Designing EthAKUL: a mobile just-in-time learning environment for bioethics in Pakistan

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Azra Naseem Kulsoom Ghias Sohail Bawani Mohammad Ali Shahab Sameer Nizamuddin Waqar Kashif Kausar S Khan Tashfeen Ahmad Murad Khan


In developing countries such as Pakistan, bioethics has not been included in mainstream thinking in medical education. The authors’ experiences suggest that current methods of teaching bioethics are problematic as students are unable to translate theory to practice. Alternative pedagogies, such as just-in-time learning (JiTL) using mobile devices, may be able to foster the development and implementation of ethical reasoning among nurses, doctors, and medical and nursing students. This research was conceived to determine the effectiveness of mobile JiTL – anytime, anyplace learning through mobile devices – for teaching bioethics. After obtaining ethical clearance, a participatory design (PD) approach was adopted to ensure input from all stakeholders for the design of ‘EthAKUL’, comprising a mobile app, five modules and just-in-time pedagogy. The name of the app is an acronym evoking ethics, learning and the university where the project originated. As a part of the design process, three PD workshops were held with junior doctors, nurses, nursing students, medical students and bioethics teaching faculty, and five meetings were held with faculty members, to discuss functional specifications and user-acceptance testing of the app. The feedback related to the nature of common ethical issues encountered in clinical settings, the existing process of teaching and learning bioethics, and the requested features of the app were recorded. These data sets were analyzed and synthesized into functional and technical specifications for the mobile app. The software programmers developed the app with the close involvement of the stakeholders. The development of teaching content continued alongside this process. While this enabled EthAKUL’s developers to incorporate needs of all stakeholders, challenges were encountered in the process relating to the pragmatic and conceptual aspects of JiTL, ML and PD. We discuss the implications of this research in bringing about transformative changes in higher education.


How to cite this article: 

NASEEM, Azra; GHIAS, Kulsoom; BAWANI, Sohail; SHAHAB, Mohammad Ali; NIZAMUDDIN, Sameer; KASHIF, Waqar; KHAN, Kausar S; AHMAD, Tashfeen; KHAN, Murad. Designing EthAKUL: a mobile just-in-time learning environment for bioethics in Pakistan. Scholarship of Teaching and Learning in the South. v. 3, n. 1, p. 36-56, Apr. 2019. Available at:


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