Background Digital health technologies hold promise to enhance patient-related outcomes, to support health care staff by reducing their workload, and to improve the coordination of care. As key users of digital health technologies, health care workers are crucial to enable a meaningful digital transformation of health care. Digital health literacy and digital skills should become prerequisite competencies for health professionals to facilitate the implementation and leverage the potential of digital technologies to improve health. Objective We aimed to assess European medical students’ perceived knowledge and opinions toward digital health, the status of digital health implementation in medical education, and the students’ most pressing needs. Methods The explanatory design of our mixed methods study was based on an online, anonymous, self-administered survey targeted toward European medical students. A linear regression analysis was used to identify the influence of the year of medical studies on the responses. Additional analysis was performed by grouping the responses by the self-evaluated frequency of eHealth technology use. Written responses to four qualitative questions in the survey were analyzed using an inductive approach. Results The survey received a total of 451 responses from 39 European countries, and there were respondents for every year of medical studies. The majority of respondents saw advantages in the use of digital health. While 40.6% (183/451) felt prepared to work in a digitized health care system, more than half (240/451, 53.2%) evaluated their eHealth skills as poor or very poor. Medical students considered lack of education to be the reason for this, with 84.9% (383/451) agreeing or strongly agreeing that more digital health education should be implemented in the medical curriculum. Students demanded introductory and specific eHealth courses covering data management, ethical aspects, legal frameworks, research and entrepreneurial opportunities, role in public health and health systems, communication skills, and practical training. The emphasis lay on tailoring learning to future job requirements and interprofessional education. Conclusions This study shows a lack of digital health-related formats in medical education and a perceived lack of digital health literacy among European medical students. Our findings indicate a gap between the willingness of medical students to take an active role by becoming key players in the digital transformation of health care and the education that they receive through their faculties.

Impact of the research: Although bilateral phrenic nerve stimulation did not increase the proportion of successful weaning from mechanical ventilation compared to the standard of care, it resulted in substantial improvements in inspiratory pressure generation capacity without major safety issues. In the absence of previous clinical data, these findings suggest that diaphragm pacing could be effective in mitigating diaphragm dysfunction in patients difficult to wean from mechanical ventilation. Author contributions:The academic authors (MD, MGDA, TS) wrote the first draft of the manuscript and verified the underlying data. All authors critically reviewed and approved the manuscript and are accountable its accuracy and integrity. Dr Martin Dres had full access to all the data in the study and takes full responsibility for the integrity of the data and the accuracy of the data analysis. Teresa Nelson conducted and is responsible for the data analysis. Support:The study was funded by Lungpacer Medical Inc, PA, USA.

No abstract

BACKGROUND Digital health technologies promise to enhance patient-related outcomes, to support the healthcare staff by reducing their workload and improve the coordination of care. As key users of digital health technologies, healthcare workers are crucial to enable a meaningful digital transformation of healthcare. Digital health literacy and digital skills are to become prerequisite competencies for health professionals to facilitate the implementation and leverage the potential of digital technologies to improve health. OBJECTIVE We aimed to assess European medical students’ perceived knowledge and opinions towards digital health, the status of digital health implementation in medical education, and the students’ most pressing needs. METHODS The explanatory design of our mixed-methods study was based on an online, anonymous, self-administered survey targeted towards European medical students. The quantitative analysis was performed using R statistical language; qualitative data was analyzed applying an inductive categorization approach using MaxQDA 2020 software. RESULTS The survey received a total of 451 responses from 39 European countries and all years of medical studies. The majority of respondents saw advantages in the use of digital health. More than half (53%) evaluated their eHealth skills as poor or very poor and 40% felt prepared to work in a digitized healthcare system. Medical students considered the reason for this a lack of education, with 85 % agreeing or strongly agreeing that digital health education should be more implemented in the medical curriculum. Students demanded introductory and specific eHealth courses covering data management, ethical aspects, legal frameworks, research and entrepreneurial opportunities,, its role in public health and health systems, communication skills, and practical training with eHealth technologies. The emphasis lay on tailoring learning to future job requirements and interprofessional education. CONCLUSIONS This study shows a lack of digital health-related formats in medical education and a perceived lack of digital (health) literacy among European medical students. Our findings indicate a gap between the willingness of medical students to take an active role by becoming key players in the digital transformation of healthcare, and the education they receive through their faculties. CLINICALTRIAL

ZusammenfassungMobile Gesundheitstechnologien (mHealth) fördern den Trend hin zu Eigenverantwortung und Selbstmanagement. Ziel des Beitrags ist es, am Beispiel von Diabetes mellitus Typ 2 (T2DM) die Diskussion zu mHealth, Eigenverantwortung und Gerechtigkeit – welche es bisher nur in Ansätzen gibt – aus einer Public-Health-ethischen Perspektive zu vertiefen. Dabei zeigt sich, dass mHealth im Bereich T2DM soziale Gesundheitsgerechtigkeit einerseits verbessern, andererseits aber auch soziale Gesundheitsungerechtigkeiten verschärfen kann. Aus einer gerechtigkeitsfokussierten, Public-Health-ethischen Perspektive auf T2DM-mHealth ist es notwendig, besser zu verstehen, ob und wie vulnerable Bevölkerungsgruppen bei mHealth-Entwicklung und -Einsatz mitbedacht werden, wie sie die Nutzung der Technologie erleben, welche sozialepidemiologischen Auswirkungen der zunehmende Einsatz von mHealth haben kann, welche gesundheitlichen Ungleichheiten im Bereich T2DM ungerecht sind, inwieweit die Eigenverantwortung in die Hände der Nutzenden gelegt werden soll und wo die Grenzen der Eigenverantwortung liegen. Die Berücksichtigung der sozialen Diversität und der sozialen Determinanten von Gesundheit ist ein stetiger Prozess und muss alle Phasen der Entwicklung und des Einsatzes von mHealth durchziehen.