LEARNING WITH SMARTPHONES Case study of learning drug prescribing using the PharmaFrog app Inauguraldissertation zur Erlangung des Akademischen Grades eines Dr. phil., vorgelegt dem Fachbereich 02 Sozialwissenschaften, Medien und Sport der Johannes Gutenberg-Universität Mainz von Dativa Tibyampansha aus Tansania Mainz, Germany Tag des Prüfungskolloquiums: July 15, 2020 PRELIMINARY REMARKS I would like acknowledge the indispensable contributions of the following individuals and institutions: 1) This thesis’ advisors 2) Programmers 3) PharmaFrog app concept and content developers 4) The participants of the surveys and of the PharmaFrog app evaluation presented in this thesis 5) My family and friends for moral support and encouragement. The PharmaFrog app can be downloaded using the following QR codes. Android iOS i TABLE OF CONTENTS LIST OF FIGURES ................................................................................................................. vi LIST OF TABLES ................................................................................................................. viii ABBREVIATIONS .................................................................................................................. ix SUMMARY ............................................................................................................................... 1 INTRODUCTION..................................................................................................................... 3 Deficiencies in drug prescribing ..................................................................................................................... 3 Reasons for poor prescribing among fresh medical graduates in resource-limited settings ............................... 3 Educational remedies ..................................................................................................................................... 4 The overall concept of PharmaFrog ................................................................................................................ 4 Need for a PharmaFrog learning framework ................................................................................................... 6 Thesis structure .............................................................................................................................................. 6 THESIS GOALS ....................................................................................................................... 7 WORK PLAN ........................................................................................................................... 8 BACKGROUND ....................................................................................................................... 9 Learning vs. education ....................................................................................................................... 9 eML ................................................................................................................................................... 10 LTs .................................................................................................................................................... 11 The lack of a validated LT for eML ................................................................................................. 12 Checklists ........................................................................................................................................... 12 Frameworks ........................................................................................................................................ 13 Classical LTs in eML context .............................................................................................................. 14 The potential of eML in medical education ..................................................................................... 15 METHODS ...............................................................................................................................17 Identification of learning elements ................................................................................................... 17 From LTs ................................................................................................................................................ 17 From existing mobile apps ....................................................................................................................... 17 From previous PharmaFrog-related research ............................................................................................ 17 PharmaFrog learning framework .................................................................................................... 17 Framework implementation ............................................................................................................. 18 User outreach and feedback collection ............................................................................................ 19 App users outreach .................................................................................................................................. 19 Surveys and interviews ............................................................................................................................ 19 App usage analytics ................................................................................................................................. 20 Data analysis ..................................................................................................................................... 20 RESULTS .................................................................................................................................21 Elements for PharmaFrog learning framework .............................................................................. 21 From LTs ................................................................................................................................................ 21 ii From existing eML apps .......................................................................................................................... 23 From preceding PharmaFrog mockups and surveys .................................................................................. 26 The resulting PharmaFrog learning activities ........................................................................................... 28 PharmaFrog IT structure and hosting ............................................................................................. 30 Overview ..................................................................................................................................................... 30 MySQL database ......................................................................................................................................... 31 SQLite database ........................................................................................................................................... 33 JSON ........................................................................................................................................................... 33 Content entry and structuring ....................................................................................................................... 34 Entering content.................................................................................................................................. 34 Linking content................................................................................................................................... 35 Revising content ................................................................................................................................. 36 Publishing content ....................................................................................................................................... 36 Implementation of the PharmaFrog Learning Framework ............................................................ 38 PharmaFrog 1.0 ........................................................................................................................................... 39 SHOW ME learning mode ....................................................................................................................... 39 General concept .................................................................................................................................. 39 Examples of card and list concepts ...................................................................................................... 39 Deployment and evaluation of SHOW ME mode ..................................................................................... 42 PharmaFrog 2.0 ........................................................................................................................................... 44 Interactivity ............................................................................................................................................. 44 General question architecture and deployment ..................................................................................... 44 Identification of question templates ..................................................................................................... 45 Question and option exclusion ...........................................................................................................