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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 Country

Study title

Journal

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 findings

Levels of learning outcomes

Articulated educational theory

Mayer et al. [17] United Kingdom

Transfusion education: can using social media help improve training? The West Midlands experience

British 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] USA

Using social media to advance medical education in a university affiliated community residency program

Journal 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] USA

WhatsApp as a supplemental learning tool for pathology

Laboratory 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 Arabia

The impact of WhatsApp use on academic achievement among Saudi medical student

Medical 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] India

Role of WhatsApp-based discussions in improving residents’ knowledge of post-operative pain management: a pilot study

Korean 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] Israel

Real 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 Forces

Disaster 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] International

Realising the potential of real-time clinical collaboration in maternal-fetal and obstetric medicine through WhatsApp

Obstetric 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] India

Effectivity of e-learning through WhatsApp as a teaching learning tool

MVP 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] India

WhatsApp for teaching pathology postgraduates: a pilot study

Journal 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 Kingdom

Virtual 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 Arabia

Impact of network aided platforms as educational tools on academic performance and attitude of pharmacology students

Pakistan 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/L

Kirkpatrick level 2 outcomes

THEORY ARTICULATED: mLearning, eLearning

Loo et al. [28] Malaysia

Use of WhatsApp in assisting psychiatry learning

Medical 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] Argentina

WhatsApp: a real-time tool to reduce the knowledge gap and share the best clinical practices in psoriasis

Telemedicine 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] Canada

Enhancing internal medicine trainees’ nephrology competency: Queen’s Nephrology e-learning using WhatsApp study

Internal 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 Kingdom

WhatsApp messenger as a tool to supplement medical education for medical students on clinical attachment

BMC 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 centre

European 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] USA

Disrupting 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] India

WhatsApp-assisted learning of anatomy as an adjuvant to traditional class-room learning: achievements and prospect

International 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] India

Perceptions on M-learning through WhatsApp application

Journal 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] India

An interventional study to assess the effectiveness of “WhatsApp” as a teaching learning tool in community medicine

International 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] India

WhatsApp 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] India

Feasibility, effectiveness, and students’ attitude toward using WhatsApp in histology teaching and learning

Journal 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