverse samples, and gaining deeper insights into decision-makers' perspectives to enhance the integration and efficacy of CBS in pharmacy education.

The relationship between technological pedagogical content knowledge and belief among preservice mathematics teachers.

The increasing interest in exploring beliefs about teaching mathematics with technology has led educators to employ belief systems as a framework for understanding the impact of technology on math instruction. However, the complex nature of pre-service teachers' beliefs in teaching mathematics with technology involves various dimensions. This study aims to investigate the predictive relationship between Technological Pedagogical Content Knowledge (TPACK) sub-components and beliefs in teaching mathematics with technology, revealing a statistically significant direct impact. Utilizing a correlational research approach, we collected data from a cohort of 159 Malaysian pre-service teachers with a focus on mathematics education. Structural Equation Modelling (SEM) was employed to analyze the proposed model. The measurement model exhibited a satisfactory fit with the collected data. Notably, technological knowledge (25 %), technological pedagogical content knowledge (69 %), and technological content knowledge (39 %) significantly influence discovery learning, while technological knowledge (24 %), technological pedagogical content knowledge (74 %), and technological content knowledge (30 %) significantly influence multiple representations. This underscores the critical role of TPACK in shaping educators' perspectives and practices, providing a crucial avenue for enhancing technology integration in teaching mathematics.

The Evolving Stethoscope: Insights Derived from Studying Phonocardiography in Trainees.

Phonocardiography (PCG) is used as an adjunct to teach cardiac auscultation and is now a function of PCG-capable stethoscopes (PCS). To evaluate the efficacy of PCG and PCS, the authors investigated the impact of providing PCG data and PCSs on how frequently murmurs, rubs, and gallops (MRGs) were correctly identified by third-year medical students. Following their internal medicine rotation, third-year medical students from the Georgetown University School of Medicine completed a standardized auscultation assessment. Sound files of 10 different MRGs with a corresponding clinical vignette and physical exam location were provided with and without PCG (with interchangeable question stems) as 10 paired questions (20 total questions). Some (32) students also received a PCS to use during their rotation. Discrimination/difficulty indexes, comparative chi-squared, and McNemar test p-values were calculated. The addition of phonocardiograms to audio data was associated with more frequent identification of mitral stenosis, S4, and cardiac friction rub, but less frequent identification of ventricular septal defect, S3, and tricuspid regurgitation. Students with a PCS had a higher frequency of identifying a cardiac friction rub. PCG may improve the identification of low-frequency, usually diastolic, heart sounds but appears to worsen or have little effect on the identification of higher-frequency, often systolic, heart sounds. As digital and phonocardiography-capable stethoscopes become more prevalent, insights regarding their strengths and weaknesses may be incorporated into medical school curricula, bedside rounds (to enhance teaching and diagnosis), and telemedicine/tele-auscultation efforts.

A Quarter-Century of Online Informatics Education: Learners Served and Lessons Learned.

The value and methods of online learning have changed tremendously over the last 25 years. The goal of this paper is to review a quarter-century of experience with online learning by the author in the field of biomedical and health informatics, describing the learners served and the lessons learned. The author details the history of the decision to pursue online education in informatics, describing the approaches taken as educational technology evolved over time. A large number of learners have been served, and the online learning approach has been well-received, with many lessons learned to optimize the educational experience. Online education in biomedical and health informatics has provided a scalable and exemplary approach to learning in this field.

More, better feedback please: are learning analytics dashboards (LAD) the solution to a wicked problem?

There is a long-standing lack of learner satisfaction with quality and quantity of feedback in health professions education (HPE) and training. To address this, university and training programmes are increasingly using technological advancements and data analytic tools to provide feedback. One such educational technology is the Learning Analytic Dashboard (LAD), which holds the promise of a comprehensive view of student performance via partial or fully automated feedback delivered to learners in real time. The possibility of displaying performance data visually, on a single platform, so users can access and process feedback efficiently and constantly, and use this to improve their performance, is very attractive to users, educators and institutions. However, the mainstream literature tends to take an atheoretical and instrumentalist view of LADs, a view that uncritically celebrates the promise of LAD's capacity to provide a 'technical fix' to the 'wicked problem' of feedback in health professions education. This paper seeks to recast the discussion of LADs as something other than a benign material technology using the lenses of Miller and Rose's technologies of government and Barry's theory of Technological Societies, where such technical devices are also inherently agentic and political. An examination of the purpose, design and deployment of LADs from these theoretical perspectives can reveal how these educational devices shape and govern the HPE learner body in different ways, which in turn, may produce a myriad of unintended- and ironic- effects on the feedback process. In this Reflections article we wish to encourage health professions education scholars to examine the practices and consequences thereof of the ever-expanding use of LADs more deeply and with a sense of urgency.

Using Mixed Reality to Teach Medical Students Lumbar Punctures.

BACKGROUND: Gaining familiarity with bedside procedures during medical school is essential for preparing medical students for intern year. However, this is often not a core component of undergraduate medical education, and students often feel unprepared to perform bedside procedures upon graduation from medical school. Extended reality technologies have rapidly developed in the past few years, become more accessible, and show great promise in education, most recently in healthcare. We aim to show the feasibility and usability of a mixed-reality lumbar puncture simulated experience. METHODS: We created the mixed-reality simulation by filming a procedure conducted by an expert on a lumbar puncture simulator from the first-person view. We performed a study to assess the feasibility and usability of mixed-reality lumbar puncture training compared with traditional faculty-led high-fidelity mannikin-based simulation training. Fourth-year medical students were randomly selected to participate in the mixed-reality lumbar puncture training. Students watched the virtual first-person teaching via a virtual reality headset while mimicking hand movements on a lumbar puncture mannikin. Faculty taught students in the traditional high-fidelity group in small groups before practicing on the high-fidelity manikin. Students in both groups then performed the procedure entirely with performance assessed via a standardized checklist. Number of attempts to achieve a predetermined minimum passing score were recorded, and students were also surveyed regarding their experience with both simulations. RESULTS: Fifty-nine percent of students felt comfortable using mixed reality as a training modality with less than 6% having any prior extended reality experience. More than 55% felt the mixed-reality experience was as effective as the traditional high-fidelity simulation training. Many students (72%) desired more mixed-reality opportunities. In terms of performance, 58.8% of students in the mixed-reality group vs 65.5% in the traditional group completed the checklist in 1 attempt (P = .79). CONCLUSIONS: We demonstrate that mixed reality is an acceptable and effective modality to train health care professionals in lumbar punctures with opportunities to further enhance the immersive learning experience.