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Table 1 Twenty-three studies included in the scoping review of WhatsApp in medical education

From: The role of WhatsApp® in medical education; a scoping review and instructional design model

Author CountryStudy titleJournal
Year
Specialty
Under−/Postgraduate
Study design
Single arm or not
Main data type(s)
Sample size
Description of intervention
Data collection tool(s)
Key messages from study findingsLevels of learning outcomes
Articulated educational theory
Mayer et al. [17] United KingdomTransfusion education: can using social media help improve training? The West Midlands experienceBritish Journal of Haematology
2017
Haematology Postgraduate
Retrospective observational study
Single arm
Qualitative
N = 25
WA case-based transfusion tutorials for 9 months
Survey
13 WA tutorials over 9 months
Feedback about WA pros and cons reported
Participant’s work on WA used as a basis for workplace-based assessment for that doctor
Kirkpatrick level 1 outcomes.
THEORY ARTICULATED: None
Bhesania et al. [18] USAUsing social media to advance medical education in a university affiliated community residency programJournal of General Internal Medicine
2018
Cardiology
Postgraduate
Prospective observational study
Single arm
Quantitative
N = 68
ECG learning group on WA for 2 years
WA discussion analysis
167 ECGs and 808 messages posted
Evidence of clinical reasoning, establishing diagnoses and proposing treatment in discussions
No Kirkpatrick outcomes
THEORY ARTICULATED: None
Elshaikh et al. [19] USAWhatsApp as a supplemental learning tool for pathologyLaboratory Investigation
2018
Pathology
Postgraduate
Retrospective observational study
Single arm
Quantitative
N = 24
Pathology group on WA for 2 years
Survey, WA discussion analysis
230 pathology cases discussed
Feedback about WA pros and cons discussed
87.5% users learned “new entities” on WA
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: None
Alkhalaf et al. [20] Saudi ArabiaThe impact of WhatsApp use on academic achievement among Saudi medical studentMedical Teacher
2018
Medical education
Undergraduate
Retrospective observational study
Single arm
Quantitative
N = 160
Correlation between end of term results and WA usage
Survey
WA used by minority (26.9%) for education
No association between summative GPAs and WA usage
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: None
Bakshi et al. [21] IndiaRole of WhatsApp-based discussions in improving residents’ knowledge of post-operative pain management: a pilot studyKorean Journal of Anaesthesia
2017
Anaesthesia-pain
Postgraduate
Prospective cohort study
Single arm
Quantitative
N = 38
Anaesthesia/Pain WA learning group for 3 months
Survey, WA discussion analysis, Pre−/post-intervention knowledge and behaviour assessment
Significant improvement in post-intervention knowledge scores (73.6% vs 69.1%, p = 0.031)
Significant improvement in learner behaviour (documentation of epidural anaesthesia efficacy) to 3 months
Kirkpatrick level 1, 2 and 3 outcomes
Level 3 outcome demonstrated 3 months after teaching
THEORY ARTICULATED: None
Blumenfeld et al. [22] IsraelReal time medical learning using the WhatsApp cellular network: a cross sectional study following the experience of a division’s medical officers in the Israel Defence ForcesDisaster and Military Medicine
2016
General Medicine
Postgraduate
Retrospective observational study
Single arm
Quantitative
N = 41
Peer discussion among military medical professionals on WA for 2 years
WA discussion analysis
478 questions and 531 responses
Categorisation of WA messages into textual/visual, questions/responses and subject matter
34% of messages related to clinical discussion
No Kirkpatrick outcomes
THEORY ARTICULATED: None
Carmona et al. [10] InternationalRealising the potential of real-time clinical collaboration in maternal-fetal and obstetric medicine through WhatsAppObstetric medicine
2018
Maternal-fetal medicine
Postgraduate
Retrospective observational study
Single arm
Quantitative study
N = 41
WA education and clinical discussion group in MFM for 2 years
Survey, WA discussion analysis
534 of 5050 (10.6%) related to clinical topics; 35% had educational purpose
Categorisation of messages into advice seeking, clinical case sharing, educational content, and miscellaneous content
Feedback about WA pros and cons reported. 97% reported “increased knowledge in rare cases”
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: None
Gon et al. [23] IndiaEffectivity of e-learning through WhatsApp as a teaching learning toolMVP Journal of Medical Sciences
2017
Pathology
Undergraduate
Prospective randomized crossover study
Qualitative and quantitative
N = 80
Blended pathology learning using WA for 5 months. Compared with traditional lectures
Survey, Pre−/post-intervention knowledge assessment
More questions asked and answered in WA than in lectures.
Both WA and lectures improved learners’ scores but no difference in improvement between teaching methods
Feedback about WA pros and cons reported
Kirkpatrick levels 1 and 2 outcomes
THEORY ARTICULATED: mLearning (mobile learning)
Goyal et al. [24] IndiaWhatsApp for teaching pathology postgraduates: a pilot studyJournal of Pathology Informatics
2017
Pathology
Postgraduate
Prospective observational study
Single arm
Quantitative.
N = 69
WA pathology discussions for 4 weeks
Survey, WA discussion analysis
16 pathology cases discussed
Feedback about WA pros and cons reported
> 1/3 of users posted no messages
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: None
Hayward et al. [25] United KingdomVirtual learning communities for faculty members: does WhatsApp work?Medical Education
2018
Clinical education faculty
Postgraduate
Prospective observational study
Single arm.
Qualitative or Quantitative - unclear
N = 58
WA discussion groups for faculty educators for 1 year
Survey
Feedback about WA pros and cons reported
Effective way for faculty to feel “connected to the medical school”
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: None
Kaliyadan et al. [26]
India
What’s up dermatology? A pilot survey of the use of WhatsApp in dermatology practice and case discussion among members of WhatsApp dermatology groups?Indian Journal of Dermatology, Venereology and Leprology
2016
Dermatology
Postgraduate
Retrospective observational study
Single arm
Quantitative
N = 100
Dermatology WA case discussions. Unknown duration of discussions.
Survey
Feedback about WA pros and cons reported
54% of users thought photo image quality suboptimal
70.5% of users in more than one WA group
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: None
Khan et al. [27] Saudi ArabiaImpact of network aided platforms as educational tools on academic performance and attitude of pharmacology studentsPakistan Journal of Medical Science
2017
Pharmacology
Undergraduate
Prospective cluster randomisation study
Quantitative
N = 72 in 6 universities
Blended learning study for 5 months comparing lectures, WA/lectures (W/L) and Learning management system/WA/lectures. (L/W/L)
End of term summative assessments
Knowledge outcomes significantly higher in W/L and L/W/L than lectures but no difference between W/L and L/W/LKirkpatrick level 2 outcomes
THEORY ARTICULATED: mLearning, eLearning
Loo et al. [28] MalaysiaUse of WhatsApp in assisting psychiatry learningMedical Education
2016
Psychiatry
Postgraduate
Retrospective observational study
Single arm
Qualitative or Quantitative - unclear
N = 122
WA discussion group to support psychiatry exam preparation. Unknown duration of discussions
WA discussion analysis
Feedback about WA pros and cons reported
Applicability to “countries with limited resources”
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: Peer-to-peer learning
Mazzuoccolo et al. [29] ArgentinaWhatsApp: a real-time tool to reduce the knowledge gap and share the best clinical practices in psoriasisTelemedicine Journal and e-Health
2019
Dermatology
Postgraduate
Prospective observational study
Single arm study
Quantitative
N = 80
WA discussion group for 1 year to link dermatologists
Survey and WA discussion analysis
197 dermatology questions posted, all answered in discussion
Impact of WA discussions on participants’ clinical practice and learning reported
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: None
Bukhari et al. [30] CanadaEnhancing internal medicine trainees’ nephrology competency: Queen’s Nephrology e-learning using WhatsApp studyInternal Medicine
2017
Nephrology
Postgraduate
Prospective observational study.
Pre−/post-intervention single arm
Quantitative
N = 27
WA discussion on nephrology topics for 16 weeks
Survey of self-reported confidence in medical knowledge
Self-reported increase in confidence in diagnosing and managing nephrology conditions
Early termination due to trainee non-participation
Kirkpatrick level 1 outcomes.
THEORY ARTICULATED: None
Raiman et al. [31] United KingdomWhatsApp messenger as a tool to supplement medical education for medical students on clinical attachmentBMC Medical Education
2017
Internal Medicine
Undergraduate
Prospective descriptive study
Single arm
Qualitative and quantitative
N = 19
Blended learning using WA discussions with face-to-face problem-based learning
WA discussion analysis, Structured interviews
WA content analysis:
a) organizational
b) educational
c) social
Emergent themes on WA usage:
a) ease of use
b) fosters understanding
c) sharing resources electronically
d) accessing recorded discussions
e) generating other learning opportunities
f) intrusiveness
g) lack of face-to-face interaction
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: mLearning
Khanna et al. [32] Uncertain“WhatsApp”ening in orthopaedic care: a concise report from a 300-bedded tertiary care teaching centreEuropean Journal of Orthopaedic Surgery and Traumatology
2015
Orthopaedics
Postgraduate
Prospective observational study
Pre−/post-intervention single arm
Quantitative
N = 8
WA group to share information about new orthopaedic patient admissions. Unknown duration of discussions
Pre−/post-intervention knowledge assessment
Knowledge about orthopaedic diagnoses significantly improved
No improvement in knowledge about orthopaedic management
Feedback about WA pros and cons reported
Kirkpatrick level 2 outcomes
THEORY ARTICULATED: NONE
Kochar et al. [33] USADisrupting fellow education through group texting. WhatsApp in fellow education?Journal of the American College of Cardiology
2018
Cardiology
Postgraduate
Prospective observational study
Single arm
Quantitative
N = 56
Cardiology WA discussion group for 5 months
Survey, WA discussion analysis
“> 500 images and videos shared” in WA discussions
Guidelines suggested for successful implementation of WA-based learning programme
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: NONE
Ranjan et al. [34] IndiaWhatsApp-assisted learning of anatomy as an adjuvant to traditional class-room learning: achievements and prospectInternational journal of anatomy and research
2017
Anatomy
Undergraduate
Prospective observational study
Single arm
Quantitative
N = 150
Blended learning combining WA anatomy discussions with standard teaching for 8 months
Survey
Feedback about WA pros and cons reported
WA used to ask questions about topics unclear from lectures
Early inclusion of all learners in learning process
“anytime and anywhere” learning
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: mLearning, Andragogy
Mohesh et al. [35] IndiaPerceptions on M-learning through WhatsApp applicationJournal of education technology in health sciences
2016
Physiology
Undergraduate
Prospective observational study
Single arm
Qualitative and quantitative
N = 46
Daily physiology WA topics discussed for 46 days
Survey
Feedback about WA pros and cons reported
Short relevant messages favoured over long messages
Suited to the “smart generation”
Kirkpatrick level 1 outcomes
THEORY ARTICULATED: mLearning, eLearning
Dyavarishetty et al. [36] IndiaAn interventional study to assess the effectiveness of “WhatsApp” as a teaching learning tool in community medicineInternational journal of community medicine and public health
2017
Community medicine
Undergraduate
Prospective observational study
Single arm
Qualitative and Quantitative
N = 49
Blended learning with WA discussion in 4 modules “complemented existing learning” for 4 months
Survey, Pre−/post-intervention knowledge assessment, WA discussion analysis, structured interviews
Knowledge improvement in 2 of 4 modules
Drop in participation over course of study
Feedback about WA pros and cons reported
Kirkpatrick level 1 and 2 outcomes
THEORY ARTICULATED: NONE
Mohanakrishnan et al. [37] IndiaWhatsApp enhances medical education: is it the future?International journal of medical science and public health
2017
Virology
Undergraduate
Prospective randomized crossover study
Qualitative and quantitative
N = 100
Blended learning comparing WA preparation for 2 days before 2 lectures with lectures alone
Survey, post-intervention knowledge assessment
Flipped classroom model in intervention group
Feedback about pros and cons of WA reported
Significantly better knowledge scores in blended learning group than lecture group after both teaching sessions
Kirkpatrick level 1 and 2 outcomes
THEORY ARTICULATED: NONE
Maske et al. [38] IndiaFeasibility, effectiveness, and students’ attitude toward using WhatsApp in histology teaching and learningJournal of education and health promotion
2017
Histopathology
Undergraduate
Prospective observational study
Single arm
Quantitative
N = 250
Three 2-month WA discussions about histology topics
Survey, Pre−/post-intervention knowledge assessment
Significant improvement in performance between pre- and post-intervention tests for all 3 lessons
Feedback about WA pros and cons reported
“anytime anywhere learning”
Kirkpatrick level 1 and 2 outcomes
THEORY ARTICULATED: NONE
  1. WA WhatsApp, GPA Grade point average, mLearning: mobile learning. Kirkpatrick 1 outcomes: learner attitudes. Kirkpatrick 2 outcomes: learner knowledge or confidence. Kirkpatrick 3 outcomes: learner behaviour