Chapitre 6. Identité physique et identité numérique à l'ère de la distanciation sociale.

The “social distancing” of the Covid-19 crisis has brought to the forefront a phenomenon that has been at work since the rise of the Web: people exchange goods and services, express themselves and meet each other more and more without being physically present. The question of digital identity then emerges. What place do we occupy on the networks? What control do people have over their image? What place do writings occupy in the definition of this digital «image» of oneself? What is the understanding of the plurality of identities that the same person can have online? This article proposes a reflection on these different questions by distinguishing digital identities with and without physical persons.

The impact of hyperlinks, skim reading and perceived importance when reading on the Web.

It has previously been shown that readers spend a great deal of time skim reading on the Web and that this type of reading can affect comprehension of text. Across two experiments, we examine how hyperlinks influence perceived importance of sentences and how perceived importance in turn affects reading behaviour. In Experiment 1, participants rated the importance of sentences across passages of Wikipedia text. In Experiment 2, a different set of participants read these passages while their eye movements were tracked, with the task being either reading for comprehension or skim reading. Reading times of sentences were analysed in relation to the type of task and the importance ratings from Experiment 1. Results from Experiment 1 show readers rated sentences without hyperlinks as being of less importance than sentences that did feature hyperlinks, and this effect is larger when sentences are lower on the page. It was also found that short sentences with more links were rated as more important, but only when they were presented at the top of the page. Long sentences with more links were rated as more important regardless of their position on the page. In Experiment 2, higher importance scores resulted in longer sentence reading times, measured as fixation durations. When skim reading, however, importance ratings had a lesser impact on online reading behaviour than when reading for comprehension. We suggest readers are less able to establish the importance of a sentence when skim reading, even though importance could have been assessed by information that would be fairly easy to extract (i.e. presence of hyperlinks, length of sentences, and position on the screen).

Anxiety and Depression from Cybervictimization in Adolescents: A Metaanalysis and Meta-regression Study / Ansiedad y depresión por cibervictimización en adolescentes: un meta-análisis y un estudio de meta-regresión

Background/Objective:Cyberbullying is one of the social problems of most concern in educational spheres, especially in adolescence, where victimization experiences have been associated with episodes of anxiety and depression. The aim of this work was to analyze the relationship between cybervictimization, anxiety and depression in adolescence in a meta-analysis and identify the moderating variables that could help to explain the various correlations.

Antecedentes/Objetivo:El ciberacoso es uno de los problemas sociales de mayor preocupación en los ámbitos educativos, especialmente en la adolescencia, en la que las experiencias de victimización se han asociado a episodios de ansiedad y depresión. Se diseñó un estudio con el objetivo de analizar la relación entre cibervictimización, ansiedad y depresión en la adolescencia mediante un meta-análisis e identificar las variables moderadoras que podrían ayudar a explicar las distintas correlaciones.Método:Se realizó una búsqueda de estudios transversales en las bases de datos Web of Science, Scopus y PsycINFO. De los 156 estudios identificados, finalmente 13, con un total de 7,348 participantes, cumplieron con los criterios de inclusión.Resultados:Los resultados sugieren correlaciones estadísticamente significativas entre cibervictimización y ansiedad (r = .31) y cibervictimización y depresión (r = .28). El análisis de meta-regresión mostró que el porcentaje de mujeres y continente son variables moderadoras en la relación de cibervictimización con depresión y ansiedad.Conclusiones:En conclusión, el mal uso de las nuevas tecnologías de la información y la comunicación puede provocar un desajuste psicológico y social de las personas, con repercusiones negativas en su desarrollo.

[Ethical issues of Internet use by pregnant women during their medical care]. / Enjeux éthiques du recours à Internet par les femmes enceintes dans leur suivi de grossesse.

INTRODUCTION: Pregnant women are heavy users of Internet and this has an impact on their medical follow-up. The purpose of this study is to highlight the ethical issues related to the use of the Internet by women in their medical care.Methode: Through a systematic literature review conducted on PubMed/Medline, Web of Science, CINAHL and Embase between June and July 2019, 10 670 results were obtained, and 79 articles were included in the post-selection study. A thematic analysis was conducted on these articles. RESULTS: More than 90% of pregnant women use Internet, particularly to find medical information and social support, mainly on pregnancy and childbirth. This research allows them more equitable access to knowledge and develops their empowerment, which modifies the relationship between caregiver and patient, through the acquisition of greater autonomy for women and the development of experiential knowledge. This access offers a central and active role to pregnant women in their medical care. However, many authors also agree on the possible abuses of this use: misinformation, disproportionate information and the presence of judgment that undermine empowerment, but also digital divide and inequity in understanding information, stigmatization of women, and risks of privacy breaches on data acquired online. CONCLUSION: In order to provide pregnant women with the central and active place they seek, the authors recommend involving caregivers in the referral to reliable sites, encouraging them to develop online content, and educating pregnant women in the search for health information on Internet.

[Ethical issues of Internet use by pregnant women during their medical care] / Enjeux éthiques du recours à Internet par les femmes enceintes dans leur suivi de grossesse.

INTRODUCTION: Pregnant women are heavy users of Internet and this has an impact on their medical follow-up. The purpose of this study is to highlight the ethical issues related to the use of the Internet by women in their medical care.Methode: Through a systematic literature review conducted on PubMed/Medline, Web of Science, CINAHL and Embase between June and July 2019, 10 670 results were obtained, and 79 articles were included in the post-selection study. A thematic analysis was conducted on these articles. RESULTS: More than 90% of pregnant women use Internet, particularly to find medical information and social support, mainly on pregnancy and childbirth. This research allows them more equitable access to knowledge and develops their empowerment, which modifies the relationship between caregiver and patient, through the acquisition of greater autonomy for women and the development of experiential knowledge. This access offers a central and active role to pregnant women in their medical care. However, many authors also agree on the possible abuses of this use: misinformation, disproportionate information and the presence of judgment that undermine empowerment, but also digital divide and inequity in understanding information, stigmatization of women, and risks of privacy breaches on data acquired online. CONCLUSION: In order to provide pregnant women with the central and active place they seek, the authors recommend involving caregivers in the referral to reliable sites, encouraging them to develop online content, and educating pregnant women in the search for health information on Internet.

Tecnologias de informação e comunicação: interfaces com o processo de trabalho da enfermagem no contexto hospitalar / Information and communication technologies: interfaces with the nursing work process in the hospital context

Introdução: Nas últimas décadas as informações e o processo de comunicação sofreram significativas modificações, sobretudo no que concerne os acelerados mecanismos de acesso à informação em tempo real. Nessa conjuntura, é necessário destacar as Tecnologias de Informação e Comunicação, pois, permeiam a capacidade de acesso e disseminação de informações que podem influenciar a dinâmica de gestão do conhecimento que permeia o processo de trabalho da enfermagem e, consequentemente, o gerenciamento do cuidado de enfermagem. Portanto, diante do exposto, a pesquisa tem como objetivos: compreender os significados que enfermeiros, no contexto hospitalar, atribuem às Tecnologias de Informação e Comunicação para o processo de trabalho da Enfermagem; identificar as inter-retro-ações entre esses significados e o processo de trabalho da enfermagem para os aspectos relacionados à gestão do conhecimento e gerenciamento do cuidado de enfermagem. Metodologia: O presente estudo caracteriza-se como explicativo, de abordagem qualitativa, utilizando, para tanto, a Teoria Fundamentada nos Dados (TFD) como referencial metodológico e a Teoria da Complexidade, na perspectiva de Edgar Morin, como referencial teórico. Para a coleta de dados foram empregadas entrevistas semiestruturadas, gravadas em dispositivo formato mp3, entre janeiro de 2019 e junho de 2019. Os participantes da pesquisa compuseram dois grupos amostrais, compostos por 12 enfermeiros assistenciais e sete residentes de Enfermagem que atuaram nos setores de clínica médica e cirúrgica de um hospital universitário federal, situado na cidade do Rio de Janeiro. Resultados: cinco categorias emergiram do processo de codificação dos dados, a saber: Fatores condicionantes para o reconhecimento e utilização das TIC por enfermeiros no processo de trabalho; Tecnologias de Informação e Comunicação: apontando finalidades, recursos e a dinâmica de utilização no processo de trabalho da enfermeiro; Revelando ações-interações entre as tecnologias de informação e comunicação e gestão do conhecimento no processo de trabalho do enfermeiro; Identificando fatores intervenientes à utilização de TIC no processo de trabalho de enfermagem e; Vislumbrando consequências a partir da utilização da TIC no processo de trabalho da enfermagem. Conclusões: Resultado desse processo, reflexões na dimensão da comunicação que apresentam conexões com o processo de trabalho, que por sua vez, demandam estratégias para as atividades da TIC no cenário do estudo. Através do referencial metodológico da Teoria Fundamentada dos Dados proporcionou a compreensão e a explicação dos dados de maneira profunda resultando na formulação do fenômeno central Tecnologias de Informação e Comunicação: mecanismos para o estabelecimento de conexões necessárias ao processo de trabalho da enfermagem. Ademais a hipótese inicial do estudo de que as gerações poderiam influenciar na utilização das Tecnologias de Informação e Comunicação fora parcialmente refutada, sendo considerada pelos participantes do estudo como um fator desencadeador, no entanto, não condicionante.

Introduction: In the last de cades the information and the communication process have under gone significant changes, especially regarding the accelerated mechanisms of Access to information in real time. At this juncture, it is necessary to highlight the Information and Communication Technologies, as they permeate the ability to Access and disseminate information that may influence the dynamics of knowledge management that permeates the nursing work process and, consequently, the management of nursing care nursing. Therefore, in light of the above, there search aims to: Understand the meanings that nurses, in the hospital context, attribute to Information and Communication Technologies in the context of the nursing work process; Identify the inter-retro-actions between these meanings and the nursing work process for knowledge management and nursing care management. Methodology: This study is characterized as explanatory, qualitative approach, qualitative approach, using the Grounded Theory (GT) as the methodological framework and the Complexity Theory, in Edgar Morin's perspective, as the theoretical framework. For data collection, semi-structured interviews were used, recorded in format mp3, between January 2019 and June 2019. The research participants consisted of two sample groups, composed of 12 assisting nurses and seven nursing presidents Who worked in the medical clinic and surgery at the Clementino Fraga Filho University Hospital (HUCFF). Results: After the data coding process, five categories emerged, namely: Conditioning Factors for the Recognition and Use of ICT by Nurses in the Work Process; Information and Communication Technologies: pointing purposes, resources and the dynamics of use in the nursing work process; Revealing Actions- Interactions between information and communication Technologies and Knowledge Management in the Nursing Work Process, Identifying Intervening Factors to the use of ICT in the Nursing Work Process and Glimpsing Consequences from the use of ICT in the Nursing Work Process. Conclusions: As a result of this process, reflections on the communication dimension that present connections with the work process, which in turn demand strategies for ICT activities in the study scenario. Through the methodological framework of the Grounded Theory of Data, it provided the understanding and explanation of the data in a profound way, resulting in the formulation of the central phenomenon Information and Communication Technologies: mechanisms for establishing the necessary connections to the nursing work process. In addition, the initial hypothesis of the study that generations could influence the use of Information and Communication Technologies had been partially refuted, being considered by the study participants as a triggering factor, however, not a conditioning factor.

Introducción: En las últimas décadas, La información y El proceso de comunicación han sufrido cambios significativos, especialmente em relación com los mecanismos acelerados de acceso a La información em tiempo real. Em esta coyuntura, es necesario destacar lãs Tecnologías de La Información y La Comunicación, ya que impregnan la capacidad de acceder y difundir información que puede influir em La dinámica de La gestión Del conocimiento que impregna El proceso de trabajo de enfermería y, em consecuencia, La gestión de los cuidados de enfermería. enfermeria Por lo tanto, a la luz de lo anterior, La investigación tiene como objetivo: Comprender los significados que lãs enfermeras, enel contexto del hospital, atribuyen a lãs Tecnologías de La Información y La Comunicación enel contexto Del proceso de trabajo de enfermería; Identificar lãs interacciones entre estos significados y elproceso de trabajo de enfermería para La gestión Del conocimiento y La gestión del cuidado de enfermería. Metodología: Este estudio se caracteriza por su enfoque explicativo, cualitativo, enfoque cualitativo, utilizando lateoría fundamentada (GT) como marco metodológico y lateoría de lacomplejidad, enla perspectiva de Edgar Morin, como marco teórico. Para larecopilación de datos se utilizaron entrevistas semiestructuradas grabadas enel dispositivo format mp3, entre enero de 2019 y junio de 2019. Los participantes de La investigación consisti eronen dos grupos de muestra, que constaban de 12 enfermeras auxiliares y enfermeras de séptima enfermería que trabajaba nen la clínica médica y cirugíaenel Hospital Universitario Clementino Fraga Filho (HUCFF). Resultados: Después Del proceso de codificación de datos, surgieron cinco categorías, a saber: Factores condicionantes para El reconocimiento y uso de las TIC por lãs enfermeras enel proceso de trabajo; Tecnologías de La información y la comunicación: propósitos de apuntamiento, recursos y ladinámica de uso enelproceso de trabajo de enfermería; Acciones reveladoras: interacciones entre lãs tecnologías de La información y la comunicación y la gestión Del conocimiento enel proceso de trabajo de enfermería, identificando factores intervinientes para el uso de las TIC enel proceso de trabajo de enfermería y vislumbrando lãs consecuencias del uso de las TIC enel proceso de trabajo de enfermería. Conclusiones: Como resultado de este proceso, reflexiones sobre la dimensión de comunicación que presentan conexiones con el proceso de trabajo, que a su vez exigen estrategias para actividades de TIC en el escenario de estudio. Através del marco metodológico de Grounded Theory, proporcionó la comprensión y explicación de los datos de una manera profunda, lo que resultó en la formulación del fenómeno central Tecnologías de la información y la comunicación: mecanismos para establecer las conexiones necesarias con el proceso de trabajo de enfermería.

Las narrativas de la inteligencia artificial / Les narratives de la intelligència artificial / The narratives of artificial intelligence

La expresión Inteligencia Artificial designa significados muy diferentes entre sí, cuando no antagónicos. En el presente artículo examinaremos algunos de estos sentidos, en concreto, Inteligencia Artificial como trending topic; como big data; como sesgo, como cuestión sociolaboral; como ente sin conciencia; como ente con conciencia; y, por último, como disciplina convergente. Cada una de estas expresiones nos muestra problemas de naturaleza muy diferente, algunos de los cuales intersecan con la bioética, de ahí el interés para nuestra disciplina. La normativa jurídica, dispersa y descoordinada, a veces incluso ausente, refleja las dificultades inherentes a no poder concretar exactamente a qué nos enfrentamos

The expression Artificial Intelligence designates meanings that are very different from each other, if not antagonistic. In this article we will examine some of these meanings, in particular, Artificial Intelligence as "trending topic"; as "big data"; as a "bias", as a "socio-labor issue"; as an "entity without conscience"; as an "entity with conscience"; and, finally, as a "convergent discipline". Each of these expressions shows us problems of different nature, some of which intersect with bioethics, hence the interest for our discipline. Legal regulations, dispersed and uncoordinated, sometimes even absent, reflects the inherent difficulties of not being able to specify exactly what we are facing

L'expressió Intel·ligència Artificial designa significats molt diferents entre si, quan no antagònics. En el present article examinarem alguns d'aquests sentits, en concret, Intel·ligència Artificial com trending topic; com big data; com a biaix, com a qüestió sociolaboral; com a ens sense consciència; com a ens amb consciència; i, finalment, com a disciplina convergent. Cadascuna d'aquestes expressions ens mostra problemes de naturalesa molt diferent, alguns dels quals intersequen amb la bioètica, d'aquí l'interès per a la nostra disciplina. La normativa jurídica, dispersa i descoordinada, a vegades fins i tot absent, reflecteix les dificultats inherents a no poder concretar exactament a què ens enfrontem

Riesgos y vulnerabilidades de la denegación de servicio distribuidos en internet de las cosas / Risks and vulnerabilities of the denial of service distributed on the internet of things / Riscos i vulnerabilitats de la denegació de servei distribuïts en internet de les coses

La dependencia de la sociedad a la tecnología es cada vez mayor, donde el monitoreo de las ciudades se ha vuelto común. En este sentido, se expone en el presente artículo el riesgo a nivel de seguridad de la información sobre Internet de las Cosas, debido a potenciales ataques de denegación de servicio distribuida. Bajo este mismo esquema, se presentan otros tipos de vulnerabilidades relacionados, tales como: el criptohackeo, blockchain, amenazas persistentes avanzadas, ransonware e inteligencia artificial, exponiendo de manera general el riesgo potencial frente a la ciberseguridad en cuanto al uso y manipulación de la información

The dependence of society on technology is growing, where the monitoring of cities has become common, either through camera systems arranged everywhere, to devices and sensors that record a number of variables that literally measure the pulse from the same. In this sense, this article exposes the risk at the level of security of information on the Internet of Things (IoT), whose level of application grows day by day and with it, vulnerabilities in terms of connectivity and navigability, due to potential distributed denial of service (DoS) attacks. Under this same scheme, other types of vulnerabilities directly and indirectly related to IoT and DoS are presented, such as cryptohack, blockchain, advanced persistent threats (APT), ransomware and artificial intelligence, generally explaining the potential risk in the face of cybersecurity regarding the use and manipulation of information

La dependència de la societat a la tecnologia és cada vegada major. A les ciutats el monitoratge s'ha tornat comú, sigui a través de sistemes de càmeres disposats per onsevulla, o a través de dispositius i sensors que registren un sens fi de variables que literalment mesuren el pols d'aquestes. En aquest article s'exposa el risc a nivell de la seguretat de la informació sobre Internet de les Coses (IoT), el nivell de les quals d'aplicació creix dia a dia i amb això, les vulnerabilitats quant a connectivitat i navegabilitat, a causa de potencials atacs de denegació de servei distribuïda (DOS). Sota aquest mateix esquema, es presenten altres tipus de vulnerabilitats relacionades directa i indirectament amb el IoT i el DDoS, tals com el criptohackeo, el blockchain, les amenaces persistents avançades (APT), el ransomware i la intel·ligència artificial, exposant de manera general el risc potencial enfront de la ciberseguretat quant a l'ús i manipulació de la información

The evolution of online ideological communities.

Online communities are virtual spaces for users to share interests, support others, and to exchange knowledge and information. Understanding user behavior is valuable to organizations and has applications from marketing to security, for instance, identifying leaders within a community or predicting future behavior. In the present research, we seek to understand the various roles that users adopt in online communities-for instance, who leads the conversation? Who are the supporters? We examine user role changes over time and the pathways that users follow. This allows us to explore the differences between users who progress to leadership positions and users who fail to develop influence. We also reflect on how user role proportions impact the overall health of the community. Here, we examine two online ideological communities, RevLeft and Islamic Awakening (N = 1631; N = 849), and provide a novel approach to identify various types of users. Finally, we study user role trajectories over time and identify community "leaders" from meta-data alone. Study One examined both communities using K-MEANS cluster analysis of behavioral meta-data, which revealed seven user roles. We then mapped these roles against Preece and Schneiderman's (2009) Reader-to-Leader Framework (RtLF). Both communities aligned with the RtLF, where most users were "contributors", many were "collaborators", and few were "leaders". Study Two looked at one community over a two-year period and found that, despite a high churn rate of users, roles were stable over time. We built a model of user role transitions over the two years. This can be used to predict user role changes in the future, which will have implications for community managers and security focused contexts (e.g., analyzing behavioral meta-data from forums and websites known to be associated with illicit activity).

Patient-Targeted "Googling:" When Therapists Search for Information About Their Patients Online.

The ubiquitous nature of the internet and of online social networking has created new opportunities but also challenges for the psychotherapist. Former notions of anonymity and privacy are now infeasible as a result of massive information sharing through electronic media. The clinical repercussions of these changes are being extensively debated, but issues involving patient privacy and anonymity have not been sufficiently explored. Although several aspects of the impact of the internet on therapeutic setting-such as the need for psychotherapists to exercise caution when making personal information available online-have been addressed in the literature, there has been comparatively little discussion on psychotherapists seeking information about their patients on the internet, a phenomenon known as "patient-targeted googling" (PTG).

[Internet and mobile-assisted interventions in mental disorders : Implementation in Germany from an ethical perspective]. / Internet- und mobilgestützte Interventionen bei psychischen Störungen : Implementierung in Deutschland aus ethischer Sicht.

BACKGROUND: Internet and mobile-based interventions (IMIs) for mental disorders are seen by some authors as a step forward to narrow the treatment gap in mental health; however, especially in Germany professionals voice ethical concerns against the implementation of IMIs. The fact that there is broad evidence in favor of IMIs and that IMIs have already been implemented in several countries requires an ethical analysis to answer these concerns. OBJECTIVE: The objective is to tackle ethical issues connected to a possible implementation of IMIs for mental disorders in Germany and to point out possible solutions. MATERIAL AND METHODS: We conducted an ethical analysis using the criteria of well-being of patients, non-maleficence, justice, and patient autonomy, based on the empirical evidence. RESULTS AND CONCLUSION: The ethical analysis showed that IMIs for mental disorders principally have a positive effect on the well-being of patients and have a low risk of impairment. Additionally, IMIs can minimize risk, improve justice, and strengthen autonomy of mentally ill patients. Despite the broad evidence, there are still research desiderates with respect to ethical aspects, e. g. patient information for mentally ill patients.

Ethical Considerations Regarding Internet Searches for Patient Information.

In 2010, the American Medical Association developed policies regarding professionalism in the use of social media, but it did not present specific ethical guidelines on targeted Internet searches for information about a patient or the patient's family members. The American Psychiatric Association (APA) provided some guidance in 2016 through the Opinions of the Ethics Committee, but published opinions are limited. On behalf of the APA Ethics Committee, the authors developed a resource document describing ethical considerations regarding Internet and social media searches for patient information, from which this article has been adapted. Recommendations include the following. Except in emergencies, it is advisable to obtain a patient's informed consent before performing such a search. The psychiatrist should be aware of his or her motivations for performing a search and should avoid doing so unless it serves the patient's best interests. Information obtained through such searches should be handled with sensitivity regarding the patient's privacy. The psychiatrist should consider how the search might influence the clinician-patient relationship. When interpreted with caution, Internet- and social media-based information may be appropriate to consider in forensic evaluations.

Medical crowdfunding and the virtuous donor.

Patients and families are increasingly turning to crowdfunding to help them cover the cost of medical care. The ethics of crowdfunding has garnered some attention in the bioethical literature. In this paper I examine an ethical aspect of medical crowdfunding (MCF) that has received limited attention: the role of donors. I defend a virtue ethical approach to analyzing the role of donors in MCF. Vicious donation, where donors do not exercise the relevant virtues, can compound some of the ethical risks associated with MCF, as seen in the several recent, high-profile cases. My primary contention in this paper is that encouraging donors to think about how donating to a particular campaign would measure against the virtues I outline could help to discourage acts of ethically problematic donation to MCF campaigns.

Mind the Gap! How the Digital Turn Upsets Intellectual Property.

Intellectual property is one of the highly divisive issues in contemporary philosophical and political debates. The main objective of this paper is to explore some sources of tension between the formal rules of intellectual property (particularly copyright and patents) and the emerging informal norms of file sharing and open access in online environments. We look into the file sharing phenomena not only to illustrate the deepening gap between the two sets of norms, but to cast some doubt on the current regime of intellectual property as an adequate frame for the new type of interactions in online environments. Revisiting the classic Arrow-Demsetz debate about intellectual property and the epistemological issues involved in assessing institutions, we suggest that seeking out new institutional arrangements aligned with the norms-in-use seems to be a more promising strategy in the new technological setting than attempting to reinforce the current legal framework. Moreover, such a strategy is less prone to committing the so-called 'Nirvana fallacies'. As a secondary task, we try to cast some doubt on the two most common moral justifications of intellectual property as being able to ground the full extent of the current intellectual property regime.

The self-assessment dilemma: an open-source, ethical method using Matlab to formulate multiple-choice quiz questions for online reinforcement.

Student self-assessment using computer-based quizzes has been shown to increase subject memory and engagement. Some types of self-assessment quizzes can be associated with a dilemma between 1) medical students who want the self-assessment quiz to be clearly related to upcoming summative assessments or curated by the exam-setters, and 2) university administrators and ethics committees who want clear guarantees that the self-assessment quizzes are not based on the summative assessments or made by instructors familiar with the exam bank of items. An algorithm in Matlab was developed to formulate multiple-choice questions for both ion transport proteins and pharmacology. A resulting question/item subset was uploaded to the Synap online self-quiz web platform, and 48 year 1 medical students engaged with it for 3 wk. Anonymized engagement statistics for students were provided by the Synap platform, and a paper-based exit questionnaire with an 80% response rate ( n = 44) measured satisfaction. Four times as many students accessed the quiz system via laptop compared with phone/tablet. Of 391 questions/items, over 11,749 attempts were made. Greater than 80% of respondents agreed with each of the positive statements (ease of use, enjoyed, engaged more, learned more, and wanted it to be extended to other modules). Despite simplistic questions and rote memorization, the questions developed by this system were engaged with and were received positively. Students strongly supported extending the system.