Tim Tripp

Objective: Medical care for cancer is increasingly directed by genomic laboratory testing for alterations in the tumor genome that are significant for diagnosis, prognosis and therapy. Uniquely in medicine, providers must search the biomedical literature for each patient to determine the clinical significance of these alterations. Access to published scientific literature is frequently subject to high fees, with access limited to institutional subscriptions. We sought to investigate the degree to which the scientific literature is accessible to clinical cancer genomics providers, and the potential role of university and hospital system libraries in information access for cancer care. Methods: We identified 265 journals that were accessed during the interpretation and reporting of clinical test results from 1,842 cancer patients at the University Health Network (Toronto, Canada). We determined the degree of open access for this set of clinically important literature, and for any journals not available through open access we surveyed subscription access at seven academic hospital systems and at their affiliated universities. Results: This study found that nearly half (116/265) of journals have open access mandates that make articles freely available within one year of release. For the remaining subscription access journals, universities provided a uniformly high level of access, but access available through hospital system collections varied widely. Conclusion: This study highlights the importance of different modes of access to the use of the scientific literature in clinical practice and points to challenges that must be overcome as genomic medicine grows in scale and complexity.

Background: As the adoption of artificial intelligence (AI) in health care increases, it will become increasingly crucial to involve health care professionals (HCPs) in developing, validating, and implementing AI-enabled technologies. However, because of a lack of AI literacy, most HCPs are not adequately prepared for this revolution. This is a significant barrier to adopting and implementing AI that will affect patients. In addition, the limited existing AI education programs face barriers to development and implementation at various levels of medical education. Objective: With a view to informing future AI education programs for HCPs, this scoping review aims to provide an overview of the types of current or past AI education programs that pertains to the programs’ curricular content, modes of delivery, critical implementation factors for education delivery, and outcomes used to assess the programs’ effectiveness. Methods: After the creation of a search strategy and keyword searches, a 2-stage screening process was conducted by 2 independent reviewers to determine study eligibility. When consensus was not reached, the conflict was resolved by consulting a third reviewer. This process consisted of a title and abstract scan and a full-text review. The articles were included if they discussed an actual training program or educational intervention, or a potential training program or educational intervention and the desired content to be covered, focused on AI, and were designed or intended for HCPs (at any stage of their career). Results: Of the 10,094 unique citations scanned, 41 (0.41%) studies relevant to our eligibility criteria were identified. Among the 41 included studies, 10 (24%) described 13 unique programs and 31 (76%) discussed recommended curricular content. The curricular content of the unique programs ranged from AI use, AI interpretation, and cultivating skills to explain results derived from AI algorithms. The curricular topics were categorized into three main domains: cognitive, psychomotor, and affective. Conclusions: This review provides an overview of the current landscape of AI in medical education and highlights the skills and competencies required by HCPs to effectively use AI in enhancing the quality of care and optimizing patient outcomes. Future education efforts should focus on the development of regulatory strategies, a multidisciplinary approach to curriculum redesign, a competency-based curriculum, and patient-clinician interaction.

BACKGROUND As the adoption of artificial intelligence (AI) in health care increases, it will become increasingly crucial to involve health care professionals (HCPs) in developing, validating, and implementing AI-enabled technologies. However, because of a lack of AI literacy, most HCPs are not adequately prepared for this revolution. This is a significant barrier to adopting and implementing AI that will affect patients. In addition, the limited existing AI education programs face barriers to development and implementation at various levels of medical education. OBJECTIVE With a view to informing future AI education programs for HCPs, this scoping review aims to provide an overview of the types of current or past AI education programs that pertains to the programs’ curricular content, modes of delivery, critical implementation factors for education delivery, and outcomes used to assess the programs’ effectiveness. METHODS After the creation of a search strategy and keyword searches, a 2-stage screening process was conducted by 2 independent reviewers to determine study eligibility. When consensus was not reached, the conflict was resolved by consulting a third reviewer. This process consisted of a title and abstract scan and a full-text review. The articles were included if they discussed an actual training program or educational intervention, or a potential training program or educational intervention and the desired content to be covered, focused on AI, and were designed or intended for HCPs (at any stage of their career). RESULTS Of the 10,094 unique citations scanned, 41 (0.41%) studies relevant to our eligibility criteria were identified. Among the 41 included studies, 10 (24%) described 13 unique programs and 31 (76%) discussed recommended curricular content. The curricular content of the unique programs ranged from AI use, AI interpretation, and cultivating skills to explain results derived from AI algorithms. The curricular topics were categorized into three main domains: cognitive, psychomotor, and affective. CONCLUSIONS This review provides an overview of the current landscape of AI in medical education and highlights the skills and competencies required by HCPs to effectively use AI in enhancing the quality of care and optimizing patient outcomes. Future education efforts should focus on the development of regulatory strategies, a multidisciplinary approach to curriculum redesign, a competency-based curriculum, and patient-clinician interaction. CLINICALTRIAL

Background: To optimize their use of a new Health Information System (HIS), supporting health care providers require effective HIS education. Failure to provide this education can significantly hinder an organization’s HIS implementation and sustainability efforts. Objective: The aim of this review is to understand the most effective educational strategies and approaches to enable health care providers to optimally use an HIS. Methods: Ovid MEDLINE, Ovid Embase, EBSCO Cumulative Index to Nursing and Allied Health Literature, and EBSCO Education Resources Information Center were searched to identify relevant papers. Relevant studies were systematically reviewed and analyzed using a qualitative thematic analysis approach. Results: Of the 3539 studies screened, 17 were included for data extraction. The literature on the most effective approaches to enable health care providers to optimally use an HIS emphasized the importance of investing in engaging and understanding learners in the clinical context, maximizing the transfer of learning to care, and designing continuous and agile evaluation to meet the emerging demands of the clinical environment. Conclusions: This review supports the advancement of a new HIS learning framework that organizational leaders and educators can use to guide HIS education design and development. Future research should examine how this framework can be translated into practice.

BACKGROUND To optimize their use of a new Health Information System (HIS), supporting health care providers require effective HIS education. Failure to provide this education can significantly hinder an organization’s HIS implementation and sustainability efforts. OBJECTIVE The aim of this review is to understand the most effective educational strategies and approaches to enable health care providers to optimally use an HIS. METHODS Ovid MEDLINE, Ovid Embase, EBSCO Cumulative Index to Nursing and Allied Health Literature, and EBSCO Education Resources Information Center were searched to identify relevant papers. Relevant studies were systematically reviewed and analyzed using a qualitative thematic analysis approach. RESULTS Of the 3539 studies screened, 17 were included for data extraction. The literature on the most effective approaches to enable health care providers to optimally use an HIS emphasized the importance of investing in engaging and understanding learners in the clinical context, maximizing the transfer of learning to care, and designing continuous and agile evaluation to meet the emerging demands of the clinical environment. CONCLUSIONS This review supports the advancement of a new HIS learning framework that organizational leaders and educators can use to guide HIS education design and development. Future research should examine how this framework can be translated into practice.

Introduction: In response to increasing demand for library support, and problems observed in working with researchers new to knowledge syntheses, University Health Network (UHN) Library and Information Services designed and implemented a new Knowledge Synthesis (KS) Service model to meet the demand while providing an opportunity to educate researchers about KS methodological guidelines and reporting standards. Description: The new service model includes three tiers: consultation only, support for course work and dissertations, and full-service with librarian co-authorship. It is accompanied by more robust information on the library's website about synthesis methods. Outcomes: An inductive thematic analysis was performed on transcripts of interviews with the seven Information Specialists to determine their experience with the new service model. Eight themes emerged: workload, control/agency, communication, professional recognition, client knowledge, client attitudes/expectations, quality, and concern over buy-in. The new service model was generally well received. Discussion: UHN Libraries could not directly adopt existing tiered models without changes to account for students in the hospital working on syntheses for reasons other than coursework. Tiers based on those found in an environmental scan were adapted for clientele who perform multiple roles. The impact on researcher experience, publication rates, and Information Specialists' workload will be examined in the future when more data are available.

Introduction The notion of compassion and compassionate care is playing an increasingly important role in health professional education and in the delivery of high-quality healthcare. Digital contexts, however, are not considered in the conceptualisation of compassionate care, nor is there guidance on how compassionate care is to be exercised while using digital health technologies. The widespread diffusion of digital health technologies provides new contexts for compassionate care, with both opportunities for new forms and instantiations of compassion as well as new challenges. How compassion is both understood and enacted within this evolving, digital realm has not been synthesised. Methods and analysis This scoping review protocol follows Arksey and O’Malley’s methodology to examine dimensions of compassionate professional practice when digital technologies are integrated into clinical care. Relevant peer-reviewed literature will be identified using a search strategy developed by medical librarians, which applies to six databases of medical, computer and information systems disciplines. Eligibility of articles will be determined using the two-stage screening process consisting of (1) title and abstract scan, and (2) full-text review. Screening, abstracting and charting will be conducted by two independent reviewers, with a third reviewer available for resolution when consensus is not achieved. In order to look at the range of current research in this area, extracted data will be thematically analysed and validated by content experts. Descriptive statistics will be calculated where necessary. Ethics and dissemination Research ethics approval and consent to participate is not required for this scoping review. The results of the review will inform resource development and strategy for Associated Medical Services (AMS) Healthcare, a Canadian charitable organisation at the forefront of advancing research and leadership development in health and humanities, as part of the AMS Phoenix Project: A Call to Caring, particularly for digital professionalism frameworks so that they are inclusive of a compassion competency.

BACKGROUND: Although medication reconciliation (Med Rec) has demonstrated a reduction in potential adverse drug events, its effect on hospital readmissions remains inconclusive.OBJECTIVE: To evaluate the impact of an interprofessional Med Rec bundle from admission to discharge on patient emergency department visits and hospital readmissions (hospital visits).METHODS: The design was a retrospective, cohort study. Patients discharged from general internal medicine over a 57‐month interval were identified through administrative databases. Patients who received an enhanced, Gold level, Med Rec bundle (including both admission Med Rec and interprofessional pharmacist‐prescriber collaboration on discharge Med Rec) were assigned to the intervention group. Patients who received partial Med Rec services, Silver and Bronze level, comprised the control group. The primary outcome was hospital visits within 30 days of discharge.RESULTS: Over a 57‐month period, 9931 unique patient visits (n = 8678 patients) met the study criteria. The main analysis did not detect a difference in 30‐day hospital visits between the intervention (Gold level bundle) and control (21.25% vs 19.26%; adjusted odds ratio, 1.06; 95% confidence interval [CI], 0.95‐1.19). Propensity score adjustment also did not detect an effect (16.7% vs18.9%; relative risk of readmission, 0.88; 95% CI, 0.59‐1.32).CONCLUSION: A long‐term, observational evaluation of interprofessional Med Rec did not detect a difference in 30‐day postdischarge patient hospital visits between patients who received enhanced versus partial Med Rec patient care bundles. In future prospective studies, researchers could focus on evaluating high‐risk populations and specific elements of Med Rec services on avoidable, medication‐related hospital admissions and postdischarge adverse drug events.

It is difficult for the nearly 20% of Canadian 15- to 24-year olds reporting symptoms to seek the help they need within the current mental health system. Web-based and mobile health interventions are promising tools for reaching this group; having the capacity to reduce access-to-service barriers and engage youth in promoting their mental well-being. A three-phased, iterative, co-creation developmental approach was used to develop Thought Spot, a platform to better enable post-secondary students to seek mental health support. Co-creation activities included student development teams, hosting a hackathon, conducting focus groups and evidence-based workshops and student advisory groups. Evaluation results highlighted the need for greater role clarity and strategies for sustainable engagement in the co-creation process. Lessons learned are informing the project optimization phase and will be utilized to inform the design and implementation of an RCT, assessing impact on help seeking behaviour.

Seventy percent of lifetime cases of mental illness emerge prior to age 24. While early detection and intervention can address approximately 70% of child and youth cases of mental health concerns, the majority of youth with mental health concerns do not receive the services they need. The objective of this paper is to describe the protocol for optimizing and evaluating Thought Spot, a Web- and mobile-based platform cocreated with end users that is designed to improve the ability of students to access mental health and substance use services. This project will be conducted in 2 distinct phases, which will aim to (1) optimize the existing Thought Spot electronic health/mobile health intervention through youth engagement, and (2) evaluate the impact of Thought Spot on self-efficacy for mental health help-seeking and health literacy among university and college students. Phase 1 will utilize participatory action research and participatory design research to cocreate and coproduce solutions with members of our target audience. Phase 2 will consist of a randomized controlled trial to test the hypothesis that the Thought Spot intervention will show improvements in intentions for, and self-efficacy in, help-seeking for mental health concerns. We anticipate that enhancements will include (1) user analytics and feedback mechanisms, (2) peer mentorship and/or coaching functionality, (3) crowd-sourcing and data hygiene, and (4) integration of evidence-based consumer health and research information. This protocol outlines the important next steps in understanding the impact of the Thought Spot platform on the behavior of postsecondary, transition-aged youth students when they seek information and services related to mental health and substance use.