Vernon Curran

Background A study at Xavier University School of Medicine introduced an integrated-shared teaching model to address the challenges of medical education. This new approach combines physiology, biochemistry, and pathology into single, organ-system-based sessions, aiming to reduce content redundancy and promote a holistic understanding. This integrated model uses cognitive learning theory to improve retention. By linking subjects like physiology and pathology, it helps students form interconnected mental frameworks called schemata. This reduces cognitive load, moving beyond simple memorization to a deeper, more meaningful understanding that's easier to apply in clinical practice. MethodsThe study included 73 medical students across two cohorts (first-year MD3 and second-year MD5). It used a one-group pretest-posttest design with clinical vignette questionnaires. In addition to the integrated lectures, students participated in interactive in-class assignments, like one-line answers and flowcharts, to encourage real-time engagement and provide formative feedback. ResultsThe results showed significant improvement in learning outcomes for both groups. The first-year MD3 students’ average scores rose from 5.19 to 7.40, while the second-year MD5 students' scores increased from 2.73 to 4.87. Both results were statistically significant (p-value<0.001). In-class activity scores, which averaged 4.45 for MD3 and 3.82 for MD5, confirmed high levels of student engagement and participation. Conclusions In conclusion, this integrated-shared teaching model, when combined with in-class assessments, demonstrably improves knowledge acquisition and retention in basic science medical education. By fostering interdisciplinary connections and reducing cognitive load, this method helps cultivate the critical thinking skills essential for future medical professionals.

Background: 360° video and virtual reality (VR) simulation may offer innovative opportunities as portable simulation-based technologies to enhance Neonatal Resuscitation Program (NRP) training, updates, and refreshers. The purpose of this study was to compare the use of 360° video with VR simulation in NRP training and the effect on NRP learning outcomes. Methods: Thirty (N = 30) NRP providers were randomly assigned to either VR simulation or 360° video study groups (n = 15 each) with pre and posttests of confidence, posttests of user satisfaction, usefulness, presence, and simulator sickness, and a performance demonstration of positive pressure ventilation (PPV) on a manikin-simulator. Participants were then exposed to the other condition and again post-tested. Results: Both systems were positively viewed. However, participants reported significantly higher perceptions of usefulness in enhancing learning and increased sense of presence with the VR simulation. VR simulation participants gained more confidence in certain NRP skills, such as proper mask placement (adjusted p-value 0.038) and newborn response evaluation (adjusted p-value 0.017). A blinded assessment of PPV skills showed participants exposed to VR performed significantly better in providing effective PPV (adjusted p-value 0.005). Conclusions: NRP providers found both systems useful; however, VR simulation was more helpful in improving learning performance and enhancing learning. Participants reported an increased feeling of presence and confidence in certain areas with VR and performed better on a crucial NRP skill, providing effective PPV. VR technologies may offer an alternative modality for increasing access to standardized and portable refresher learning opportunities on NRP.

Objectives: Virtual reality (VR) offers the potential to provide a lifelike, safe, and interactive environment where healthcare providers can practice and refresh their skills. The Neonatal Resuscitation Program (NRP) is an evidence-based and standardized approach for training healthcare providers on the resuscitation of the newborn where VR can be applied. Here we describe a development study for a VR-NRP simulation. This contribution is relevant for researchers and developers in the health sector interested in the integration of VR and other extended reality (XR) technologies in medical education and training. Methods: For the implementation of the VR simulation, we used the Unity game engine, a VR-capable laptop, and an HTC Vive Pro Head-Mounted Display. We focused on the skill of positive pressure ventilation (PPV) using a bag and mask as the main scenario for the simulation since this is a foundational skill in NRP. To validate the prototype, we compared the VR-NRP simulation with 360° immersive VR videos in a crossover study involving 30 health-care providers and students, collecting various data through questionnaires and skill assessments by NRP instructors. Results: We described in detail the creation process by which a highly realistic VR simulation was produced reflecting the visual elements and sounds of a Neonatal Intensive Care Unit in a hospital setting. In the crossover study, we found both VR technologies were positively viewed by healthcare professionals and performed very similarly. However, the VR simulation provided a significantly increased feeling of presence. Participants found the VR simulation more useful and reported higher confidence in NRP skills such as proper mask placement and newborn response evaluation, reflecting improved experiential learning outcomes. Conclusion: This research represents a step forward in understanding how VR technologies can be developed and applied for effective, immersive medical training, increasing the availability of NRP refresher sessions, and providing insights into similar applications.

Virtual care appointments expanded rapidly during COVID-19 out of necessity and to enable access and continuity of care for many patients. While previous work has explored health care providers’ experiences with telehealth usage on small-scale projects, the broad-level adoption of virtual care during the pandemic has expounded opportunities for a better understanding of how to enhance the integration of telehealth as a regular mode of health care services delivery. Training and education for health care providers on the effective use of virtual care technologies are factors that can help facilitate improved adoption and use. We describe our approach to designing and developing an accredited continuing professional development (CPD) program using e-learning technologies to foster better knowledge and comfort among health care providers with the use of virtual care technologies. First, we discuss our approach to undertaking a systematic needs assessment study using a survey questionnaire of providers, key informant interviews, and a patient focus group. Next, we describe our steps in consulting with key stakeholder groups in the health system and arranging committees to inform the design of the program and address accreditation requirements. The instructional design features and aspects of the e-learning module are then described in depth, and our plan for evaluating the program is shared as well. As a CPD modality, e-learning offers the opportunity to enhance access to timely continuing professional education for health care providers who may be geographically dispersed across rural and remote communities.

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.

UNSTRUCTURED Virtual care appointments expanded rapidly during COVID-19 out of necessity and to enable access and continuity of care for many patients. While previous work has explored healthcare providers’ experiences with telehealth usage on small-scale projects, the broad level adoption of virtual care during the pandemic has expounded opportunities for better understanding how to enhance integration of telehealth as a regular mode of healthcare services delivery. Training and education for healthcare providers on effective use of virtual care technologies is one factor that can help facilitate improved adoption and use. We describe our approach to designing and developing an accredited continuing professional development (CPD) program using e-learning technologies to foster better knowledge and comfort amongst healthcare providers with the use of virtual care technologies. First, we discuss our approach in undertaking a systematic needs assessment study using a survey-questionnaire of providers and key informant interviews. Next, we describe our steps in consulting with key stakeholder groups in the health system and arranging committees to inform the design of the program and address accreditation requirements. The instructional design features and aspects of the e-learning module are then described in-depth and our plan for evaluating the program is shared as well. As a CPD modality, e-learning offers the opportunity to enhance access to timely continuing professional education for healthcare providers who may be geographically dispersed across rural and remote communities, and at times convenient for them to learn.

Objective: Extended reality (XR) has emerged as an innovative educational modality that offers the potential for the creation of more interactive and engaging forms of patient education experiences and products. The purpose of this article is to describe the field of XR technologies and review its potential through a critical lens as well as its possible adoption as a mainstream technology for providing patient education in the future. Method: A review of the literature was undertaken to summarise the emerging evidence concerning the effectiveness of XR as a patient education modality. The findings of several reviews are summarised and a critical discussion of potential issues and challenges in the adoption and use of XR among particular marginalised populations are explored. Results: The emerging evidence suggests that different forms of XR technology applications have the potential to create immersive and engaging patient education experiences that can lead to enhanced patient satisfaction, positive educational outcomes and reduced patient anxiety. Nonetheless, there have been calls for greater consideration of how patient characteristics, including socioeconomic status, gender, cultural and generational differences, influence the learning effects of virtual reality educational applications, as well as its adoption and implementation for patient education purposes. Conclusion: The evidence surrounding the effectiveness of XR in patient education is growing; however, various factors could influence the successful adoption and implementation of XR in different patient populations who have traditionally experienced challenges with digital health literacy. The paper offers some recommendations for enhancing the evidence base and potential approaches to advance the design and evaluation of XR applications in patient education.

Background: Virtual care has expanded during the COVID-19 pandemic and enabled greater access and continuity of care for many patients. From a patient-oriented research perspective, understanding the patient experience with virtual care appointments is an important first step in identifying ways to better support patient use and satisfaction. Objective: The purpose of this qualitative study was (1) to explore patients’ experiences and perspectives with the adoption and use of virtual care during COVID-19 in Newfoundland and Labrador, Canada, and (2) identify the education and informational needs of patients to inform future strategies for supporting patient use of virtual care. Methods: Using a phenomenological approach, we conducted a focus group interview with a purposive sample of patient representatives representing a cross-section of the population of the province of Newfoundland and Labrador. Five patient representatives were recruited from the Newfoundland and Labrador Support Patient Advisory Council and participated in the focus group. The focus group was conducted in February 2022 via videoconferencing technology. Using thematic analysis, we identified several recurrent themes that described respondents’ experiences with the use of virtual care during COVID-19, as well as their perceptions of education and informational needs to support more effective patient use of virtual care. Results: Respondents felt that virtual care is a beneficial addition to the health care system, enabling greater convenience and access to health care services. Key barriers and challenges in adopting and using virtual care appear to primarily arise from patients’ lack of knowledge, understanding, and familiarity with respect to virtual care. Cost, technological access, connectivity, and low digital literacy were challenges for some patients, particularly in rural communities and among older patient population. Patient education and support were critical and needed to be inclusive, easy to understand, and include information regarding privacy, security, consent, and the technology itself. The types of patient education experiences regarded as most helpful included peer support and knowledge sharing among patients themselves. Conclusions: Beyond the COVID-19 pandemic, virtual care will have a continuing role in enhancing the continuity of care for patients through more convenient access. The education and informational needs of patients are important considerations in promoting the adoption and use of virtual care. Key education and informational needs and strategies were identified to enable and empower patients with the knowledge, digital literacy skills, and support to effectively use virtual care.

Introduction: Virtual care has expanded during COVID-19 and enabled continued access to healthcare services. For many healthcare providers, the adoption of virtual care has been a new experience in the provision of healthcare services. The purpose of this survey study was to explore healthcare providers' experiences with virtual care during COVID-19.Methods: A web-based survey-questionnaire was developed by applying Rogers' theory of diffusion of innovation and distributed to healthcare providers (physicians, nurses and allied health professionals) in Newfoundland and Labrador, Canada to explore virtual care experiences, satisfaction and continuing professional development (CPD) needs. Analyses included descriptive statistics and thematic analysis of survey responses.Results: Fifty-one percent of respondents (n = 432) indicated they were currently offering virtual care and a majority (68.9%) reported it has improved their work experience. Telephone appointments were preferred over videoconferencing by respondents, with key challenges including the inability to conduct a physical exam, patients' cell phone services being unreliable and patients knowing how to use videoconferencing. Majority of respondents (57.5%) reported quality of care by telephone was lower than in-person, whereas quality of care by videoconferencing was equivalent to in-person. Main benefits of virtual care included increased patient access, ability to work from home, and reduction in no-show appointments. Key supports for adopting virtual care included in-house organizational supports (e.g., technical support staff), local colleague support, and technology training. Important topics for virtual care CPD included complying with regulatory standards/rules, understanding privacy or ethical boundaries, and developing competency and digital professionalism while engaging in virtual care.Discussion: Beyond the COVID-19 pandemic, virtual care will have a continuing role in enhancing continuity of care through access that is more convenient. Survey findings reveal a number of opportunities for supporting healthcare providers in use of virtual care, including CPD, guidelines and resources to support adaptation to virtual care provision (e.g., virtual examinations/assessments), as well as patient educational support.

Introduction: Virtual care has expanded during COVID-19 and enabled continued access to healthcare services. As with the introduction of any new technology in healthcare delivery, the preparation of healthcare providers for adopting and using such systems is imperative. The purpose of this qualitative study was to explore experts’ ascribed opinions on healthcare providers’ continuing professional development (CPD) needs in virtual care. Methods: Semistructured interviews were conducted with a purposive sample of key informants representing Canadian provincial and national organizations with expertise in virtual care delivery. Results: Three main areas of knowledge, skills, and abilities that would be most helpful for healthcare providers in preparing to adopt and use virtual care were identified. The use of technology necessitates knowledge of how to integrate technology and virtual care in the practice workflow. This includes knowing how to use the technology and the privacy and security of the technology. Providers need to be able to adapt their clinical skills to virtual care and build rapport through good communication with patients. Virtual care is not appropriate for all visits, therefore providers need to understand when an in-person visit is necessary with respect to the nature of the appointment, as well as contextual factors for individual patients. Finally, providers need to adapt their examination skills to virtual care. Discussion: Beyond the COVID-19 pandemic, virtual care will have a continuing role in enhancing continuity of care through access that is more convenient. Key informants identified barriers and challenges in adopting and using virtual care effectively, fundamental knowledge, skills and/or abilities required, and important topics and/or educational experiences to guide CPD program development on virtual care for healthcare providers.