Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Microlearning, the acquisition of knowledge or skills in the form of small units, is endorsed by health professions educators as a means of facilitating student learning, training, and continuing education, but it is difficult to define in terms of its features and outcomes. Objective: The goal of this review was to conduct a systematic search of the literature on microlearning in health professions education to identify key concepts, characterize microlearning as an educational strategy, and evaluate pedagogical outcomes experienced by health professions students. Methods: A scoping review was performed in 2018 using the bibliographic databases PubMed (MEDLINE), CINAHL, Education Resources Information Center, Embase, PsycINFO, Education Full Text (H.W. Wilson), and ProQuest Dissertations & Theses Global. A combination of keywords and subject headings related to microlearning, e-learning, or just-in-time learning combined with health professions education were used. No date limits were placed on the search, but inclusion was limited to materials published in English. Pedagogical outcomes were evaluated on the basis of the four-level Kirkpatrick’s model. Results: A total of 3,096 references were retrieved, of which 17 articles were selected after applying the inclusion and exclusion criteria. Articles that met the criteria were published between 2011 and 2018, and their authors were from a range of countries including the United States, China, India, Australia, Canada, Iran, Netherlands, Taiwan, and the United Kingdom. The 17 studies reviewed included various health-related disciplines, such as medicine, nursing, pharmacy, dentistry, and allied health. While microlearning appeared in a variety of subject areas, different technologies, such as podcast, short messaging service, microblogging, and social networking service, were also used. Based on Buchem and Hamelmann’s 10 microlearning concepts, each study satisfied at least 40% of the characteristics while all studies featured concepts of maximum time spent less than 15 minutes as well as content aggregation. According to our assessment of each article using the Kirkpatrick's model, 16 (94%) assessed student reactions to the microlearning (level 1); 14 (82%) evaluated knowledge or skill acquisition (level 2); 5 (29%) measured the effect of the microlearning on student behavior (level 3), and no studies were found at the highest level. Conclusions: Microlearning as an educational strategy has demonstrated a positive effect on the knowledge and confidence of health professions students in performing procedures, retaining medication knowledge, studying, and engaging in collaborative learning. However, downsides to microlearning include pedagogical discomfort, technology inequalities, and privacy concerns. Future research should look at higher-level outcomes including benefits to patients or practice changes. The findings of this scoping review will inform education researchers, faculty, and academic administrators on the application of microlearning, pinpoint gaps in the literature, and help identify opportunities for instructional designers and subject matter experts to improve course content in didactic and clinical settings.

This study was conducted to identify and compare the effects of two education programs for infection control―a simulation using standardized patients and a peer role-play―on standard precaution knowledge, standard precaution awareness, infection-related anxiety, and infection control performance. This study used a nonequivalent control group pretest-posttest design. A total of 62 undergraduate nursing students in their 3rd year participated in the study, and were assigned to the experimental and control groups, accordingly. The infection control education program was developed based on the analysis, design, development, implementation, and evaluation model. The program for the experimental group included lectures, skills training, simulation using standardized patients, and debriefing, while the control group participated in the usual infection control education, consisting of lectures, skills training, and peer tutoring practices. Both groups exhibited statistically significant increases in knowledge, awareness of standard precaution, and infection control performance after the intervention. Infection-related anxiety and infection control performance were significantly higher in the simulation using a standardized patient group. Both education programs influenced compliance with the standard precaution for infection control. The results of this study contribute to the evidence regarding effective educational methods to improve infection control.

The integration of artificial intelligence such as ChatGPT into educational frameworks marks a pivotal transformation in teaching. This quasi-experimental study, conducted in September 2023, aimed to evaluate the effects of artificial intelligence–assisted learning on nursing students' ethical decision-making and clinical reasoning. A total of 99 nursing students enrolled in a pediatric nursing course were randomly divided into two groups: an experimental group that utilized ChatGPT and a control group that used traditional textbooks. The Mann-Whitney U test was employed to assess differences between the groups in two primary outcomes: (a) ethical standards, focusing on the understanding and applying ethical principles, and (b) nursing processes, emphasizing critical thinking skills and integrating evidence-based knowledge. The control group outperformed the experimental group in ethical standards and demonstrated better clinical reasoning in nursing processes. Reflective essays revealed that the experimental group reported lower reliability but higher time efficiency. Despite artificial intelligence's ability to offer diverse perspectives, the findings highlight that educators must supplement artificial intelligence technology with strategies that enhance critical thinking, careful data selection, and source verification. This study suggests a hybrid educational approach combining artificial intelligence with traditional learning methods to bolster nursing students' decision-making processes and clinical reasoning skills.

Objectives: We constructed a model explaining families’ positive adaptation in chronic crisis situations such as the problematic behavior of elderly patients with dementia and attendant caregiving stress, based on the family resilience model. Our aim was to devise an adaptation model for families of elderly patients with dementia. Method: A survey of problematic behavior in elderly patients with dementia, family stress, family resilience, and family adaptation was conducted with 292 consenting individuals. The collected data were analyzed using structural equation modeling. Results: The communication process, family stress, and problematic behavior of elderly patients with dementia had direct and indirect effects on family adaptation, while belief system, organization pattern, and social support had indirect effects. Specifically, family stress and more severe problematic behavior by elderly patients with dementia negatively influenced family adaptation, while greater family resilience improved such adaptation. Conclusion: Interventions aiming to enhance family resilience, based on the results of this study, are required to help families with positive adaptation. Such family programs might involve practical support such as education on the characteristics of elderly persons with dementia and coping methods for their problematic behavior; forming self-help groups for families; revitalizing communication within families; and activating communication channels with experts.