# data[].attributes.body
What is Preflexion and How Can Educators Use It?

Preflexion is a reflective practice that occurs before an experience or learning activity, allowing learners to anticipate potential challenges, identify strategies for success, and clarify their goals. Unlike reflection, which looks backward, preflexion focuses on proactive thinking and mental rehearsal. Educators can use preflexion to help students become intentional about their learning by asking guiding questions such as, “What do you expect to learn from this session?” or “What challenges might you face, and how will you address them?” This approach promotes metacognition, self-regulation, and readiness to learn, which are critical for developing adaptive, lifelong learners.

Using Preflexion in Large or Small Groups

Preflexion can be implemented effectively in both large and small group settings. In a large group, an instructor might begin a lecture by asking students to jot down their expectations or anticipated challenges related to the topic, then share themes anonymously through a poll. In a small group, such as a case-based discussion or simulation team, participants can engage in a brief dialogue about how they plan to approach the scenario and what strategies they will use if complications arise.

For example, in medical education, preflexion is especially valuable before a clinical skills simulation. Before entering the simulation, students could discuss questions like, “What steps will you take to ensure patient safety?” and “How will you handle uncertainty if you encounter an unfamiliar symptom?” This primes learners for active engagement, reduces anxiety, and fosters critical thinking before the hands-on experience begins.

# data[].attributes.attachment_link.readable_text
Access Other Reports and Resources

Use more personalized reports and interactive tools to learn how to develop and succeed using your CliftonStrengths. Learn more about personalized reports .

Join 26,723,755 People Using Their CliftonStrengths to Thrive at Work and Everywhere Else

# data[].attributes.attachment_link.description
Use more personalized reports and interactive tools to learn how to develop and succeed using your CliftonStrengths. Learn more about personalized reports . Join 26,723,755 People Using Their CliftonStrengths to Thrive at Work and Everywhere Else

# data[].attributes.attachment_link.title
The 9 Enneagram Types — The Enneagram Institute

# data[].attributes.attachment_link.description
Get detailed descriptions about each of the nine Enneagram types for free. Find your Enneagram Type by taking the RHETI test.

# data[].attributes.attachment_link.title
How a Learning Style Inventory Can Help Your Student Find Strengths

# data[].attributes.attachment_link.description
Find out how a learning style inventory can help students discover insights into their learning preferences.

# data[].attributes.attachment_link.readable_text
The purpose of the Myers-Briggs Type Indicator ® (MBTI ®) personality inventory is to make the theory of psychological types described by C. G. Jung understandable and useful in people's lives. The essence of the theory is that much seemingly random variation in the behavior is actually quite orderly and consistent, being due to basic differences in the ways individuals prefer to use their perception and judgment.

"Perception involves all the ways of becoming aware of things, people, happenings, or ideas. Judgment involves all the ways of coming to conclusions about what has been perceived. If people differ systematically in what they perceive and in how they reach conclusions, then it is only reasonable for them to differ correspondingly in their interests, reactions, values, motivations, and skills."

In developing the Myers-Briggs Type Indicator [instrument], the aim of Isabel Briggs Myers, and her mother, Katharine Briggs, was to make the insights of type theory accessible to individuals and groups. They addressed the two related goals in the developments and application of the MBTI instrument:

The identification of basic preferences of each of the four dichotomies specified or implicit in Jung's theory.

The identification and description of the 16 distinctive personality types that result from the interactions among the preferences."

Excerpted with permission from the MBTI® Manual: A Guide to the Development and Use of the Myers-Briggs Type Indicator®

Favorite world: Do you prefer to focus on the outer world or on your own inner world? This is called Extraversion (E) or Introversion (I).

Information: Do you prefer to focus on the basic information you take in or do you prefer to interpret and add meaning? This is called Sensing (S) or Intuition (N).

Decisions: When making decisions, do you prefer to first look at logic and consistency or first look at the people and special circumstances? This is called Thinking (T) or Feeling (F).

Structure: In dealing with the outside world, do you prefer to get things decided or do you prefer to stay open to new information and options? This is called Judging (J) or Perceiving (P).

Your Personality Type: When you decide on your preference in each category, you have your own personality type, which can be expressed as a code with four letters.

The 16 personality types of the Myers-Briggs Type Indicator ® instrument are listed here as they are often shown in what is called a "type table."

For a description of your MBTI type, place your cursor over the box containing your four-letter type code. You may also wish to browse through all of the 16 type descriptions.

If you do not know your MBTI type, you may wish to take the instrument.

Type tables can also be used to gather and facilitate analysis of information about teams or specific groups of people.

All types are equal: The goal of knowing about personality type is to understand and appreciate differences between people. As all types are equal, there is no best type.

The MBTI instrument sorts for preferences and does not measure trait, ability, or character. The MBTI tool is different from many other psychological instruments and also different from other personality tests.

The best reason to choose the MBTI instrument to discover your personality type is that hundreds of studies over the past 40 years have proven the instrument to be both valid and reliable. In other words, it measures what it says it does (validity) and produces the same results when given more than once (reliability). When you want an accurate profile of your personality type, ask if the instrument you plan to use has been validated.

The theory of psychological type was introduced in the 1920s by Carl G. Jung. The MBTI tool was developed in the 1940s by Isabel Briggs Myers and the original research was done in the 1940s and '50s. This research is ongoing, providing users with updated and new information about psychological type and its applications. Millions of people worldwide have taken the Indicator each year since its first publication in 1962.

# data[].attributes.attachment_link.title
The Myers & Briggs Foundation - MBTI® Basics

# data[].attributes.attachment_link.description
The purpose of the Myers-Briggs Type Indicator ® (MBTI ®) personality inventory is to make the theory of psychological types described by C. G. Jung understandable and useful in people's lives. The essence of the theory is that much seemingly random variation in the behavior is actually quite orderly and consistent, being due to basic differences in the ways individuals prefer to use their perception and judgment.

# data[].attributes.attachment_link.readable_text
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Abstract

Purpose: Mentoring is vital to professional development in the field of medicine, influencing career choice and faculty retention; thus, the authors reviewed mentoring programs for physicians and aimed to identify key components that contribute to these programs' success.

Method: The authors searched the MEDLINE, EMBASE, and Scopus databases for articles from January 2000 through May 2011 that described mentoring programs for practicing physicians. The authors reviewed 16 articles, describing 18 programs, extracting program objectives, components, and outcomes. They synthesized findings to determine key elements of successful programs.

Results: All of the programs described in the articles focused on academic physicians. The authors identified seven mentoring models: dyad, peer, facilitated peer, speed, functional, group, and distance. The dyad model was most common. The authors identified seven potential components of a formal mentoring program: mentor preparation, planning committees, mentor-mentee contracts, mentor-mentee pairing, mentoring activities, formal curricula, and program funding. Of these, the formation of mentor-mentee pairs received the most attention in published reports. Mentees favored choosing their own mentors; mentors and mentees alike valued protected time. One barrier to program development was limited resources. Written agreements were important to set limits and encourage accountability to the mentoring relationship. Program evaluation was primarily subjective, using locally developed surveys. No programs reported long-term results.

Conclusions: The authors identified key program elements that could contribute to successful physician mentoring. Future research might further clarify the use of these elements and employ standardized evaluation methods to determine the long-term effects of mentoring.

Similar articles

Positive Value of a Women's Junior Faculty Mentoring Program: A Mentor-Mentee Analysis.

Voytko ML, Barrett N, Courtney-Smith D, Golden SL, Hsu FC, Knovich MA, Crandall S. Voytko ML, et al. J Womens Health (Larchmt). 2018 Aug;27(8):1045-1053. doi: 10.1089/jwh.2017.6661. Epub 2018 May 29. J Womens Health (Larchmt). 2018. PMID: 29813008

Evaluation of a Speed Mentoring Program: Achievement of Short-Term Mentee Goals and Potential for Longer-Term Relationships.

Cellini MM, Serwint JR, D'Alessandro DM, Schulte EE, Osman C. Cellini MM, et al. Acad Pediatr. 2017 Jul;17(5):537-543. doi: 10.1016/j.acap.2016.12.012. Epub 2016 Dec 28. Acad Pediatr. 2017. PMID: 28040574

Mentoring programs for medical students--a review of the PubMed literature 2000-2008.

Frei E, Stamm M, Buddeberg-Fischer B. Frei E, et al. BMC Med Educ. 2010 Apr 30;10:32. doi: 10.1186/1472-6920-10-32. BMC Med Educ. 2010. PMID: 20433727 Free PMC article. Review.

# data[].attributes.attachment_link.keywords[]
national center for biotechnology information

# data[].attributes.attachment_link.title
Mentoring programs for physicians in academic medicine: a systematic review - PubMed

# data[].attributes.attachment_link.description
The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site. The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

# data[].attributes.attachment_link.readable_text
Your browser either doesn't support Javascript, or you've turned it off. To use Mentimeter, please make sure to turn Javascript on. How do I enable Javascript?

Gain valuable insights from everyone around you with Word Clouds, Polls, and Quizzes.

Unlocking success with Mentimeter

For work

Maximize the value of your work-related meetings. Gather valuable input, feedback, and insights from your colleagues to make better decisions together!
Read more

For education

Enhance learning outcomes and engage every student in the classroom. Experiment with modern teaching methods using Mentimeter's features!
Read more

Works with your favorite apps

Turn tough crowds into engaged audiences

Build an immediate connection with your audience and make them a part of your presentation.

Create an interactive experience letting everyone vote, ask questions, and interact throughout.

Create truly unique presentations

Use a wide range of interactive slides to pose questions, gather feedback, and connect with your audience.

Build an impressive slide deck in minutes, craft an insightful icebreaker instantly, or find a new and creative way to engage your audience!

Millions of voices have already been heard

"Mentimeter allows everyone to ask questions, to get clarification or a clearer understanding on subjects resulting in a more fulfilling learning experience." Teresa Delfin, California State Polytechnic University Explore more stories

Want to become a better presenter?

Impress with Interactive Presentations

# data[].attributes.attachment_link.description
Interact with your audience using real-time voting. No installations or downloads required and it's free!

# data[].attributes.attachment_link.title
Kahoot! | Learning games | Make learning awesome!

# data[].attributes.attachment_link.description
Kahoot! is a game-based learning platform that brings engagement and fun to 1+ billion players every year at school, at work, and at home.

# data[].attributes.attachment_link.readable_text
Visualize your ideas in a new and collaborative way

Unleash your team's creativity with Jamboard. Sketch your ideas whiteboard-style while benefiting from the access and connectivity of an interactive canvas, on mobile, or right from your web browser. Drop images, add notes, and pull assets directly from the web while collaborating with team members from anywhere.

Google Jamboard 55 hardware is approaching end of life. Elevate your whiteboarding needs to the Google Meet Series One Board 65.

# data[].attributes.attachment_link.title
Google Jamboard: Whiteboard App for Business | Google Workspace

# data[].attributes.attachment_link.description
Use Google Jamboard for a collaborative digital whiteboard app. Learn what Jamboard is and start sharing your ideas with teammates.

# data[].attributes.attachment_link.title
Transformation Learning - Theory to Practice

# data[].attributes.attachment_link.description
Transformative experiences trigger dramatic changes in how we see the world and how we relate to it by altering our perspectives, shifting our attitudes, and changing our behaviors. Jack Mezirow, the theory’s originator, defined transformative learning as “constructivist, an orientation which holds

# data[].attributes.attachment_link.title
Transformative Teaching Handout Printable (1)

# data[].attributes.attachment_link.readable_text
4623 Accesses

5 Citations

9 Altmetric

Metrics

Abstract

Background

To review published literature on the use of quick response (QR) codes within healthcare education. In addition, the authors aimed to gain information on user perceptions and the challenges faced when implementing QR codes in an educational context.

Methods

Medline, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), HMIC (Healthcare Management Information Consortium) and HBE (Health Business Elite) were searched using specified search terms that included 'quick response code' and 'education'. Title and abstract review of 217 publications was performed. Papers which discussed the application of QR codes relevant to healthcare education were included. A total of 24 articles were reviewed and thematic analysis conducted to generate themes.

Results

Use of QR codes in healthcare education were broadly aligned to four common themes. These included: to increase participant engagement, for simulation training, for just-in-time (JIT) learning and to facilitate with administrative tasks in training. Perceptions towards the use of QR codes was generally positive. Challenges identified, included: problems with technical infrastructure, unavailability of smartphones and resistance to use in certain environments.

Conclusions

The use of QR codes for healthcare education is increasing, and whilst they offer some advantages there are also some important considerations including: provision of the necessary technological infrastructure, patient and staff safety and governance and adherence to guidelines on safe and appropriate use of this technology in sensitive settings.

Peer Review reports

Background

In 1994, quick response (QR) codes were developed by Denso Wave, a previous subsidiary company of Toyota, to track car components during manufacturing and distribution [ 1]. Denso Wave holds the patent for QR codes but has made the technology widely available, free of cost. Since then, the use of these black-and-white pixelated squares has rapidly increased, due to their ability to contain more information than a standard bar code in a 10th of the space and their high-speed, omnidirectional scanning capabilities.

The versatility of QR codes has also generated interest for use in a number of healthcare settings. Applications have been explored for storage of case histories in maxillofacial radiology [ 6], safer use of medications by elderly patients [ 7] and patient instructions following orthopaedic cast application [ 8].

In addition, QR codes have been shown to have value in education. Technology now facilitates a greater variety of visual learning materials. Integration of verbal and visual learning materials in spatial contiguity reduces the split-attention effect [ 9]. In addition, QR codes could offer a method to temporally link a variety of materials reducing learners' extraneous cognitive load. QR codes can be thought of as advocating a student-centred learning approach by giving students' autonomy over what and how they learn [ 10]. QR codes can help to enhance students' intrinsic motivation and allow accommodation of different learning preferences by providing enrichment of current learning materials, allowing flexibility for accessing materials and offering self-assessment opportunities [ 11]. Through the paradigm of social constructivism, QR codes are enablers of learning through interaction as demonstrated in studies by Al-Khalifa [ 12] and Chaisatien and Akahori [ 13]. Specific examples are detailed below.

In the classroom, Rikala & Kankaanranta demonstrated that QR codes support both independent and collaborative learning approaches and can engage learners [ 14]. Lai et al. demonstrated how QR code incorporation onto green maps [ 15] could help to achieve learning outcomes, provide opportunities for further interaction and allow for teaching in a diverse range of locations. Lee et al. used QR codes during a biology field trip [ 16] and postulated that it could more effectively motivate learners than non-digital means in today's "information" generation. The potential for healthcare professional education holds equally promising potential, but literature on this topic has not yet been reviewed or mapped.

In this review, we aimed to explore the use of QR codes specifically for healthcare education, identify perceptions towards their use and any challenges that have been encountered during implementation.

Methods

The review followed the PRISMA (preferred reporting items for systematic reviews and meta-analyses) extension for scoping reviews checklist and explanation [ 17]. Arksey and O'Malley's six steps were used as the methodological framework [ 18].

Research questions

The research questions that guided this review were:

1. 1)
How are QR codes currently being used in healthcare education?

2. 2)
What are the perceptions of individuals that currently use QR codes for healthcare education?

3. 3)
Have challenges been identified when implementing QR codes for healthcare education?

Identification of relevant studies

Databases used for the search were Medline, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), HMIC (Healthcare Management Information Consortium) and HBE (Health Business Elite). These were selected following discussion with a clinical librarian to identify those most likely to produce the greatest number of relevant articles.

Database searches were undertaken on 8 February 2019. The following keywords were used: qr. ADJ3 cod*, (quick response) AND ((barcod*) OR (cod*)), matrix ADJ3 barcod*, ((two-dimensional) OR (2d ADJ3 barcod*) OR (cod*)), ((Educat*) OR (train*) or (instruct*). MeSH (Medical Subject Headings) terms included: medical education, professional education, clinical competence and inservice training. These keywords and MeSH terms were combined with Boolean operators to yield relevant results.

The search was conducted without time or language restrictions. A total of 185 records were obtained. Additional records were identified through other sources, such as Google Scholar and reference mining, bringing the total number of records to 217.

Study selection

All articles were initially screened for suitability from the title by CTK and AH. Articles were included if they discussed an application of QR codes ( n = 110). Abstracts were subsequently and independently reviewed for eligibility by CTK and AH, before a further review of the full article. Records were excluded if the main application of QR codes was not for healthcare education ( n = 57) or if it did not discuss an original application for QR code use ( n = 29). Any disagreement over article eligibility was resolved through further discussion between CTK and AH.

The PRISMA flowchart was used to show the search strategy and subsequent study selection process (Fig. 1). Citations and bibliographies were managed using the software package Mendeley Desktop for macOS (Mendeley Ltd., London, UK).

Charting, collating and reporting of the studies

A data-charting form was created by CTK and AH on an Excel spreadsheet using Microsoft Excel for Mac Version 16.25 (Microsoft Corp., Redmond, WA, USA). Data concerning study design, methods, participants, the intervention and outcomes were extracted independently from the articles by CTK and AH. This was followed by narrative information on problems associated with the application of QR codes. A further review of the form was performed thereafter to ensure consistency and agreement on extraction of relevant information.

Narrative data synthesis was conducted using thematic analysis. This was performed by CTK, AH and SC using content analysis to categorise, code and sort articles on QR codes in healthcare education into distinct uses. Any conflicts over coding of articles was resolved through further discussion between CTK and SC.

Results

Article characteristics

A total of 24 articles published between 2011 and 2019 were included in this review. Most studies took place in Western countries (United States being the major contributor ( n = 11)). The majority of articles reported the use of QR codes for nursing students ( n = 6). Article types included research articles, editorials, communications and commentaries. A summary of article characteristics is show in in Table 1.

Table 1 Summary of article characteristics

The main uses of QR codes in healthcare education emerging from thematic analysis were as follows:

1. 1)
Increasing participant engagement

2. 2)
Just-in-time (JIT) learning

3. 3)
Simulation

4) Training support

Table 2 summarises all articles included in this review.

Table 2 Summary of included articles

Theme 1: increasing participant engagement

Nine articles discussed ways in which QR codes could be utilised to enhance participant engagement [ 20, 28, 29, 30, 31, 32, 36, 40, 42]. These can be broadly divided into those focusing on anatomy teaching, formative assessment, case-based learning and engagement with publications.

Three articles discussed the application of QR codes for anatomy teaching [ 32, 36, 40]. Mogali et al. reported how a medical student's experience of an anatomy specimen museum could be enhanced by the use of QR codes [ 32] attached to specimens. This allowed further contextual information to be gained, such as annotated images and clinical histories. In this study, 78% of students agreed that QR codes were useful for learning and the majority of students agreed or strongly agreed that specimen information was easy to access via QR codes. Key benefits of QR codes cited by the author included its low-cost and adaptability in any learning environment. It also limits damage to specimens from actual handling. In a similar manner, Siderits et al. used QR codes to facilitate the distribution of, and enhance the educational content at, tumour board presentations [ 36].

Two studies used QR codes to aid learning through formative assessment [ 40, 42]. From questionnaire responses, over 80% of students reported that they found QR codes to be more helpful than traditional learning aids. However, despite this, neither study demonstrated a positive impact on student examination performance compared to the control group. There were high levels of total engagement in both cases and students using QR codes for gross anatomy learning, in particular, appreciated the receipt of immediate feedback. The authors also discuss how their use can act as a cost-effective self-assessment solution [ 40].

Lin et al. investigated the use of QR codes during a pharmacology course for third year nursing students in Taiwan [ 28, 29] and reported most participants held positive attitudes towards QR codes, with their utility for learning activities being cited as a key benefit. Lin noted that when used for case-based learning, a subset of students performed better in asking questions and discussions than they did prior to the introduction of QR codes.

Finally, an editorial by MacRae reported on the introduction of QR codes onto articles in the journal, Neurosurgery [ 30]. This has allowed linking to further multimedia information and easier dissemination by readers.

The majority of the aforementioned studies demonstrated how students found QR codes easy to use [ 20, 28, 29, 40, 42] and had a desire to continue using them in the future for classroom exercises or otherwise [ 20, 28, 29, 42].

Interestingly, 47% of students in Lin's study declined to trial the use of QR codes because of eyestrain from the use of cellular devices and distractions from work by surfing the internet [ 29]. Zurmehly et al. also noted that not all students had a smartphone [ 42]. This problem was overcome during the study through pairing students without a smartphone with those who did have one. Other limitations discussed included the need to ensure QR codes were large enough and not wrinkled from the surface they were applied to; both of which would make it harder for the scanner to read.

Theme 2: Just-in-time (JIT) learning

Six articles discussed how QR codes can be used for JIT learning [ 25, 26, 27, 34, 39, 41]. This is a paradigm in which training is available on demand and can be accessed by staff when needed [ 43]. These applications can be broadly divided into those that allow reference to guidelines [ 26, 27, 34, 41] and those that contain information on how to perform a skill or use a piece of equipment [ 25, 27, 39]. For example, Tracey et al. discuss the recording of video clips demonstrating step-by-step procedures for wound care, medication administration and Foley catheter insertion [ 39]. Downer et al. discuss the use of QR codes for using equipment such as blood pressure machines [ 25].

Articles on the use of QR codes for referencing include checking plastic surgery and immune-related adverse event guidelines [ 26, 41], allowing nurses to view the management guidelines for falls [ 27] and accessing doctor's phone numbers, in a labour room [ 34]. Rosario et al. demonstrated that QR codes provide high levels of functionality, usability and usefulness [ 34]. Gardiner et al. perceived that QR codes have a significant role in disseminating information to both healthcare staff and patients, with environmental and cost benefits because QR codes can 'never run out' [ 26].

Similar to other studies [ 29, 40], Jamu identified a reluctance to use devices in certain environments [ 27]. In this case, a clinical environment in front of patients. Additionally, Jamu noted a need for technical support in those with 'little or no' previous IT experience.

Theme 3: simulation

Four articles discussed the adoption of QR codes to aid with simulation [ 21, 22, 23, 24]. Damjanovic discussed the use of QR codes in creating a low-budget point-of-care ultrasound simulator [ 24]. QR codes were printed and stuck on an ultrasound phantom for practice. This provided a less resource intensive solution compared to radio frequency identification or near-field communication alternatives that require hardware. However, it was acknowledged that there is a time cost related to ensuring correct coding for corresponding video clips.

A novel use of QR codes in augmented reality (AR) integrated simulation training was reported by Carlson [ 22]. In this study, an average of five QR codes were used per scenario to act as a marker in order to trigger virtual images from AR software. Facilitators also had QR codes that could be scanned in order to validate a correct action. Perceptions related to this integrated simulation were rated positively, although no specific questions relating to the use of QR codes were asked. Users also felt that this particular application was a not a replacement for more traditional simulation teaching.

Theme 4: training support

Sobhani et al. [ 38] and Reynolds et al. [ 33] both investigated how feedback could be received through assigning an individual QR code to each student or resident that could then be scanned by a faculty member. In both cases, it was demonstrated that faculty found the QR-linked feedback form superior to the paper alternative.

Sobhani et al. demonstrated that faculty found the feedback method easier to understand and navigate, with faculty feeling more comfortable to approach students [ 38]. However, students from the study did not report increased efficacy to elicit feedback when compared to the paper form.

Reynolds findings from a mix of faculty and students indicated that the QR form provided improved educational benefits [ 33]. Overall, more evaluations were also submitted by residents over 6 months compared to paper assessments.

Snyder et al. compared the use of QR feedback forms at 15 family medicine clerkship sites across the United States to online or paper alternatives [ 37]. It was found that the QR feedback forms were associated with the highest usability score and took the shortest amount of time to prepare by students. Although, adoption of the QR feedback forms was challenged by wireless network limitations.

Avidan et al. discussed the use of QR codes for improving the logging of cases for anaesthetic trainees [ 19]. In this study, QR codes were generated by a computer system at the conclusion of each case containing information such as the date of surgery, type of surgery and type of anaesthesia. This was then scanned by a trainee using their smartphone to store the data in their own spreadsheet. Avidan et al. hypothesised that this method would reduce reliance on the IT department, whom trainees contacted to receive a list of all their cases at the end of their residency. It would also ensure that trainees did not come to the end of their residency and realise that they had not performed enough of a particular type of procedure, at which point the deficit would be harder to correct.

Evaluation was performed prior to the introduction of QR codes and then at 3 and 6 months after introduction. Residents rated that usability of the technology highly and most stated they would recommend the use of QR codes for case logging to colleagues. The overall rate of case logging had increased by over 45% when compared to before the introduction of QR codes.

Discussion

This review has provided an overview of the diverse uses of QR codes in healthcare education. We reviewed 24 articles, published over the last 10 years, which demonstrated that the exploration of QR codes for healthcare education is still in its infancy. However, over half of the articles reviewed were published in the last 2 years, suggesting an increasing interest in the subject area.

The key benefits of using QR codes for healthcare education lie in the ability to provide timely, multimodal information in a cost-effective manner. Several studies demonstrated an improvement in engagement from students or faculty [ 19, 28, 29, 32, 33, 37, 38, 40, 42], which may be due to ease of use, availability and immediacy compared to other available methods of accessing information. Additional benefits lie in adaptability, simplicity of creation and potential environmental benefits of QR codes. In addition, the use of dynamic QR codes allows the creator to monitor useful metrics including: where the code was scanned, device used to scan and at what time the code was scanned. This could allow identification of topics that students are finding more difficult, or help in producing more tailored resources for students as a result [ 40].

In addition to the included articles, we identified three published conference abstracts that provided further examples of QR code utilisation for healthcare education. Following the introduction of QR codes to access a form to record procedural experiences by anaesthetic trainees, Singhapricha et al. demonstrated a 52% increase in the number of intubations and central venous access procedures logged, compared to the previous year [ 44]. Kee et al. have demonstrated that using QR codes in anaesthetic presentations help to enhance submissions by offering immediacy and raising the level of participation of the reader [ 45]. Additionally, a questionnaire distributed to members of the International Society for Medical Publication Professionals by McGrath and Fisher aimed to gain insight into the benefits of using QR codes for scientific poster presentations [ 46]. Suggested benefits included: increased audience engagement, wider data dissemination, enhanced poster metric tracking and increased capacity for multimedia presentation.

Our review has also highlighted some important considerations and potential challenges associated with the use of QR codes in healthcare education, particularly in a clinical setting.

Firstly, use of smartphones in the clinical environment to scan QR codes could be perceived as unprofessional by some patients. Thus, consideration needs to be given to the governance of introducing a QR code solution into a healthcare education setting. It is important to advise doctors, trainees and students on appropriate use of smartphones to scan QR codes in the clinical environment and to inform patients that smartphones are being used to support teaching. In addition, there are potential risks when using a smart device in certain settings, such as in an anatomy laboratory [ 40] where accidental or deliberate inappropriate sharing of sensitive (or patient identifiable) information could occur. Similarly, teachers need to ensure QR codes intended for healthcare professional education are secure and can only be accessed by the intended audience.

Other problems related to an inability to scan QR codes, either due to difficulty with the scanner or the way in which the QR code was displayed. However, these are likely to be minor issues that can be resolved with further adoption of the technology. A couple of studies have also acknowledged that their applications for QR codes could have been succeeded by automated software to capture data. This would have negated the need for QR codes in the first place. Albeit these software solutions would have been more resource-intensive [ 19, 23].

Patient safety concerns could arise if healthcare professionals were using QR codes to access guidelines that were either out of date, no longer in use or had been moved from their original online location, as alluded to by Upton et al. [ 41]. This can be avoided be ensuring that any QR codes generated are dynamic rather than static. Dynamic codes (usually only available with a website subscription) allow the linked resource to be changed without the need to replace the original QR code. Static codes, however, require a new code to be generated if the location or nature of the resource changes. In addition, the more information encoded in a static code, the more complex the code appears, which can impede scanning success. However, the one advantage of using a static QR code is related to the fact that they contain all information within the code itself. Therefore, they can work effectively in areas of poor network connection. If dynamic QR codes are used to provide access to guidelines, it is imperative that responsibility is taken by the institution to ensure the links are kept up to date.

Although, some students or staff may have a lack of familiarity with QR codes, own a smartphone that can download a QR code reader, or own a smartphone at all, this is likely to change moving forwards. In 2018, 78% of the UK adult population owned a smartphone, up from 17% a decade earlier [ 47]. The millennial generation are also establishing themselves in the healthcare environment with more competence and self-sufficiency with technology than their predecessors. Nonetheless, before smartphones become ubiquitous, it may lead to challenges by disadvantaging students and staff from certain socio-economic backgrounds and therefore affect their subsequent attainment.

Limitations

Literature surrounding the use of QR codes in healthcare education is still relatively scarce, however, the body of evidence is growing rapidly. The majority of articles included in this review use qualitative student perceptions rather than quantifiable data from questionnaires. Although this can limit subsequent analysis, it is a reasonable outcome to measure for gaining initial perceptions. In addition, a majority of the articles are from Western countries or countries with more developed healthcare systems. This therefore raises the question of whether findings are generalisable to other areas of the world. Similarly, the majority of articles focus on the use of QR codes for nursing students or staff, raising the question of whether findings are applicable to other members of a multidisciplinary healthcare team. Despite these limitations, the overall perceptions and challenges encountered from each included article are congruent to one another.

Conclusion

In the healthcare sector, we are generally slower at embracing innovation and new technologies compared to other industries. This is sometimes rightly so, due to concerns around confidentiality, infrastructure, equality of access, patient safety and ethics, amongst other considerations. However, as with any other innovation, the uptake of QR code technology will depend on demonstrating effective benefit for patients and professionals along with a background change in social norms. Improvements in network infrastructure across healthcare institutions is also required to allow for more effective adoption. We need to be mindful, however, that not every facet of healthcare education requires a technological solution. There may be some instances or environments where using smart devices is less beneficial. Nonetheless, QR codes provide an exciting opportunity to excite and engage learners in ways we have not been able to, thus far. Potential uses are still being explored and benefits have already been demonstrated in a select number of use-cases. Table 3 summarises the author's top tips from the review for using QR codes effectively in healthcare education.

Table 3 Top 10 tips for implementing QR codes in healthcare education

Further work should focus on feasibility studies related to the use of QR codes in clinical environments and the perceptions of patients towards their use. Guidelines for protecting patients, trainees and staff also needs to be considered. Further studies investigating whether the use of this technology can have a significant positive impact on student performance would also be beneficial.

Availability of data and materials

All data generated or analysed during this study are included in this published article and its references.

Abbreviations

AR:

Augmented reality

CINAHL:

Cumulative index to nursing and allied health literature

HBE:

Health business elite

HMIC:

Healthcare management information consortium

JIT:

Just-in-time

MeSH:

Medical subject headings

PRISMA:

Preferred reporting items for systematic reviews and meta-analyses

QR:

Quick response

Acknowledgements

The authors wish to thank Pip Divall, clinical librarian at the University Hospitals of Leicester NHS Trust, for assistance with the development of search terms.

Funding

No sources of funding were required for this study.

Author information

Affiliations

Department of Clinical Education, University Hospitals of Leicester, Leicester, LE1 5WW, UK

Chiraag Thakrar Karia, Andrew Hughes & Sue Carr

Contributions

CTK & AH contributed to the conception and design of the study. CTK, AH and SC contributed to the analysis and interpretation of data. All authors read and approved the final manuscript and agree to be personally accountable for their contributions.

Corresponding author

Correspondence to Chiraag Thakrar Karia.

Ethics declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Reprints and Permissions

About this article

Download citation

# data[].attributes.attachment_link.title
Uses of quick response codes in healthcare education: a scoping review - BMC Medical Education

# data[].attributes.attachment_link.description
Background To review published literature on the use of quick response (QR) codes within healthcare education. In addition, the authors aimed to gain information on user perceptions and the challenges faced when implementing QR codes in an educational context.

# data[].attributes.attachment_link.title
Transformative Teaching Handout Printable (5)

# data[].attributes.attachment_link.title
Transformative Teaching Handout Printable (2)

# data[].attributes.attachment_link.readable_text
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Affiliation

¹ Dieter Scheffner Center for Medical Education and Educational Research, Dean's Office of Student Affairs, Charité - Universitätsmedizin Berlin , Berlin , Germany.

Abstract

Introduction: Beyond participation in evaluation of teaching, there is sparse research available on more active roles of medical students in curriculum development. We report on a model of student engagement where medical students function as module co-directors, and how this is experienced by faculty and student module directors. Methods: Student engage in co-development of their curriculum with a high level of autonomy in organizing their activities. We conducted a mixed-methods, convergent design study based on surveys with faculty and student module co-directors and a student co-director focus group. Quantitative data were analyzed descriptively. Qualitative analysis was performed inductively. Results: Quantitatively, the majority of both faculty and student module directors report that the curriculum benefits from the students' work (95 and 94%). Both groups see each other as equal partners (80 and 87%). Qualitatively, this is related to students' competencies such as "bringing in broad and unique knowledge of the curriculum", "giving the students' perspective a voice," and "contributing ideas for improvement". Key strategies and challenges of the student co-module directors are illuminated. Conclusions: Student module co-directors represent a well-accepted practice model for curriculum development. This report may stimulate other faculties to engage their students more actively in medical education.

Similar articles

Lessons learned about integrating a medical school curriculum: perceptions of students, faculty and curriculum leaders.

Muller JH, Jain S, Loeser H, Irby DM. Muller JH, et al. Med Educ. 2008 Aug;42(8):778-85. doi: 10.1111/j.1365-2923.2008.03110.x. Med Educ. 2008. PMID: 18627445

Interdisciplinary integration of the CVS module and its effect on faculty and student satisfaction as well as student performance.

Ayuob NN, Eldeek BS, Alshawa LA, ALsaba AF. Ayuob NN, et al. BMC Med Educ. 2012 Jul 2;12:50. doi: 10.1186/1472-6920-12-50. BMC Med Educ. 2012. PMID: 22747781 Free PMC article.

Medical professionalism in the formal curriculum: 5th year medical students' experiences.

Stockley AJ, Forbes K. Stockley AJ, et al. BMC Med Educ. 2014 Nov 30;14:259. doi: 10.1186/s12909-014-0259-0. BMC Med Educ. 2014. PMID: 25433816 Free PMC article.

Teaching the social sciences to undergraduate medical students.

Benbassat J. Benbassat J. Isr J Med Sci. 1996 Mar-Apr;32(3-4):217-21. Isr J Med Sci. 1996. PMID: 8606138 Review.

Educating the Educator: Evaluation and Review of the ADMSEP Education Scholars Program.

Fore-Arcand L, Lehmann SW. Fore-Arcand L, et al. Acad Psychiatry. 2022 Jun;46(3):338-341. doi: 10.1007/s40596-021-01531-x. Epub 2021 Sep 23. Acad Psychiatry. 2022. PMID: 34557993 Free PMC article. Review.

Cited by

Psychometrics evaluation of the university student engagement inventory in online learning among Arab students.

Sharif-Nia H, Marôco J, Rahmatpour P, Ghahrani N, Muhammad Ibrahim F, Mohammad Ibrahim M, Kaveh O. Sharif-Nia H, et al. BMC Nurs. 2023 May 9;22(1):158. doi: 10.1186/s12912-023-01318-5. BMC Nurs. 2023. PMID: 37158930

# data[].attributes.attachment_link.keywords[]
national center for biotechnology information

# data[].attributes.attachment_link.title
Student engagement in medical education: A mixed-method study on medical students as module co-directors in curriculum development - PubMed

# data[].attributes.attachment_link.description
Introduction: Beyond participation in evaluation of teaching, there is sparse research available on more active roles of medical students in curriculum development. We report on a model of student engagement where medical students function as module co-directors, and how this is experienced b ...

# data[].attributes.attachment_link.title
'I could never have learned this in a lecture': transformative learning in rural health education.

# data[].attributes.attachment_link.description
'I could never have learned this in a lecture': transformative learning in rural health education.