Stage 1: development of WeMed

The WeMed mini program was developed in Guangzhou by a multidisciplinary team, which included MLS experts and educators. There were also software engineers from a professional technology services company on the team. A four-step development process was followed according to rapid application development (RAD) model. Comparing to traditional system development approaches (e.g., waterfall model), RAD is more flexible and adaptive due to its rapid application development process [15]. A shorter planning phase is adopted with this approach and a greater focus on development, testing, and feedback [15].

Theories and research relating to mobile applications, experiential learning and laboratory biosafety education have been studied to establish a conceptual framework. The primary goal of the study was to create a virtual training environment for students with the flexibility to access it anytime and anywhere [10]. For content delivery, WMP was chosen due to four reasons. First, mobile phones have become a key part of everyday life for this generation [16]. Since college students are growing up alongside the development of the internet and mobile phones, they are used to having access to information and communication at the touch of a finger [16]. As a multifunctional application, WeChat has seamlessly penetrated most aspects of students’ daily lives, from staying connected with family to making payments [16]. With these features, educators and software engineers can design, develop and publish their products approaching the population. Second, WeChat provides developers with tools (e.g., WeChat developer tool) to reduce development difficulty and shorten development cycles [12]. These tools provide developers with a comprehensive set of application programming interfaces and Software Development Kits, enabling them to quickly build applications and publish them to the platform. This reduces development time and costs, which makes it ideal for RAD model. Third, with its user-friendly interface, WeChat users can access Mini Programs directly from WeChat without downloading or installing, making it more convenient and user-friendly for MLS students [6]. Fourth, the messaging and social media capabilities of WeChat enable users to share their thoughts and experiences about the program to teachers and classmates [16].

In accordance with Kolb’s ELM, a number of learning activities were designed based on the four learning stages of the cycle (see Fig. 1). First, concrete experience provide students with hands-on experience by reading about preventing hazards, risk control guidelines, and outbreak preparedness [17]. Second, reflective observation is used to organize information from previous step through critical thinking [17]. With the practice mode, students have the opportunity to practice wearing PPE multiple times with guidance on organizing SOP information. Third, abstract conceptualization involves students explaining their learning from previous phases and forming new concepts [17]. Self-assessment quizzes can provide instant feedback to independent learner instant feedback on how well they are understanding key concepts. In laboratory biosafety training, the main stage is active experimentation, which involves simulations designed to allow the students to duplicate procedures multiple times, mastering the skills and techniques necessary to maintain biosafety [12]. These skills and techniques can be difficult to develop in classical lab sessions due to the time constraints. Thus, the distinctive feature of WeMed lies in its utilization of interactive simulations to deliver the learning content.

WeMed was developed according to WeChat mini-program design guidelines [18]. It consisted of three modules: the learning content module, the interactive practice module, and the self-assessment module (see Table 1). All the content was designed according to the 4th edition of the WHO laboratory biosafety manual [19]. The learning content module included learning materials targeting the SOP, PPE, waste management, risk control guidelines, and outbreak preparedness. It also covered the introduction of multiple infectious diseases such as coronavirus disease 2019 (COVID-19), human immunodeficiency virus (HIV), viral hepatitis, and hand, foot, and mouth disease (HFMD). In the learning content module, students can gain knowledge through a variety of modes, such as text, drawings, and interactive simulations. In the interactive practice module, the contents were delivered via interactive simulations and ‘drop and drag’ activities, allowing students to interact with and practice safety procedures, such as donning and doffing PPE (i.e., clothing, gloves, masks, and goggles). Figure 2 illustrates an example of an interactive ‘drop and drag’ activity for donning and doffing clothing. The self-assessment module included quizzes to help students review and assess their understanding of the material (see Fig. 2).

Selected screenshots of the WeMed program

The structure of the WeMed program

• Introduction to biosafety level 1, 2, and 3

• Foundation of personal protection

• Infection prevention and control recommendations for patients with suspected or confirmed infectious diseases

• Epidemiology of viral hepatitis

• Epidemiology of HIV

• Epidemiology of HFMD

• The prevention and treatment of HFMD

• Epidemiology of COVID-19

• Safe handling of specimens in the laboratory

• Putting on and removing PPE (i.e., coveralls, footwear, gloves, and eye protection)

• Hand hygiene

• Use of biological safety cabinets

• Disinfection and sterilization

• Waste handling

• Risk control guidelines

• Emergency procedures for microbiological laboratories

• Safe handling of specimens in the laboratory

• Pre-use checks, putting on and removing PPE

• Hand hygiene

• Use of biological safety cabinets

• Disinfection and sterilization

• Waste handling

• Risk control guidelines

• Emergency procedures for microbiological laboratories

In this study, expert validation was used to evaluate the validity of WeMed. A panel of ten experts evaluated its technical quality requirements on a 4-point Likert scale (1 = irrelevant, 4 = very relevant) in accordance with a framework developed by Almaiah et al. [20]. The panel was composed of four MLS technicians with at least 10 years of experience, two university lecturers, and four specialists in Android application development. The Content Validity Index (CVI) was used to measure appropriateness and accuracy of content [21]. In this study, the CVI calculation proposed by Polit and Beck was employed [21]. WeMed had excellent expert validity as indicated by its CVI of 0.83 to 1.00 at the item level, and 0.93 at the scale level [21].