Et

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Critically analyze local and

global geopolitical and
socioeconomic factors posing
as trials and opportunities for
Sara Reza
contemporary medical Chemical Pathologist
education MHPE Scholar
The outcomes of a mobile just-in-time-
learning intervention for teaching bioethics
in Pakistan
Azra Naseem, Sameer Nizamuddin and Kulsoom Ghias
BMC Medical Education 2022
Importance of Bioethics in
Healthcare Education
1 Complex Decisions 2 Respect and Dignity
Healthcare professionals Respecting patients'
often navigate complex wishes and maintaining
medical decisions, their dignity is crucial Et
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balancing patient care while making sound
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with ethical ethical decisions.
considerations.
3 Advocacy
Bioethics advocates for the relationship between scientific practice
and societal values, enriching the healthcare profession.
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Challenges in Bioethics Education

Developing In countries like Inadequate Medical school
Late Adoption

Health Inequities

Interprofessional Training
Inadequate governance
countries have Pakistan, socio- regulatory curricula often
been slow to political and mechanisms and lack
integrate bioethics infrastructural governance interprofessional
education, with weaknesses complicate ethical bioethics training,
many medical exacerbate health decision-making, a gap that needs
colleges lacking inequities, underscoring the addressing with
formal curricula. underlining the urgency of contemporary
need for bioethics bioethics training healthcare
training. challenges.
Mobile Learning in Medical
Education
1 Adoption of m-Learning
Smartphones and tablets support healthcare education,
with positive outcomes reported in medical learning
environments.

2 Benefits of m-Learning Et
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Efficiency, portability, quick access to resources and
relevance to residency stages influence the adoption of
m-Learning among healthcare residents.

3 Challenges and Considerations

While m-Learning offers many benefits, it is essential to
avoid potential pitfalls such as superficial learning.
Just-In-Time Learning (JiTL)
Approach
Learner Control
JiTL empowers learners with control over the timing and
location of their education.

Collaboration Et
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Mobile technology facilitates timely communication and

collaboration among learners and teachers.

Assessment Tools
Mobile devices serve as efficient tools for conducting
assessments, streamlining the learning process.
Introducing EthAKUL
• Mobile app developed to improve bioethics education for

healthcare professionals in Pakistan.

• Provides easy access to bioethics learning modules and

supports discussions among users.

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• Aimed at evaluating mobile learning's impact on ethical

reasoning.

• Demonstrates the potential of mobile technology to enhance

medical education
Study Methodology
Mixed Methods
The study utilized a mixed-
methods triangulation
approach, combining
quantitative and qualitative
data for a comprehensive
analysis.
Participant Diversity
Participants included
undergraduate and
postgraduate medical and
nursing students, residents,
and practicing nurses. Et
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Intervention
The intervention involved engaging learners with EthAKUL to
explore real-life ethical dilemmas as part of the m-JiTL
approach.
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Study Participation and Demographics

67 29
Participants Completed
Initially, 67 learners joined the intervention. Only 29 completed the post-intervention
questionnaire and knowledge test.

41% 25
Completion Rate Average Age
The study had an overall 41% completion rate. The average age of participants was 25 years.
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Findings: Knowledge improvement

9.34 ±2.37 10.38 ±1.98

Pre-Test Post-Test
The average pre-intervention The average post-intervention
bioethics knowledge test score score, indicating an increase in
knowledge

The study revealed a noticeable change with p-value of 0.012,

indicating a significant increase in knowledge scores.
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Learners' Attitude Towards m-Learning

Pre-Intervention Post-Intervention No Significant Change
Attitude Attitude
Before the intervention, Post-intervention, the The paired sample T-test
learners had a positive attitude remained revealed no significant
attitude with a mean positive with a mean difference (p=0.231) in
score of 3.32±0.42 score of 3.17±0.44, attitudes before and
towards m-Learning. indicating a stable after the intervention.
perception of m-
Learning.

Usage Patterns and Features of EthAKUL
1 Android Access
A majority of 75.9% accessed
EthAKUL on an Android phone.
3 User-Friendly Design
Facilitators found EthAKUL to
be user-friendly and well-
designed for engaging learners
outside the classroom.
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2 Weekend Usage
Most learners used EthAKUL on
weekends, with 55.14% logging
in during this time.
4 Popular Features
The "Let's Talk" discussion
forum was the most used
feature, followed by "Learn
More" with organisational
policies.
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• Difficulty in finding recent posts and lack of chronological order

Foru
m in the "Let's Talk" forum posed challenges.
Navig
ation
Challenges

Notifi • The absence of alert notifications for new posts made timely
catio
n responses challenging.
Syste
m

• No option for audio-responses limited participation for those

Lang
uage whose first language was not English.
Barri
er

• Low participation rates, lack of closure in discussions, and

Othe disparities in perceptions of the purpose of the discussion forum.
rs
Facilitation and Learner Engagement
1 Initial Engagement
Learners posted actively during the first month, but
participation declined over time.

2 Facilitation Challenges Et
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Facilitators found it challenging to engage learners in

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discussions and provide closure to ethical dilemmas.

3 Reflection and Interaction

The need for learners to reflect in-action and on-action and
for facilitators to foster critical thinking was emphasized.
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Reflection
"Considering the technological and
infrastructural challenges in your region, how do
you see mobile learning platforms like EthAKUL
impacting bioethics education?"

Recommendations
App Enhancements
Suggestions included making the
forum searchable and adding
private spaces for reflection
Audio-discussions option
Audio-discussions included to
support learners who had difficulty
expressing themselves in writing
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Curriculum update
Updating the curriculum to
address learners' needs
Student involvement
Involving students in co-
creating learning experiences
Blended Learning Approach
Integration of m-JiTL with face-to-
face teaching suggested
Further Research
Recommended to explore
EthAKUL's integration in various
contexts
Limitations:
• Small participant number due to app limitations and preliminary
testing phase.
• Participants exclusively from a private university in Karachi,
known for bioethics teaching and tech integration.
• Modest response rate and participation with no usage logs to
track continuous app usage.
• Improvement in bioethics knowledge observed but not solely Et
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attributable to the intervention due to optional participation and
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potential external resources.

• No investigation into changes in bioethics practice.
• Findings are not generalizable beyond the study's context,
highlighting the need for further research across different
institutions
Conclusion
•First study in Pakistan to test a custom mobile app and m-JiTL for
bioethics education, showing promising results.
•Generated practical suggestions for mobile app features and m-
JiTL pedagogy in bioethics teaching. Et
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•Emphasizes the need for mobile apps to align with curricular

outcomes and preparedness of faculty and students.
•Advises careful consideration of learning outcomes, pedagogy,
and assessment for successful m-JiTL implementation.
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Your opinion matters

“How different geopolitical environments might
influence the adoption and effectiveness of
mobile learning solutions in medical education."
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Local Trials and Opportunities

• Infrastructure and Resources:
– In regions like Pakistan, limited access to traditional educational resources presents
challenges
– Opens doors for mobile learning solutions, offering a flexible and accessible
alternative
• Cultural and Ethical Awareness:
– The importance of culturally relevant bioethics education is paramount.
– Mobile apps like EthAKUL provide localized content, addressing ethical dilemmas
specific to each locale.
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Global Geopolitical Factors

• Diverse Ethical Standards:
• Global health emergencies expose the variance in ethical standards across countries,
underscoring the need for educational tools that are both flexible and universally
accessible

• International Collaborations and Policies:

• Geopolitical relations and international policies significantly impact medical
education, influencing curriculum development, accreditation, and the mobility of
healthcare professionals
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Socioeconomic Factors
• Economic Barriers to Education:
– Socioeconomic disparities globally hinder access to medical education.
– Mobile learning emerges as a cost-effective solution, enhancing accessibility

• Workforce Development:
– A global shortage of healthcare professionals calls for innovative
educational tools to support workforce development, particularly in
underserved regions
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Technological Opportunities:
• Innovation and Scalability:
– The scalability of mobile learning solutions like EthAKUL to various contexts
highlights the role of technology in overcoming educational barriers.

• Data-Driven Insights:
– Data collected from mobile learning apps can guide the development of
medical education curricula and policies, ensuring education meets
emerging needs
 Debate the statement
“Mobile learning in medical education can
bridge the gap created by socioeconomic Et
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disparities more effectively than traditional

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education methods."
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Additional resources
• https://youtu.be/sGQeWRpmglU?si=_LMbu9XxwHZ5TVxo
• Han, H., Hurtubise, L., Plantegenest, G., Vitek, C., Patwari, R. & Foshee, C., 2020. Mobile Learning Literature
Review in Medical Education.
• Seethalakshmi, S., Vedam, V.A., Ghanta, M.K., 2024. An assessment of utility of educational apps in medical
education among undergraduate medical students - A cross-sectional survey. National Journal of Physiology,
Pharmacy and Pharmacology, 14(01), pp. 182-187.
• Shrivastava, S.R.B.L. & Shrivastava, P.S., 2022. Mobile and medical education: Points to ponder. Indian
Journal of Health Sciences and Biomedical Research (KLEU), 15(1), pp. 99-100. Available from:
10.4103/kleuhsj.kleuhsj_39_21
• Ravichandran, D., Krishnamoorthy, K., Villanueva, J., Prescod, U., Gottam, V. & Sriya, S., 2022. The Use of
Smartphones in Medical Education: Insights from a Caribbean Medical School. The FASEB Journal, 36(S1).
Available from: 10.1096/fasebj.2022.36.s1.0r758
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Additional resources
• Shirazi, Bushra & Riaz, Qamar & Jafarey, Aamir & Ahmed, Rashida & Shamim, Muhammad. (2023). The
Current Status and Challenges of Bioethics Education in Undergraduate Medical Education in Karachi,
Pakistan.. 10.21203/rs.3.rs-3315723/v1.
• Spencer SP, Lauden S, Wilson S, Philip A, Kasick R, Mahan JD, Fernandes AK. Meeting the challenge of
teaching bioethics: a successful residency curricula utilizing Team-Based Learning. Ann Med. 2022
Dec;54(1):359-368. doi: 10.1080/07853890.2021.2013523. PMID: 35114873; PMCID: PMC8820793.
• Klitzman RL. Understanding Ethical Challenges in Medical Education Research. Acad Med. 2022 Jan
1;97(1):18-21. doi: 10.1097/ACM.0000000000004253. PMID: 34292193.
• https://www.youtube.com/watch?v=ldkaPd5uWoQ
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The Bioethics Innovation Lab

Imagine you are part of a "Bioethics Innovation Lab" tasked with
designing a new module for the EthAKUL app, focusing on a
pressing global bioethical issue.
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THANKS
Do you have any questions?

sara.qmc@gmail.com
+92-333-4603388
www.linkedin.com/in/sara-
reza-a93092106