Objectives To investigate the definitions and applications of ‘spaced learning’ and to propose future directions for advancing its study and practice in health professions education. Method The authors searched five online databases for articles published on spaced learning in health professions education prior to February 2018. Two researchers independently screened articles for eligibility with set inclusion criteria. They extracted and analysed key data using both quantitative and qualitative methods. Results Of the 2972 records retrieved, 120 articles were included in the review. More than 90% of these articles were published in the last 10 years. The definition of spaced learning varied widely and was often not theoretically grounded. Spaced learning was applied in distinct contexts, including online learning, simulation training and classroom settings. There was a large variety of spacing formats, ranging from dispersion of information or practice on a single day, to intervals lasting several months. Generally, spaced learning was implemented in practice or testing phases and rarely during teaching. Conclusions Spaced learning is infrequently and poorly defined in the health professions education literature. We propose a comprehensive definition of spaced learning and emphasise that detailed descriptions of spacing formats are needed in future research to facilitate the operationalisation of spaced learning research and practice in health professions education.

Purpose: Medical Massive Open Online Courses (MOOCs) have been integrated into formal campus teaching by several universities. However, teaching attributes of medical MOOCs have not been systematically investigated. Additionally, guidelines are needed to inform integration practices. This study systematically investigated the available teaching modes and socialepistemological dimensions of medical MOOCs. Methods: An overview of MOOCs on a medical topic was compiled and inclusion criteria were developed. A data collection tool was composed and calibrated. For data collection, out of 410 MOOCs 33 were selected based on these criteria. Investigators enrolled in selected MOOCs and analyzed teaching modes after examination of all course pages. Teaching modes were categorized in social-epistemological dimensions according to the Teaching Approach Framework. Results: Twenty-nine different teaching modes were found, showing wide distributions. Analysis of social-epistemological dimensions showed medical MOOCs focus on constructivist and individual teaching modes as opposed to objectivist and group modes. Conclusions: Medical MOOCs do not have a universal teaching mode profile. They contain a rich variety of teaching modes for integration in campus education of which videos, discussion boards, and multiple choice questions are used regularly. Constructivist teaching modes are readily available in medical MOOCs and can support educational innovation of formal campus teaching when integrated.

Purpose: Medical Massive Open Online Courses (MOOCs) are of interest for campus education. With growing interest in integrating medical MOOCs, their quality must be ensured. This however, has not been studied. We investigated if medical MOOCs meet the instructional design principles: problem-centeredness, activation, demonstration, application, integration, collective knowledge, collaboration, differentiation, authentic resources, feedback, and goal-setting. Methods: An overview of medical MOOCs and inclusion criteria were developed. Out of 410 MOOCs, 33 were selected. A data collection tool was compiled and calibrated. Investigators enrolled in selected MOOCs and coded presence of instructional design principles after examination of all course pages. Results: Application, authentic resources, problem-centeredness, and goal-setting were found to be present in many of the courses. Activation, collective knowledge, differentiation, and demonstration were present in less than half of the courses. Finally, integration, collaboration, and expert feedback were present in less than 15% of the courses. Conclusions: Medical MOOCs meet these principles in varying degree. Certain principles might be scarcely present due to a problematic fit with the MOOC concept or a need for further development in online settings. Assessment of instructional design quality is desired before integrating so that MOOC quality can be considered in relation to the quality of existing campus education.

Massive open online courses (MOOCs) are a novel and emerging mode of online learning. They offer the advantages of online learning and provide content including short video lectures, digital readings, interactive assignments, discussion fora, and quizzes. Besides stand-alone use, universities are also trying to integrate MOOC content into the regular curriculum creating blended learning programs. In this 12 tips article, we aim to provide guidelines for readers to integrate MOOC content from their own or from other institutions into regular classroom teaching based on the literature and our own experiences. We provide advice on how to select the right content, how to assess its quality and usefulness, and how to actually create a blend within your existing course.

Background The COVID-19 pandemic has markedly affected renal transplant care. During this time of social distancing, limited in-person visits, and uncertainty, patients and donors are relying more than ever on telemedicine and web-based information. Several factors can influence patients’ understanding of web-based information, such as delivery modes (instruction, interaction, and assessment) and social-epistemological dimensions (choices in interactive knowledge building). Objective The aim of this study was to systemically evaluate the content, delivery modes, and social-epistemological dimensions of web-based information on COVID-19 and renal transplantation at time of the pandemic. Methods Multiple keyword combinations were used to retrieve websites on COVID-19 and renal transplantation using the search engines Google.com and Google.nl. From 14 different websites, 30 webpages were examined to determine their organizational sources, topics, delivery modes, and social-epistemological dimensions. Results The variety of topics and delivery modes was limited. A total of 13 different delivery modes were encountered, of which 8 (62%) were instructional and 5 (38%) were interactional; no assessment delivery modes were observed. No website offered all available delivery modes. The majority of delivery modes (8/13, 62%) focused on individual and passive learning, whereas group learning and active construction of knowledge were rarely encountered. Conclusions By taking interactive knowledge transfer into account, the educational quality of eHealth for transplant care could increase, especially in times of crisis when rapid knowledge transfer is needed.

IntroductionMassive Open Online Courses (MOOCs) are informal learning environments. Since a few years, MOOCs are being reused and integrated in formal medical education. However, what constitutes optimal integration is still unclear. In this mixed methods study protocol we describe how we will investigate three MOOC integration designs using the same MOOC.This study holds multiple objectives(1) Describe motivation profiles in medical students that learn in integrated MOOCs, and discern if motivation profiles are associated with specific MOOC integration designs; (2) investigate how psychological needs of medical students are satisfied or frustrated in different MOOC integration designs; (3) investigate the relationship between autonomous motivation to learn in an integrated MOOC and use of self-regulated learning skills in that MOOC; (4) uncover processes that are involved in goal acceptance or rejection of medical students in integrated medical MOOC designs with assigned learning goals; and (5) identify obstacles medical students encounter when learning with assigned learning goals in integrated medical MOOCs.Methods and analysisObjectives 1 and 2 will be pursued with a cross-sectional study design, objective 3 with an observational cohort study design and objectives 4 and 5 with a qualitative interview study design. All medical students in one of three MOOC integration designs at Leiden University Medical Center (LUMC) will be invited to participate. Primary endpoints for objectives 1 and 2 are motivation profiles, and variety in need satisfaction and frustration. For objective 3 the primary endpoints are autonomous motivation and self-regulated online learning. For objectives 4 and 5 primary endpoints are process themes regarding goal acceptance or rejection, and perceived obstacles when working with assigned online learning goals.Ethics and disseminationThis study has been approved by the Educational Research Review Board of the LUMC. Planned dissemination of findings include three presentations at (inter)national conferences and three research articles.

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The COVID-19 pandemic has markedly affected renal transplant care. At times of social distancing, limited in-person visits, and confronting uncertainties, patients and donors rely more than ever on telemedicine and online information. Several factors could influence patients’ understanding of online information, such as delivery modes (instruction, interaction, and assessment) and social-epistemological dimensions (choices in interactive knowledge building).