Personal digital assistants: a review of current and potential utilization among medical residents

Mobile device: a useful tool to teach inhaler devices to healthcare professionals

BACKGROUND

Proper inhaler device usage is paramount for control of underlying obstructive airway disease. Hence, education to healthcare professionals who will eventually educate patients need to be done effectively. We developed an application for mobile devices for education on six medical inhaler devices, the metered-dose inhaler (MDI), Turbuhaler, Accuhaler, Breezhaler, Ellipta and Respimat, and studied if there were any difference between the application and the manufacturer's instructions on inhaler technique. The aim of this study is to see if inhaler education via a mobile phone app is comparable to manual instruction for health care professions.

METHODS

Participants, who were nursing students, were randomized to learn the inhaler devices via the manufacturer's instruction guide or a mobile device app designed specifically for education on inhaler devices.

RESULTS

There were 45 participants in each group. 78% of them were females with a median age of 21 (IQR 3). 67% used an Apple mobile device and the remainder used an Android device. The mobile device showed better total improvement points for the Turbuhaler device (262 vs 287 points; P = 0.02). Participants learning from the manufacturer's guide had a significantly higher total improvement points in the Breezhaler (370 vs 327 points; P < 0.01) and Ellipta (214 vs 174 points; P < 0.01) device. Both interventions showed improvement in total scores for demonstrating the correct usage of all inhaler devices. MDI has the least number of correct steps for both interventions. The participants' reported their mean (SD) self-rated knowledge was significantly higher for those using the app for all devices as compared to those that did not (4.33 (0.68) vs 4.73 (0.42); P = < 0.01). Self-reported confidence level was found to be higher in the mobile app group, but this was not statistically significant. The app was well received and scored of 4.42 of 5 with regards to its quality.

CONCLUSION

Using a mobile inhaler app is just as effective to teach inhaler device techniques to healthcare professionals and is likely a more convenient, versatile and important adjunct to learning.

TRIAL REGISTRATION

National Healthcare Group Ethics Board (2018/00960).

Academic use of smartphones among medical students in Pakistan

This study examined the use of smartphones as an academic tool amongst medical students from a developing country context. The study also aimed at identifying the perceived benefits and barriers to using smartphones in medical education. A cross sectional survey was administered to the students from nine medical institutes in Pakistan. A structured questionnaire was self-administered to 270 students from MBBS program. Data were analyzed using SPSS 23. All the respondents owned a smartphone. They used smartphones to browse the Internet to find medical information (100%), to share educational material (90%), and to take notes (79%). Easy and speedy access to information and improvement in study skills were the major benefits, while limited wireless access, small screen, and lack of awareness about medical resources were the main barriers. The students had a positive attitude towards smartphone as an academic tool. Smartphones use is likely to increase with the emergence of new developments in terms of design, medical apps and educational resources.

Mobile technologies in medical education: AMEE Guide No. 105

Mobile technologies (including handheld and wearable devices) have the potential to enhance learning activities from basic medical undergraduate education through residency and beyond. In order to use these technologies successfully, medical educators need to be aware of the underpinning socio-theoretical concepts that influence their usage, the pre-clinical and clinical educational environment in which the educational activities occur, and the practical possibilities and limitations of their usage. This Guide builds upon the previous AMEE Guide to e-Learning in medical education by providing medical teachers with conceptual frameworks and practical examples of using mobile technologies in medical education. The goal is to help medical teachers to use these concepts and technologies at all levels of medical education to improve the education of medical and healthcare personnel, and ultimately contribute to improved patient healthcare. This Guide begins by reviewing some of the technological changes that have occurred in recent years, and then examines the theoretical basis (both social and educational) for understanding mobile technology usage. From there, the Guide progresses through a hierarchy of institutional, teacher and learner needs, identifying issues, problems and solutions for the effective use of mobile technology in medical education. This Guide ends with a brief look to the future.

Performance of a core of transversal skills: self-perceptions of undergraduate medical students

BACKGROUND

There is an increasingly growing trend towards integrating scientific research training into undergraduate medical education. Communication, research and organisational/learning skills are core competences acquired by scientific research activity. The aim of this study was to assess the perceived performance of a core of transversal skills, related with scientific research, by Portuguese medical students.

METHODS

A cross-sectional study was conducted in 611 Portuguese students attending the first, fourth and sixth years of the medical course, during the same academic year. A validated questionnaire was applied for this purpose.

RESULTS

Medical students felt confident regarding the majority of the analyzed transversal skills, particularly regarding team work capacity (72.7% perceived their own capacity as good). On the other hand, the perceived ability to manage information technology, time and to search literature was classified only as sufficient by many of them. The progression over the medical course and participation in research activities were associated with an increasing odds of a good perceived performance of skills such as writing skills (research activity: OR = 2.00; 95% CI: 1.34-2.97) and English proficiency (research activity: OR = 1.59; 95% CI: 1.06-2.38/final year medical students: OR = 3.63; 95% CI: 2.42-5.45).

CONCLUSIONS

In this line, the early exposure to research activities along undergraduate medical education is an added value for students and the implementation of an integrated research program on medical curriculum should be considered.

An integrative review of the impact of mobile technologies used by healthcare professionals to support education and practice

AIM

The aim of this study was to provide evidence of the impact of mobile technologies among healthcare professionals in education and practice settings.

DESIGN

Integrative literature review.

METHODS

Electronic databases including MEDLINE, CINAHL, PsycINFO, EMBASE, ERIC and Web of Science were searched for papers published between 2002-2012. Quantitative studies were critically evaluated based on Thomas et al.'s framework, while the consolidated criteria for reporting qualitative research was used to appraise the rigour of the qualitative studies.

RESULTS

Seventeen quantitative and three qualitative studies were included. The findings suggest a largely positive influence of mobile technologies on various clinical practice and educational outcomes. However, robust evidence was limited. Use of mobile technologies in health care are associated with improvements in access to information, accuracy and efficiency, evidence-based decision making at the point of care and enhancement in performance, confidence and engagement in different contexts.

Resident use of the Internet, e-mail, and personal electronics in the care of surgical patients

BACKGROUND

The use of smartphones, e-mail, and the Internet has affected virtually all areas of patient care. Current university and hospital policies concerning the use of devices may be incongruent with day-to-day patient care.

PURPOSE

The goal was to assess the current usage patterns of the Internet, e-mail, and personal electronics for clinical purposes by surgical residents as well as their communication habits and preferences. Also assessed was residents' knowledge regarding the institutional policies surrounding these issues.

METHODS

Surgical residents (n = 294) at a large teaching institution were surveyed regarding their knowledge of university policies as well as daily use of various communication technologies. Communication preferences were determined using theoretical clinical scenarios.

RESULTS

Our survey with a response rate of 54.7% (n = 161) revealed that 93.8% of participants indicated daily Internet use for clinical duties. Most respondents (72%) were either completely unaware of the existence of guidelines for its use or aware but had no familiarity with their content. Use of e-mail for clinical duties was common (85%), and 74% of the respondents rated e-mail as "very important" or "extremely important" for patient care. Everyone who responded had a mobile phone with 98.7% being "smartphones," which the majority (82.9%) stated was "very important" or "extremely important" for patient care. Text messaging was the primary communication method for 57.8% of respondents. The traditional paging system was the primary communication method for only 1.3% of respondents and the preferred method for none.

CONCLUSIONS

Daily use of technology is the norm among residents; however, knowledge of university guidelines was exceedingly low. Residents need better education regarding current guidelines. Current guidelines do not reflect current clinical practice. Hospitals should consider abandoning the traditional paging system and consider facilitating better use of residents' mobile phones.

Left to their own devices: medical learners' use of mobile technologies

BACKGROUND

Although many medical learners and teachers are using mobile technologies within medical education, there has been little evidence presented describing how they use mobile devices across a whole curriculum.

METHODS

The Northern Ontario School of Medicine (NOSM) introduced a new mobile device program in 2010. Incoming undergraduate medical learners received a laptop and an iPad and learners entering year three of the four-year program received a laptop and an iPhone. A survey was sent to all learners to gather information on their use of and attitudes toward these devices. A combination of quantitative and qualitative methods was used to analyze the data and to generate a series of themes that synthesized student behaviors, perceptions and attitudes.

RESULTS

Context and learner autonomy were found to be important factors with learners using multiple devices for different purposes and adopting strategic approaches to learning using these devices. The expectation that school-issued devices would be regularly and enthusiastically used to replace more traditional study media was not reflected in practice.

CONCLUSIONS

Learners' approaches to using mobile devices are heterogeneous as is the extent to which they use them. Learners adapt their use of mobile devices to the learning cultures and contexts they find themselves in.

Smartphone use at a university health science center

This article describes the results of a survey of library patrons conducted by librarians and information technology specialists at the Health Science Center Libraries at the University of Florida. The purpose of the survey was to learn if and how library patrons were using smartphones to perform their work-related tasks and how patrons felt the library could support smartphone use at the Health Science Center.

Introducing technology into medical education: two pilot studies

OBJECTIVES

Educators are integrating new technology into medical curriculum. The impact of newer technology on educational outcomes remains unclear. We aimed to determine if two pilot interventions, (1) introducing iPads into problem-based learning (PBL) sessions and (2) online tutoring would improve the educational experience of our learners.

METHODS

We voluntarily assigned 26 second-year medical students to iPad-based PBL sessions. Five students were assigned to Skype for exam remediation. We performed a mixed-method evaluation to determine efficacy.

RESULTS

Pilot 1: Seventeen students completed a survey following their use of an iPad during the second-year PBL curriculum. Students noted the iPad allows for researching information in real time, annotating lecture notes, and viewing sharper images. Data indicate that iPads have value in medical education and are a positive addition to the curriculum. Pilot 2: Students agreed that online tutoring is at least or more effective than in-person tutoring.

CONCLUSIONS

In our pilot studies, students experienced that iPads and Skype are beneficial in medical education and can be successfully employed in areas such as PBL and remediation.

PRACTICE IMPLICATIONS

Educators should continue to further examine innovative opportunities for introducing technology into medical education.

Decreasing sugar-sweetened beverage consumption in the rural adolescent population

Adolescent consumption of sugar-sweetened beverages (SSBs) has increased drastically with detrimental effects such as weight gain, weakened bones, dental caries, and associated higher levels of type II diabetes in this population. While in the clinical setting, rural family nurse practitioner (FNP) students, using Kellogg-funded Smart Phones, screened adolescents aged 13 to 17 years for SSB consumption in the previous 24 hours. Adolescents initially were provided with a pamphlet and related oral teaching concerning SSBs by the FNP students, as well as a water bottle to encourage healthy fluid intake. Screening SSB information was loaded onto Smart Phones, which resulted in immediate access by the primary investigator sometimes even hundreds of miles distant. After 30 days, FNP students completed follow-up phone interviews to reassess SSB consumption in the previous 24 hours. Results concerning decreased SSB consumption were statistically significant. Additionally, Smart Phones were instrumental in high-speed data transfer. Both advantages and disadvantages were encountered when using this evolving technology.

A systematic review of healthcare applications for smartphones

BACKGROUND

Advanced mobile communications and portable computation are now combined in handheld devices called "smartphones", which are also capable of running third-party software. The number of smartphone users is growing rapidly, including among healthcare professionals. The purpose of this study was to classify smartphone-based healthcare technologies as discussed in academic literature according to their functionalities, and summarize articles in each category.

METHODS

In April 2011, MEDLINE was searched to identify articles that discussed the design, development, evaluation, or use of smartphone-based software for healthcare professionals, medical or nursing students, or patients. A total of 55 articles discussing 83 applications were selected for this study from 2,894 articles initially obtained from the MEDLINE searches.

RESULTS

A total of 83 applications were documented: 57 applications for healthcare professionals focusing on disease diagnosis (21), drug reference (6), medical calculators (8), literature search (6), clinical communication (3), Hospital Information System (HIS) client applications (4), medical training (2) and general healthcare applications (7); 11 applications for medical or nursing students focusing on medical education; and 15 applications for patients focusing on disease management with chronic illness (6), ENT-related (4), fall-related (3), and two other conditions (2). The disease diagnosis, drug reference, and medical calculator applications were reported as most useful by healthcare professionals and medical or nursing students.

CONCLUSIONS

Many medical applications for smartphones have been developed and widely used by health professionals and patients. The use of smartphones is getting more attention in healthcare day by day. Medical applications make smartphones useful tools in the practice of evidence-based medicine at the point of care, in addition to their use in mobile clinical communication. Also, smartphones can play a very important role in patient education, disease self-management, and remote monitoring of patients.

Reproducibility of literature search reporting in medical education reviews

PURPOSE

Medical education literature has been found to lack key components of scientific reporting, including adequate descriptions of literature searches, thus preventing medical educators from replicating and building on previous scholarship. The purpose of this study was to examine the reproducibility of search strategies as reported in medical education literature reviews.

METHOD

The authors searched for and identified literature reviews published in 2009 in Academic Medicine, Teaching and Learning in Medicine, and Medical Education. They searched for citations whose titles included the words "meta-analysis," "systematic literature review," "systematic review," or "literature review," or whose publication type MEDLINE listed as "meta-analysis" or "review." The authors created a checklist to identify key characteristics of literature searches and of literature search reporting within the full text of the reviews. The authors deemed searches reproducible only if the review reported both a search date and Boolean operators.

RESULTS

Of the 34 reviews meeting the inclusion criteria, 19 (56%) explicitly described a literature search and mentioned MEDLINE; however, only 14 (41%) also mentioned searches of nonmedical databases. Eighteen reviews (53%) listed search terms, but only 6 (18%) listed Medical Subject Headings, and only 2 (6%) mentioned Boolean operators. Fifteen (44%) noted the use of limits. None of the reviews included reproducible searches.

CONCLUSIONS

According to this analysis, literature search strategies in medical education reviews are highly variable and generally not reproducible. The authors provide recommendations to facilitate future high-quality, transparent, and reproducible literature searches.

Going mobile: free and easy

After almost two decades, mobile technologies are now such a part of the fabric of the hospital environment that hospital libraries must take this opportunity to continue to positively impact health outcomes by providing health professionals with valuable information and services via personal digital assistants (PDAs) and smartphones. This article provides background information on mobile technology use and handheld devices. It describes how hospital librarians, regardless of staff, budget, or access to technology, can position the hospital library to connect health professionals to clinically relevant mobile resources and library services. Suggestions for the promotion of mobile resources are included, as well as tips for keeping current. A significant amount of free content is identified.

Medical student case presentation performance and perception when using mobile learning technology in the emergency department

BACKGROUND

Hand-held mobile learning technology provides opportunities for clinically relevant self-instructional modules to augment traditional bedside teaching. Using this technology as a teaching tool has not been well studied. We sought to evaluate medical students' case presentation performance and perception when viewing short, just-in-time mobile learning videos using the iPod touch prior to patient encounters.

METHODS

Twenty-two fourth-year medical students were randomized to receive or not to receive instruction by video, using the iPod Touch, prior to patient encounters. After seeing a patient, they presented the case to their faculty, who completed a standard data collection sheet. Students were surveyed on their perceived confidence and effectiveness after using these videos.

RESULTS

Twenty-two students completed a total of 67 patient encounters. There was a statistically significant improvement in presentations when the videos were viewed for the first time (p=0.032). There was no difference when the presentations were summed for the entire rotation (p=0.671). The reliable (alpha=0.97) survey indicated that the videos were a useful teaching tool and gave students more confidence in their presentations.

CONCLUSIONS

Medical student patient presentations were improved with the use of mobile instructional videos following first time use, suggesting mobile learning videos may be useful in medical student education. Clinical educators should consider whether, in an instance where live bedside or direct interactive teaching is unavailable, using just-in-time educational videos on a handheld device might be useful as a supplemental instructional strategy.