The ID Digital Institute: Building a digital education toolset and community.

Organic digital education (ODE) includes online medical education content that can take various forms, such as blogs, social media, videos, podcasts, or infographics. Multimedia ODE platforms have unique benefits and have quickly become an essential part of medical education. Modern medical educators with competency in digital teaching modalities can leverage these for teaching as well as career development and dissemination of scientific research. The ID Digital Institute is a digital education program with a curriculum designed to equip infectious diseases (ID) professionals with the skills to appraise, create, curate, and integrate ODE into their teaching and career. We share the structure, content, and lessons learned from the ID Digital Institute program. We also illustrate how digital education skills can present unique opportunities to align with current and future transplant and immunocompromised host infectious diseases education efforts.

Optimizing the consent process for emergent laparoscopic cholecystectomy using an interactive digital education platform: a randomized control trial.

BACKGROUND: Informed consent is essential for any surgery. The use of digital education platforms (DEPs) can enhance patient understanding of the consent discussion and is a method to standardize the consent process in elective, ambulatory settings. The use of DEP as an adjunct to standard verbal consent (SVC) has not been studied in an acute care setting. METHODS: We conducted a prospective randomized control trial with patients presenting to the emergency department of a tertiary care hospital with acute biliary pathology requiring a laparoscopic cholecystectomy (LC) between August 2021 and April 2023. Participants were randomized 1:1 to receive either a DEP module with SVC or SVC alone. Baseline procedure-specific knowledge and self-reported understanding of risks and benefits of LC were collected using a questionnaire. Primary outcome was immediate post-intervention knowledge assessed using a 21-question multiple choice questionnaire. Secondary outcomes were delayed procedure-specific knowledge and participants' satisfaction with the consent discussion. RESULTS: We recruited 79 participants and randomized them 1:1 into the intervention group (DEP + SVC, n = 40) and the control group (SVC, n = 39). Baseline demographics and baseline procedure-specific knowledge were similar between groups. The immediate post-intervention knowledge was significantly higher for participants in the intervention versus the control group with a Cohen's d effect size of 0.68 (85.2(10.6)% vs. 78.2(9.9)%; p = 0.004). Similarly, self-reported understanding of risks and benefits of LC was significantly greater for participants in the intervention versus the control group with a Cohen's effect size of 0.76 (68.5(16.4)% vs. 55.1(18.8)%; p = 0.001). For participants who completed the delayed post-intervention assessment (n = 29), there continued to be significantly higher retention of acquired knowledge in the intervention group with a Cohen's effect size of 0.61 (86.5(8.5)% vs. 79.8 (13.1)%; p = 0.024). There was no difference in participants' self-reported satisfaction with the consent discussion between groups (69.5(6.7)% vs. 67.2(7.7)%; p = 0.149). CONCLUSION: The addition of digital education platform to standard verbal consent significantly improves patient's early and delayed understanding of risks and benefits of LC in an acute care setting.

Digital health's influence on the association between birth preference and vaginal birth.

BACKGROUND: Women's preferred mode of birth during pregnancy is predictive of their actual mode of birth. Digital prenatal care services are a promising method for educating women on mode of birth to reduce elective cesareans. This study aimed to evaluate the influence of digital health on the association between birth preference and mode of birth. METHODS: Data come from 5409 pregnant women enrolled in a digital platform for women's and family health. Multi-trajectory modeling identified trajectories of digital health usage throughout pregnancy. Adjusted logistic regression models tested associations between birth preferences and mode of birth. The modifying effect of digital health usage on the association between birth preference and mode of birth was assessed on the multiplicative scale. RESULTS: Four distinct trajectories of digital service usage were identified and labeled as: (1) baseline users (52%): the reference group; (2) just-in timers (16%): high usage during the third trimester; (3) learners (26%): high educational resource usage (e.g., articles and classes) throughout pregnancy; and (4) super users (6%): high usage of both education and care resources throughout pregnancy. Overall, preferred mode of birth at enrollment was predictive of actual mode of birth; however, digital health usage moderated this association, whereby super users and learners who preferred a cesarean at enrollment were more likely to deliver vaginally, compared to baseline users who preferred a cesarean. CONCLUSION: For the increasing proportion of women considering an elective cesarean, education through a prenatal digital health platform may help to encourage vaginal birth and reduce cesarean births.

Non-communicable diseases, digital education and considerations for the Indian context - a scoping review.

INTRODUCTION: The increasing ageing of the population with growth in NCD burden in India has put unprecedented pressure on India's health care systems. Shortage of skilled human resources in health, particularly of specialists equipped to treat NCDs, is one of the major challenges faced in India. Keeping in view the shortage of healthcare professionals and the guidelines in NEP 2020, there is an urgent need for more health professionals who have received training in the diagnosis, prevention, and treatment of NCDs. This paper conducts a scoping review and aims to collate the existing evidence on the use of digital education of health professionals within NCD topics. METHODS: We searched four databases (Web of Science, PubMed, EBSCO Education Research Complete, and PsycINFO) using a three-element search string with terms related to digital education, health professions, and terms related to NCD. The inclusion criteria covered the studies to be empirical and NCD-related with the target population as health professionals rather than patients. Data was extracted from 28 included studies that reported on empirical research into digital education related to non-communicable diseases in health professionals in India. Data were analysed thematically. RESULTS: The target groups were mostly in-service health professionals, but a considerable number of studies also included pre-service students of medicine (n = 6) and nursing (n = 6). The majority of the studies included imparted online learning as self-study, while some imparted blended learning and online learning with the instructor. While a majority of the studies included were experimental or observational, randomized control trials and evaluations were also part of our study. DISCUSSION: Digital HPE related to NCDs has proven to be beneficial for learners, and simultaneously, offers an effective way to bypass geographical barriers. Despite these positive attributes, digital HPE faces many challenges for its successful implementation in the Indian context. Owing to the multi-lingual and diverse health professional ecosystem in India, there is a need for strong evidence and guidelines based on prior research in the Indian context.

Digital education about delirium for health care professional students: a mixed methods systematic review.

BACKGROUND: Competence in delirium care begins with pre-registration education for health care professionals. Although a common complication for hospitalised patients, delirium is avoidable and reversible. Delirium requires early recognition in person-centred care. Students need to learn how to identify and effectively care for 'at risk' patients. AIM: To identify and examine literature on how pre-registration health care professional students are prepared to recognise, assess, and deliver interventions to prevent delirium in practice, using digital/web based educational interventions. METHOD: Mixed methods systematic review with narrative synthesis. A protocol was registered with PROSPERO. The review questions and search strategy were guided by the Population, Phenomena of Interest, Context (PICo) framework. The PRISMA framework guided the screening, data extraction and analysis. Database searches (MEDLINE, Web of Science, Embase, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO & Scopus) were undertaken in April 2023 for publications from 2012 to 2023. Covidence software [30] was used to extract and manage the data. Quality appraisal was guided by the Crowe Critical Appraisal Tool (CCAT) [31]. FINDINGS: Ten papers were included: mixed methods (2), qualitative (1) and quantitative (7). Medical students were the most studied group (n = 5), followed by student nurses (n = 4) and mixed nursing and medical students (n = 1). Length of learning experience varied from 12 min virtual reality (VR) to a two-week 'geriatrics' elective. Learning was enhanced by player autonomy, engagement, safety, applicability, choices, multiple perspectives and moral reasoning opportunities. DISCUSSION: Digital programmes should be visually appealing, interactive with opportunities for practice and timely appropriate feedback.

Leveraging the use of a social media app as a collaborative medical information and knowledge sharing tool-insights from experiential use and survey of a CME WhatsApp community.

BACKGROUND AND AIM: Continuing Medical Education (CME) is crucial for physicians to stay current in the rapidly advancing field of medicine. A WhatsApp (WA) based community of physicians was initiated in 2016 'WhatsApp CME India Group' to facilitate learning, knowledge sharing, and discussion among physicians. Due to participant size constraints of the technology, it evolved into seven distinct WA groups, overseen by a central administrator. A survey undertaken in the group's 7th year aimed to evaluate its effectiveness in achieving its goals, measure participant engagement, and uncover the primary factors driving its usage. METHODS: The survey questionnaire was distributed to 3500 members across the 07 WhatsApp CME groups for voluntary participation. Data collected was analysed using SPSS version 24.0 (SPSS Inc., Chicago, IL, USA) and reported using descriptive statistics. RESULTS: Among the 581 survey respondents, the study found 43% of physicians use the WhatsApp academic groups for CME content, with 32% accessing their group over four times daily. The primary motivation for 77% was to discuss challenging cases and to gain knowledge updates from fellow physician (70%). Medical websites (57%), referral books (49%), and Google (43%) were other significant resources. Every participant (100%) found the WhatsApp CME India group the most beneficial resource for daily medical science updates. A significant portion (57%) of the respondents found the group valuable for real-time information exchange. Over 78% stated it kept them current with knowledge and guidelines. Notably, 94% viewed WhatsApp CME as complementary to physical conferences, not a replacement. The post-conference/webinar summaries were appreciated by 81% participants. Case discussions (31%) and update posts from fellow physicians sharing their insights and learnings (24%) were noted as activities of great academic interest. CONCLUSION: This study underscores the potential of digital platforms like WhatsApp in supplementing CME in India and potentially other comparable settings. The blend of digital and traditional resources suggests a balanced learning approach. While real-time engagement is a strength, challenges like information overload and privacy concerns require careful management. Striking a balance is crucial for ensuring content quality, structured discussions and privacy. As the digital age advances, professionals must critically assess shared information on these platforms to guarantee evidence-based and reliable knowledge dissemination. TRIAL REGISTRATION: ARK 001.

Adapting to new challenges in medical education: a three-step digitization approach for blended learning.

This research work focuses on evaluating the development of our three-step digitization approach, designed to transform traditional lectures into engaging digital learning experiences. Aimed at offering an easy-to-use solution for educators, this approach addresses the pressing challenges of modern educational environments by enhancing accessibility, engagement, and effectiveness of learning through digital means.Quantitative analysis demonstrated a notable increase in knowledge gain for students engaged with the digital format (t(230) = -2.795, p = 0.006) over traditional methods. Additionally, it was observed that the online setting significantly improved concentration levels (t(230) = -5.801, p < .001) and reduced distractions (t(230) = 2.848, p = 0.005). Emotional assessments, based on the Achievement Emotions Questionnaire (AEQ), indicated an elevation in enjoyment (t(230) = -4.717, p < .001) and a reduction in anxiety (t(230) = 9.446, p < .001) within the digital learning environment. A substantial preference for the digital course format was expressed by 61.0% of participants, with 71.4% acknowledging its superior efficiency compared to 14.3% for traditional lectures.Qualitative feedback underscored the digital format's flexibility, comprehensive learning experience, and immediate feedback as key benefits. Nevertheless, nuances such as a preferred understanding in face-to-face interactions and the absence of a social component in digital settings were noted.To conclude, the findings from this study illuminate the significant advantages of the three-step digitization approach in meeting contemporary educational challenges. By facilitating an enhanced knowledge acquisition and fostering a supportive emotional climate, this approach signifies a promising direction for the future of medical education and beyond, fusing the convenience of digital solutions with the depth and engagement of traditional learning methodologies.

Surface and deep learning: a blended learning approach in preclinical years of medical school.

BACKGROUND: Significant challenges are arising around how to best enable peer communities, broaden educational reach, and innovate in pedagogy. While digital education can address these challenges, digital elements alone do not guarantee effective learning. This study reports a blended learning approach integrating online and face-to-face components, guided by the Student Approaches to Learning framework. METHODS: This study was carried out investigating learning in first and second year medical students over two academic years, 2019/20 and 2020/21. We evaluated: (1) comparison of students engaged with blended learning and traditional learning; and (2) student learning engaged with blended learning approach over a two-year preclinical curriculum. A revised two-factor study process questionnaire (R-SPQ-2F) evaluated students' surface/deep learning before and after an academic year. Learning experience (LE) questionnaire was administered over the domains of learning engagement, and outcomes of learning approach. In-depth interviews were carried out to understand the context of students' responses to the R-SPQ-2F and LE questionnaires. RESULTS: The R-SPQ-2F analysis indicated first year students maintained deep learning but second year students became neutral across the academic year, regardless of learning approach, with workload contributing to this outcome. R-SPQ-2F sub-scales showed that students engaged with blended learning maintained an intrinsic interest to learning, as compared to traditional learning which led to surface learning motives. The LE questionnaire showed students engaged with blended learning had deeper subject interest, and more positive perceptions of workload, feedback, and effectively developed skills and knowledge. However, peer interactions from blended learning were significantly lacking. In-depth interviews revealed that the flexibility and multi-modality of blended learning enabled learning, but the best use of these features require teacher support. Online interactions could be cultivated through intentional institutional efforts. CONCLUSIONS: This study highlights the importance of designing blended learning that leverages technology-enabled flexibility while prioritising collaborative, learner-centred spaces for deep engagement and knowledge construction.

A Novel Digital Educational Strategy Improves Treatment Adherence and Quality of Life in Patients with Multiple Myeloma.

Multiple myeloma, the second most common hematologic malignancy worldwide, is an aggressive disease with high morbidity and mortality rates. Although myeloma remains incurable, new treatments have improved patients' life expectancy and quality of life. However, as these therapies are administered for prolonged and often indefinite periods, their success depends on high treatment adherence and significant patient engagement. This study aimed to evaluate the impact of a novel digital educational strategy on treatment adherence, quality of life, and the development of complications in patients with newly diagnosed myeloma. To this end, a two-arm, randomized, prospective, double-blind study was conducted to compare the conventional educational approach alone or combined with the novel digital strategy. This strategy was based on some principles of the Persuasive Systems Design model and incorporated the educational recommendations of patients and caregivers. Compared to the control group that only received information through the conventional educational approach, patients randomized to the digital strategy showed significantly higher treatment adherence and quality of life, associated with increased functionality and rapid reincorporation into daily routines. The digital strategy empowered patients and caregivers to understand the disease and therapeutic options and helped patients recall treatment information and implement healthy lifestyle habits. These results support that patient-targeted educational strategies can positively influence treatment adherence and thus improve their quality of life.

Digital learning in nursing education: lessons from the COVID-19 lockdown.

BACKGROUND: The COVID-19 pandemic necessitated a swift transition to e-learning, significantly impacting nursing education due to its reliance on practical, hands-on experiences and the critical role nurses play in healthcare. Nursing students need to achieve high levels of clinical competence through experiences traditionally obtained in clinical settings, which e-learning had to replicate or supplement. Understanding the unique challenges faced by nursing students in e-learning environments is crucial for developing educational strategies that enhance learning outcomes and contribute to improved patient care. This study aimed to explore the experiences of nursing students and newly qualified nurses (as students) with e-learning during the COVID-19 lockdown, focusing on how it influenced their learning and professional development. METHOD: This exploratory and descriptive study employed qualitative interviews with 31 participants, including full-time nursing students, part-time nursing students, and newly qualified nurses (as nursing students). Conducted online via Zoom during February and March 2022. RESULTS: The findings suggest that integrating small group interactions and employing strategic pedagogical support can enhance e-learning effectiveness. However, barriers such as technological difficulties, psychological challenges, and social isolation were also identified. Understanding these unique opportunities and challenges can help educational institutions optimize e-learning strategies, ensuring nursing students are well-prepared for their crucial roles in healthcare. CONCLUSION: The rapid shift to e-learning due to the COVID-19 pandemic presented challenges such as technological, psychological and social aspects, but also opportunities to rethink and enhance nursing education delivery. Implementing appropriate pedagogical e-learning strategies, such as scaffolding and small group learning, can better prepare nursing students for their essential roles in healthcare. This study contributes to the body of knowledge on digital education and provides a foundation for future research aimed at optimizing e-learning in nursing education.

Digital Education for the Deployment of Artificial Intelligence in Health Care.

Artificial Intelligence (AI) represents a significant milestone in health care's digital transformation. However, traditional health care education and training often lack digital competencies. To promote safe and effective AI implementation, health care professionals must acquire basic knowledge of machine learning and neural networks, critical evaluation of data sets, integration within clinical workflows, bias control, and human-machine interaction in clinical settings. Additionally, they should understand the legal and ethical aspects of digital health care and the impact of AI adoption. Misconceptions and fears about AI systems could jeopardize its real-life implementation. However, there are multiple barriers to promoting electronic health literacy, including time constraints, overburdened curricula, and the shortage of capacitated professionals. To overcome these challenges, partnerships among developers, professional societies, and academia are essential. Integrating specialists from different backgrounds, including data specialists, lawyers, and social scientists, can significantly contribute to combating digital illiteracy and promoting safe AI implementation in health care.

Digital education for health professionals in India: a scoping review of the research.

BACKGROUND: The World Health Organization (WHO) predicts a global shortfall of 18 million health workers by 2030, particularly in low- and middle-income countries like India. The country faces challenges such as inadequate numbers of health professionals, poor quality of personnel, and outdated teaching styles. Digital education may address some of these issues, but there is limited research on what approaches work best in the Indian context. This paper conducts a scoping review of published empirical research related to digital health professions education in India to understand strengths, weaknesses, gaps, and future research opportunities. METHODS: We searched four databases using a three-element search string with terms related to digital education, health professions, and India. Data was extracted from 36 included studies that reported on empirical research into digital educational innovations in the formal health professions education system of India. Data were analysed thematically. RESULTS: Most study rationales related to challenges facing the Indian health care system, rather than a wish to better understand phenomena related to teaching and learning. Similarly, most studies can be described as general evaluations of digital educational innovations, rather than educational research per se. They mostly explored questions related to student perception and intervention effectiveness, typically in the form of quantitative analysis of survey data or pre- and post-test results. CONCLUSIONS: The analysis revealed valuable insights into India-specific needs and challenges. The Indian health professions education system's size and unique challenges present opportunities for more nuanced, context-specific investigations and contributions to the wider digital education field. This, however, would require a broadening of methodological approaches, in particular rigorous qualitative designs, and a focus on addressing research-worthy educational phenomena.

Learners' characteristics and the mastery of digital education during the COVID-19 pandemic in students of a medical faculty in Germany.

BACKGROUND: In response to the spread of the coronavirus, educational institutions have been closed and digital education has become a new teaching method to ensure the continuity of medical education. Since this format was a new form of learning for students at medical faculties in Germany, little is known about the perception of it and the factors that contribute to successful mastery. The current study aimed to analyze students' learning experiences during the first online semester and to identify associations between learners' characteristics and enjoyment, mastery experiences, as well as the perceived stress level. METHODS: In this cross-sectional study, students of a medical faculty from Germany answered an online questionnaire including information about perceptions towards digital education and learners' characteristics (study skills and dispositions). Data were analyzed using multivariate linear regression analysis. RESULTS: In total, 383 students responded to the online survey. A majority of students felt at least somewhat worse about their studies compared to before the pandemic. Success of study tasks was related to preferences for cooperative learning (B = - 0.063, p < .001) and success of study organization was associated to the use of metacognitive learning strategies (B = 0.019, p = .04). Enjoyment of studying in times of digital education was positively related to the use of metacognitive strategies (B = 0.049, p = .04) and self-efficacy (B = 0.111, p = .02). The perceived stress was influenced by cognitive strategies (B = 0.401, p = .02) and test anxiety (B = 0.466, p < .001). CONCLUSIONS: Although students perceive digital teaching as a good alternative for big courses, those with low self-efficacy beliefs and low self-regulation have problems in coping with the demands of this learning format and need further support.

Technology-Enhanced Learning in the Education of Oncology Medical Professionals: A Systematic Literature Review.

As cancer continues to be a significant global health challenge, the education of oncology professionals plays a crucial role in providing quality cancer care and achieving optimal patient outcomes. In order to meet the growing need for flexible, accessible, and effective training, this study examines the role of technology-enhanced learning (TEL) in the education of oncology medical professionals. Following the PRISMA guidelines, this systematic review included 34 articles published between 2012 and 2022 in EBSCO and PubMed databases. Findings reveal a diverse range of digital tools being used in oncology training, despite a shortage of advanced educational technologies and limited functional improvement compared to traditional instruction. Since the training primarily targeted at multiple professions in the medical expert role, with radiation oncologists being overrepresented, other oncology domains should be examined more thoroughly in the future, taking into account distinct professional abilities, e.g. communication, collaboration, and leadership skills with reference to the CanMEDS framework. Although the training programmes generally resulted in positive outcomes according to the Kirkpatrick evaluation model, experimental research designs were rather limited. Therefore, the substantial contribution and limitations of TEL in oncology education need to be clarified. Precise reporting of digital tools and instructional processes, as well as challenges encountered, is highly recommended to increase transparency and replicability. Research methodology in digital oncology education remains a major concern and should be addressed accordingly in future research.

Animated video development COVID-19 prevention and management for anxiety among older adults in Indonesia.

BACKGROUND: Rapid increase in information on coronavirus disease (COVID-19) has led to an infodemic that exposes older adults to a greater risk of anxiety. AIMS: To develop an animated educational video for COVID-19 prevention and management and evaluate its feasibility and preliminary effectiveness in improving knowledge and anxiety levels among older adults. METHODS: A pilot test of feasibility and preliminary effectiveness was conducted in three phases: expert agreement, content validation, and video creation. An intervention group received an animated educational video, whereas a control group received an educational leaflet. A total of 126 respondents were recruited from 15 community health centers in Indonesia. RESULTS: Results showed that knowledge of intervention group respondents about COVID-19 misinformation improved, and anxiety levels significantly decreased after watching the video compared to the control group (p<0.001). CONCLUSIONS: The animated educational video on COVID-19 prevention and management based on Indonesian preferences successfully improved knowledge and reduced anxiety levels among older adults.

Developing a personalised, evidence-based and inclusive learning (PEBIL) model of blended learning: A cross-sectional survey.

Whilst the use of various blended learning models preceded the COVID-19 pandemic, the abrupt shift to remote delivery served as catalyst within the sector in enhancing digital solutions to meet immediate student needs. As we emerge from the pandemic, a return to purely didactic and impersonal in-person teaching seems anticlimactic, with the return to the lecture theatre seeing many lecturers trialling various digital tools in creating more interactive in-person, synchronous, and asynchronous sessions. In evaluating students' experiences of the various tools and approaches applied by academic staff, a survey was developed by a multidisciplinary team of educators at Cardiff University's School of Medicine exploring student perceptions of e-learning resources (ELRs), as well as student experiences of various blended learning approaches. The primary aim of this study was to evaluate student experience, satisfaction, and engagement with ELRs and blended learning. A total of 179 students (undergraduate and postgraduate) completed the survey. 97% confirmed that e-learning resources were blended within the teaching they received, with 77% rating the quality of e-learning as good-to-excellent and 66% reporting a preference for asynchronous resources that enable them to learn at their own pace. A variety of platforms, tools, and approaches were identified by students as meeting their diverse learning needs. We therefore propose a personalised, evidence-based and inclusive learning (PEBIL) model enabling the application of digital technologies both on and offline.

Modelling the sustainability of a primary school digital education curricular reform and professional development program.

Sustaining changes in teachers' practices is a challenge that determines the success of curricular reforms, from which Digital Education (DE) is not exempt. As the literature on sustainability is considered "scarce" and "scattered", long-term studies modelling the factors impacting teachers' sustained uptake of DE pedagogical content are lacking. Thus, we investigate whether and how 287 in-service teachers sustained a primary school DE curricular reform over a year after they completed their two-year DE professional development program. We model the sustainability of the reform through Structural Equation Modelling, and identify critical sustainability-factors. The validated Sustainable Adoption of Digital Education (SADE) model confirms that sustainability in the fourth year of the reform depends on perceived usefulness of teaching the new content, ease of implementation, and access to sufficient support in schools. Such factors should thus be evaluated, accounted for in the implementation phase of the reform, and sustained over time. The findings confirm that the DE curricular reform model contributes to positive self-efficacy to teach DE, provides sufficient in-school support, and promotes increasing adoption over time. However, as teachers' practices have not yet stabilised, and teachers may still adopt more to cover the breadth of DE-concepts, it is important to remain attentive to remaining sustainability barriers: lack of time, effort required to teach DE with teachers preferring to delegate, and lack of student-learning evidence, the latter being a significant challenge to address in the literature. These barriers must therefore be jointly addressed by researchers and practitioners in the field in order to promote the sustainability of the reform.

Assessing teachers' digital competence in primary and secondary education: Applying a new instrument to integrate pedagogical and professional elements for digital education.

Teachers' digital competence (DC) is an important condition for the effective application of technology in education. Although several DC tools have been designed, adjustments to digital education and pedagogical or professional components are still scarce. Therefore, this study aims at developing a new instrument for assessing teachers' DC regarding their pedagogical and professional activities in the context of digital school and digital education. The study also examines the teachers' total DC scores and explores the differences between teacher profiles on a sample of 845 teachers in primary and secondary education in Greece. The final instrument comprises 20 items allocated in six components: 1) Teaching preparation; 2) Teaching delivery & students' support; 3) Teaching evaluation & revision; 4) Professional development; 5) School's development; and 6) Innovating education. The PLS-SEM analysis indicated the validity and reliability of the model in respect to its factorial structure, internal consistency, convergence validity, and model fitness. The results revealed DC inefficiency among teachers in Greece. Primary school teachers reported significantly lower scores in Professional development and Teaching delivery & students support. Female teachers reported significantly lower scores in Innovating education and School's development, but they reported higher scores in Professional development. The contribution and practical implications are discussed in the paper.

A qualitative analysis of publicly available Standards and Guidance about Digital Literacies in U.S. States.

Before the COVID-19 pandemic, schools had been adopting digital instruction in many parts of the world. The concept of digital literacies has also been evolving in complexity alongside the digital technologies that support it. However, little is known about what guidance available to support various levels of government in supporting digital literacies alongside digital instruction in local schools. The purpose of this study was to determine what guidance for digital literacies U.S. state departments of education had made available through their websites to local schools just prior to the onset of the pandemic. Using qualitative content analysis techniques, digital literacies guidance information was located on U.S. state departments of education websites and analyzed. Most states did not indicate that they used guidance from professional organizations about digital literacies. The 16 states that did have guidance used standards from the International Society for Technology in Education (ISTE), which have not been positioned by the organization as digital literacies standards, but instead reflect traditional understandings of Information Computing Technology (ICT). Implications of this study highlight potential strategies educational ministries might use to acknowledge and support digital literacies.

Digital approach to informed consent in bariatric surgery: a randomized controlled trial.

BACKGROUND: Informed consent is of paramount importance in surgery. Digital media can be used to enhance patient's comprehension of the proposed operation. The objective of this study was to examine the effects of adding a digital educational platform (DEP) to a standard verbal consent (SVC) for a laparoscopic Roux-en-Y gastric bypass (LRYGB) on patient's knowledge of the procedure, satisfaction with the clinical encounter and duration of the consent appointment. METHODS: This prospective non-blinded randomized controlled trial allocated 51 patients, who were candidates for a LRYGB, into DEP+SVC (intervention, n = 26) or SVC (control, n = 25) groups. Data were collected at one Bariatric Centre of Excellence (Ontario, Canada) between December 2018 and December 2019. DEP consisted of a 29-slide video-supplemented module detailing the risks, benefits, expectations and outcomes for the LRYGB. Primary outcome was knowledge about the LRYGB operation following the consent discussion. Secondary outcomes were knowledge retention, patient satisfaction, and duration of time required to obtain an informed consent. RESULTS: Baseline demographic data were equivalent between groups except for a greater proportion of male patients in the DEP+SVC group (7/19 vs 0/25; p < 0.01). Baseline procedure-specific knowledge was equivalent between the groups (72.3 ± 11.3% vs 74.7 ± 9.6%; p = 0.41). Post-consent knowledge was significantly higher in the DEP + SVC vs SVC group (85.0 ± 8.8% vs 78.7 ± 8.7%; p = 0.01; ES = 0.72). The duration of time to obtain informed consent was significantly shorter for the DEP + SVC vs SVC group (358 ± 198 sec vs 751 ± 212 sec; p < 0.01; ES = 1.92). There was no difference in knowledge retention at 4-6 weeks (84.4 ± 10.2% vs 82.9 ± 6.8%; p = 0.55) and in patient satisfaction (31.5 ± 1.1 vs 31 ± 2.7; p = 0.10). CONCLUSION: The addition of a DEP online module to a standard verbal consent for LRYGB resulted in improved patient's understanding of the procedure-specific risks and benefits, high patient satisfaction, and over 50% time savings for the bariatric surgeon conducting the consent discussion.