A Phenomenological Study of Postgraduate Medical Trainees' Incidental Learning Experiences and Psychological Well-Being During the COVID-19 Pandemic.

BACKGROUND:  During the COVID-19 pandemic, postgraduate medical trainees contributed significantly to the healthcare workforce, as multiple vulnerabilities in the healthcare system and medical training were expounded. The burden of training, learning, and working at this time introduced unique psychological and emotional stressors within a context of generalized volatility and radically different ways to work and learn. This study explored postgraduate trainees' experiences with coping, managing, and learning during the COVID-19 pandemic. METHODOLOGY:  Using a phenomenological approach, semistructured interviews were conducted with an intradisciplinary sample (n = 8) of postgraduate trainees in Newfoundland and Labrador, Canada, between May and October 2022. Five researchers performed inductive and deductive thematic analysis to develop a coding structure and identify common themes. RESULTS:  The COVID-19 pandemic prompted the use of restrictive public health measures and an unprecedented shift from in-person to virtual learning. This affected trainees' exposure to normalized learning experiences, training rotations, and opportunities to learn from peers and staff. Certainly, trainees reported that virtual learning improved their educational experiences in unique ways, increased engagement and attendance, and enabled regular meetings and learning when in-person options were unavailable. Trainees also reported enhanced self-directed learning skills, greater ownership of and leadership in their education, and increased confidence and experience with virtual care. Some also reported a perceived increase in elements of emotional intelligence (e.g., self-awareness, empathy, and compassion). CONCLUSIONS:  Trainees reported a variety of incidental learning experiences from working and training during COVID-19. Although some experiences were challenging, there was a perception that such experiences led to new learnings that were beneficial to one's professional development and future career, as well as implications for future training provided to trainees. While there was a reported shift in the culture surrounding postgraduate trainees' health and safety, respondents also described the need for additional support for postgraduate trainees' well-being during a pandemic.

YouTube as an Educational Resource in Medical Education: a Scoping Review.

YouTube has emerged as a growing educational resource for medical learners and educators; yet, its broad implementation may lack guidance from evidence-based evaluations. This article presents a scoping review of the utility, effectiveness, and validity of YouTube video resources in medical education. Of the 113 articles identified, 31 articles met inclusion criteria that focused on use of YouTube in medical education. Only 19.4% of the articles (n = 6) reported evaluative outcomes related to the use of YouTube for instructional purposes. Recommendations are offered for improving the usefulness and quality of YouTube videos as an educational resource in medical education.

Adoption and Use of Mobile Learning in Continuing Professional Development by Health and Human Services Professionals.

INTRODUCTION: Health and human services professionals are increasingly using mobile devices to support clinical decision-making and evidence-based practice. However, research on self-directed learning in an era of growing digital technology utilization is underdeveloped. This study explored the adoption and use of mobile learning as a continuing professional development (CPD) activity. METHODS: A mixed-methods case study using semistructured interviews and a web-based questionnaire was conducted with health and human services professionals in Newfoundland and Labrador, Canada. RESULTS: Respondents reported using a smartphone (53.8%), tablets (50.4%), YouTube (43.0%), and mobile apps (35.8%) for CPD. The highest-rated benefits of mobile learning included improved access to information (M = 3.51); potential for enhanced knowledge acquisition (M = 3.45); staying up to date (M = 3.44); and verifying information (M = 3.40). The greatest barriers included cost of some apps and resources (M = 3.07); websites/programs not functional on mobile devices (M = 2.84); workplace barriers preventing access to digital resources (M = 2.82); and social media use linked to negative perceptions of professionalism (M = 2.65). Interview respondents described the flexibility and convenience of mobile learning, the level of autonomy it offered, and the advantages of learning on their own time. Technical issues, particularly for rural and remote practitioners, and digital professionalism also emerged as potential barriers. DISCUSSION: A systems model organizes the factors influencing the adoption and use of mobile devices and resources to support "just-in-time" learning. Addressing policies, practices, and regulations that enable or inhibit adoption of mobile learning for CPD may foster enhanced use to support better clinical decision-making, improved accuracy, and greater patient safety.

A Review of Digital, Social, and Mobile Technologies in Health Professional Education.

INTRODUCTION: Digital, social, and mobile technologies (DSMTs) can support a wide range of self-directed learning activities, providing learners with diverse resources, information, and ways to network that support their learning needs. DSMTs are increasingly used to facilitate learning across the continuum of health professional education (HPE). Given the diverse characteristics of DSMTs and the formal, informal, and nonformal nature of health professional learning, a review of the literature on DSMTs and HPE could inform more effective adoption and usage by regulatory organizations, educators, and learners. METHODS: A scoping review of the literature was performed to explore the effectiveness and implications of adopting and using DSMTs across the educational continuum in HPE. A data extraction tool was used to review and analyze 125 peer-reviewed articles. Common themes were identified by thematic analysis. RESULTS: Most articles (56.0%) related to undergraduate education; 31.2% to continuing professional development, and 52.8% to graduate/postgraduate education. The main DSMTs described include mobile phones, apps, tablets, Facebook, Twitter, and YouTube. Approximately half of the articles (49.6%) reported evaluative outcomes at a satisfaction/reaction level; 45.6% were commentaries, reporting no evaluative outcomes. Most studies reporting evaluative outcomes suggest that learners across all levels are typically satisfied with the use of DSMTs in their learning. Thematic analysis revealed three main themes: use of DSMTs across the HPE continuum; key benefits and barriers; and best practices. DISCUSSION: Despite the positive commentary on the potential benefits and opportunities for enhancing teaching and learning in HPE with DSMTs, there is limited evidence at this time that demonstrates effectiveness of DSMTs at higher evaluative outcome levels. Further exploration of the learning benefits and effectiveness of DSMTs for teaching and learning in HPE is warranted.

Exploratory Study of Rural Physicians' Self-Directed Learning Experiences in a Digital Age.

INTRODUCTION: The nature and characteristics of self-directed learning (SDL) by physicians has been transformed with the growth in digital, social, and mobile technologies (DSMTs). Although these technologies present opportunities for greater "just-in-time" information seeking, there are issues for ensuring effective and efficient usage to compliment one's repertoire for continuous learning. The purpose of this study was to explore the SDL experiences of rural physicians and the potential of DSMTs for supporting their continuing professional development (CPD). METHODS: Semistructured interviews were conducted with a purposive sample of rural physicians. Interview data were transcribed verbatim and analyzed using NVivo analytical software and thematic analysis. RESULTS: Fourteen (N = 14) interviews were conducted and key thematic categories that emerged included key triggers, methods of undertaking SDL, barriers, and supports. Methods and resources for undertaking SDL have evolved considerably, and rural physicians report greater usage of mobile phones, tablets, and laptop computers for updating their knowledge and skills and in responding to patient questions/problems. Mobile technologies, and some social media, can serve as "triggers" in instigating SDL and a greater usage of DSMTs, particularly at "point of care," may result in higher levels of SDL. Social media is met with some scrutiny and ambivalence, mainly because of the "credibility" of information and risks associated with digital professionalism. DISCUSSION: DSMTs are growing in popularity as a key resource to support SDL for rural physicians. Mobile technologies are enabling greater "point-of-care" learning and more efficient information seeking. Effective use of DSMTs for SDL has implications for enhancing just-in-time learning and quality of care. Increasing use of DSMTs and their new effect on SDL raises the need for reflection on conceptualizations of the SDL process. The "digital age" has implications for our CPD credit systems and the roles of CPD providers in supporting SDL using DSMTs.

Associations among eating regulation and body mass index, weight, and body fat in college students: the moderating role of gender.

This study investigated associations between eating regulation behaviors and body mass index (BMI), weight, and percent body fat in male and female students over the first two years of college. Subjects included 328 college students (215 females and 113 males). Height and weight (via standard techniques), body composition (via bioelectrical impedance analysis), and eating regulation behaviors (using the Regulation of Eating Behavior Scale) were conducted two to three times during both the freshman and sophomore years. Significant associations between eating regulation and BMI, weight, and/or percent body fat were shown mostly in females. In females, higher BMI, weight, and/or percent body fat at the end of the second year of college were found in those with low levels of autonomous, intrinsic motivation, and identified regulation, and high levels of amotivation, while lower BMI, weight, and/or percent body fat were associated with high levels of autonomous, intrinsic motivation, and identified regulation, and low levels of amotivation. The findings that specific eating behaviors in females during the first two years of college influence BMI, weight, and/or percent body fat may be useful for inclusion in university programs focused on college student health to help decrease the risk of obesity and disordered eating/eating disorders in female college students.

Weight and Body Composition Changes during the First Three Years of College.

Differences in weight, body mass index (BMI), percent and absolute body fat, fat-free mass, and waist circumference were investigated in a group of males and females during the first three years (from 2007 to 2010) of college. Significant three-year gains were observed for weight 2.1 ± 4.7 kg, BMI 0.7 ± 1.6 kg/m(2), percent body fat 2.7 ± 3.3%, and fat mass 2.3 ± 3.5 kg. A significant loss of fat-free mass, -0.5 kg, was observed among females. Absolute gains in weight, BMI, and percent and absolute body fat were highest during the freshman year, followed by the junior year, and lowest during the sophomore year. Among the 70% of students gaining weight over the three years, weight gain averaged 4.3 kg. The numbers of females with over 30% body fat doubled, and the number of males with over 20% body fat increased fivefold. Initially 15% of students were classified as obese/overweight and 79% normal weight; by the end of the junior year, 24% were obese/overweight and 70% were normal weight. Efforts on college campuses to promote healthy lifestyles among its student population are needed throughout the college years.

Changes in body weight, composition, and shape: a 4-year study of college students.

The objectives of this study were to examine changes in body weight, body mass index (BMI), body composition, and shape in a group of male and female students over the 4-year college period. Anthropometric assessments including height and weight (via standard techniques), body composition (via bioelectrical impedance analysis), and body shape (via 3-dimensional body scanning) were conducted at the beginning of the freshman year and end of the senior year in 131 college students. Four-year changes included significant (p < 0.0001) gains in weight (3.0 kg), BMI (1.0 kg·m(-2)), body fat (3.6%), and absolute fat mass (3.2 kg). Males gained significantly (p < 0.0001) greater amounts of weight, BMI, percent and absolute fat mass, and fat-free mass than females. Weight change ranged from (-)8.7 to (+)16.8 kg. About 70% of the participants gained weight, which averaged 5.3 kg; significant (p < 0.0001) gains in BMI, fat-free mass, absolute fat mass, and percent body fat and significant (p < 0.0005) increases in neck, chest-bust, waist, hips, seat, and biceps circumferences were also observed in this weight gain group. The percentage of participants classified as overweight-obese increased from 18% to 31%. The number of females and males with ≥30% and 20% body fat, respectively, increased from n = 14 to n = 26 (with n = 4 exhibiting normal weight obesity) over the 4-year period. The waist circumference changes were significantly (p < 0.0001) correlated with both weight and percent body fat changes. In conclusion, the increasing prevalence of obesity and normal weight obesity among this college population suggests the need for additional health promotion strategies on college campuses.

Eating regulation styles, appearance schemas, and body satisfaction predict changes in body fat for emerging adults.

Obesity and high body fat percentages are a major public health issue. The percentage of obese and overweight Americans has increased over the past 30 years. On average, overweight individuals with higher percent body fat than normal weight individuals are at increased risk for numerous negative outcomes both physically and mentally. A prime time to investigate changes in body composition and associated psychological influences on decision making is during the emerging adulthood period. The first few years of college are a time when adolescents begin to regulate for themselves their own eating behaviors. Previous research shows that freshmen gain weight and increase in percent body fat during their first year of college. The current study addresses the limitations of previous research by investigating (1) individual growth in percent body fat over a longer period of time in college than previous available research and (2) important psychological and sex differences in this growth. This study measures percent body fat across the first 3 years of college at 8 time points for 542 undergraduates (351 females, 65 %; 191 males, 35 %). Longitudinal data analysis was conducted to identify changes in percent body fat, psychological predictors of those changes, and how changes differ for males and females. Our study found that significant increases exist in percent body fat during undergraduates' college years and that change differs for males and females. In addition, through the use of nested hierarchical models, eating regulation style (autonomous or controlled regulation), appearance schema (self-evaluative salience or motivational salience), and body satisfaction were identified as influential predictors of change in percent body fat. For example, young females, who do not feel in control of their physical appearance yet spend a great deal of time maintaining their appearance, have the highest initial body fat percentage and the steepest increase in percent body fat. Overall, males and females with high autonomous regulation and high motivational salience are likely to maintain (instead of increase) percent body fat over the college years. Knowing the influence of these predictors can be useful for promoting health and intervening with young adults in the college setting and other emerging adults who are not enrolled in postsecondary institutions.

Body composition changes during the first two years of university.

OBJECTIVE: Changes in body weight, composition, and shape were investigated in male and female college students between the freshman and sophomore years. METHODS: Changes in weight, body mass index (BMI), percent and absolute body fat and fat-free mass (via bioelectrical impedance), and waist circumference (via body scans) were assessed over the freshman and sophomore years (2007-2009) among 120 students attending a Southern public university. RESULTS: Weight (2.5 and 1.7 lbs) and BMI gains (0.3 and 0.3 kg/m(2)) did not significantly differ between the freshman and sophomore years, respectively. Significantly more percent body fat and fat mass were gained during the freshman (1.9% and 3.3 lbs, respectively) than the sophomore year (0.0% and 0.6 lbs, respectively). Females lost significantly more fat-free mass during the freshman (-0.8 lb) than during the sophomore year (1.0 lb). Changes in waist circumference and weight were significantly correlated. Increases in the percentages of females classified as overweight and with unhealthy body fat amounts and waist circumferences were observed. CONCLUSION: While the sophomore year was characterized by slightly healthier body composition changes than the freshman year, the gains in weight, fat mass, and waist circumference measurements suggest increased health risks for many college females.

The freshman 15-a closer look.

UNLABELLED: OBJECTIVES AND PARTICIPANTS: Changes in body weight, composition, and size were examined in college freshmen at the beginning (initial, n = 240) and end of fall semester 2007 (n = 214) and the end of spring semester 2008 (n = 205). METHODS: Height, weight, body composition, and waist and hip measurements were assessed. RESULTS: Mean weight, body mass index (BMI), absolute and percent body fat all increased significantly over fall semester and the academic year. About 31% of freshmen lost > or =5 lbs. Mean academic year weight gain was 2.6 lbs (entire group) and 6.0 lbs (weight gainers); body fat increased by 4.4 lbs in the weight gainers. A significant correlation (r = .509) was found between weight change and waist circumference change, but not between weight change and waist to hip ratio change. CONCLUSIONS: Freshmen weight gain is associated with increases in body fat and waist circumference, which may be troublesome should the trend continue throughout college.