Tablet computer enhanced training improves internal medicine exam performance

Association of Smartphone Use and Digital Addiction with Mental Health, Quality of Life, Motivation and Learning of Medical Students: A Two-Year Follow-Up Study

Background: Despite studies evaluating the insertion of technology and the use of smartphones in the mental health and learning of medical students, few have investigated these outcomes longitudinally. This study aims to investigate the association between smartphone use and digital addiction with mental health, quality of life, learning, and academic motivation of medical students. Methods: This is a longitudinal study conducted between 2016 and 2018. Socio-demographics, smartphone use, digital dependence (Internet Addiction Test), surface and deep learning approach (Biggs), motivation (Academic Motivation Scale), evaluation of symptoms of depression, anxiety, and stress (DASS- 21) and Quality of Life (WHOQOL-BREF) were assessed. Adjusted regression models were used for data analysis. Results: A total of 269 students were included(51.4% of the total). In the two-year follow-up, despite an increase in the frequency of smartphone use in general and also in the classroom for non-educational activities, no increase in digital dependence was found. In the adjusted models, the frequency of smartphone use and digital dependence were predictors of lower academic motivation and greater surface learning after two years of follow up. However, only digital dependence was a predictor of worse mental health (anxiety, depression, and stress) and worse quality of life. Conclusion: Greater use of smartphones and high addiction scores were associated with worse educational outcomes. Digital dependence was another marker of outcomes in mental health and quality of life. It is important that educators are aware of these negative effects and can guide students on the proper and safe use of these devices.

Technology-Enhanced Preclinical Medical Education (Anatomy, Histology and Occasionally, Biochemistry): A Practical Guide

The recent explosion of technological innovations in mobile technology, virtual reality (VR), digital dissection, online learning platform, 3D printing, and augmented reality (AR) has provided new avenues for improving preclinical education, particularly in anatomy and histology education. Anatomy and histology are fundamental components of medical education that teach students the essential knowledge of human body structure and organization. However, these subjects are widely considered to be some of the most difficult disciplines for healthcare students. Students often face challenges in areas such as the complexity and overwhelming volume of knowledge, difficulties in visualizing body structures, navigating and identifying tissue specimens, limited exposure to learning materials, and lack of clinical relevance. The COVID-19 pandemic has further exacerbated the situation by reducing face-to-face teaching opportunities and affecting the availability of body donations for medical education.To overcome these challenges, educators have integrated various educational technologies, such as virtual reality, digital 3D anatomy apps, 3D printing, and AI chatbots, into preclinical education. These technologies have effectively improved students' learning experiences and knowledge retention. However, the integration of technologies into preclinical education requires appropriate pedagogical approaches and logistics to align with educational theories and achieve the intended learning outcomes.The chapter provides practical guidance and examples for integrating technologies into anatomy, histology, and biochemistry preclinical education. The author emphasizes that every technology has its own benefits and limitations and is best suited to specific learning scenarios. Therefore, it is recommended that educators and students should utilize multiple modalities for teaching and learning to achieve the best outcomes. The chapter also acknowledges that cadaver-based anatomy education is essential and proposes that educational technologies can serve as a crucial complement for promoting active learning, problem solving, knowledge application, and enhancing conventional cadaver-based education.

Information Seeking Practices and Availability of Smart Devices Among Healthcare Professionals in a Lower-Middle-Income Country: An Analysis From Pakistan

Introduction Evidence-based medicine (EBM) is a principle that integrates clinical experience with relevant information available to provide adequate healthcare. It requires access to current medical literature. This paper analyzes the information requirements of a lower-middle-income country (LMIC) and the resources available and preferred by medical professionals. Methods A survey-based cross-sectional study was carried out among 160 participants, ranging in expertise from students to attending physicians in Karachi, Pakistan. The survey comprised questions to assess the clinical background, technology access, need for health-related information, and the preference for resources to obtain that information in different scenarios. They were also asked if they use PubMed and their recommended methods to improve information access. Statistical Package for the Social Sciences (SPSS; IBM, NY, USA) software was used for all analyses. Results A basic mobile phone (with limited internet connectivity) was the most common device used at home (n=159; 99.4%) and work (n=141; 88.1%). No smart devices were available to 28 (17.5%) participants at work. Internet connectivity was available for 155 (96.9%) participants at home but only for 118 (73.7%) participants at work. About one-third (n=49; 30.6%) experienced questions arising in practice two to four times a day, and half of the participants (n=80; 50%) were very likely to look up a reference. The most common resource for the majority of given clinical scenarios was a senior colleague. At the same time, medical websites (Medscape, Up-to-Date, WebMD) were the first choice for a non-specific general medical query. About 68.75% (n=110) of participants claimed to use PubMed in daily practice. The most common reason for not using PubMed was the ease of using other search engines (like Google). Conclusions Improved access to the internet and well-reputed journals can enhance the practice of EBM in Pakistan. Limitations of technological access must be considered while designing information resources in lower-middle-income countries.

The Effect of Mobile Learning on Student Success and Anxiety in Teaching Genital System Anatomy

The widespread use of smartphones has led to the emergence of new mobile learning tools. The aim of this study was to compare traditional methods to mobile learning applications, and their effect on the academic achievement and anxiety levels of students learning genital system anatomy. This research study was a randomized controlled study conducted with students who took anatomy between November and December 2018. The cohort consisted of 63 students who met the sampling criteria. Groups (control = 31, experimental = 32) were randomly selected using a simple number table. The mobile application developed for the experimental group was installed on the students' mobile devices with the extension "genitalsystem.apk." The anatomy of the genital system was taught to the control group using the standard curriculum and to the experimental group using the mobile application. After teaching the anatomy of the genital system, the state anxiety levels of the students in the control group were determined to be higher at 45.6 (±8.7) than the experimental group at 40.4 (±8.3) as measured by the 20-80 point STAI scale. The posttest examination average of the control group was 8.9 (±6.9) out of 22 or 40.4 (±6.9)% and the posttest average of the experimental group using mobile application was 14.9 (±5.5) or 67.7 (±5.5)%. State anxiety levels and examination grades showed a highly significant difference in favor of the experimental group. These results indicate that using mobile applications when teaching anatomy may be an effective method to enhance learning and reduce anxiety levels when compared to the traditional teaching methods.

Development and Application of an Interactive Neuropathology iBook as a Complementary Learning Tool for Veterinary Medicine Students

Neuropathology is a challenging subject for most medical students. Delivering a gamified learning tool on this topic may motivate students and increase knowledge in the discipline. We report the development of such a tool in iBook format for the systemic pathology course delivered at Ross University School of Veterinary Medicine. Composed of 10 chapters (cases), this Neuropathology iBook (NP-iB) reviews basic clinical manifestations, neuropathology, and pathogenesis of common non-neoplastic conditions that cause brain disease in domestic animals. The goal of each chapter is to reach a diagnosis by interactively answering specific questions after reviewing relevant medical history, clinical pathology, and autopsy findings. Our hypothesis: the NP-iB improves students' ability to recognize these diseases, reflected in higher test scores. Using a post-test only control group design, data were gathered from all students enrolled in the course in two different semesters, fall 2017 and spring 2018 (n = 300). NP-iB users (n = 51, 17%) and usage time were identified by answers to multiple-choice questions embedded in the course assessments. Ninety percent of users had a positive perception although no statistically significant differences were found in median test scores between users and non-users. Statistically significant test score differences were found across how much time students used the NP-iB (p = .005); the lowest test score median values were found for neuropathology questions not related to the NP-iB, in students who used it for more than 3 hours. Unexpectedly, a low number of students preferred this digital learning tool, and its use did not improve their learning outcomes.

Urology at your fingertips: the development of a urology m-learning app for medical students

Background

Surgical education has embraced advancing technology with an emphasis on e-learning in recent years. Smartphones are a useful tool for medical teaching and learning with increasing use by medical students to access e-books, medical calculators, podcasts, and medical applications (apps). Our aim was to develop a dedicated urology app for medical students as an adjunct to traditional teaching.

Methods

We published an e-book: Urology Handbook for Medical Students in 2017 based on the core urology curriculum for medical students. Subsequently, we developed a concise, simple and user-friendly smartphone app for medical students called "Urology Med", available for download on App Store and Google Play.

Results

This app is an introduction to urology for medical students but may also be useful for interns and surgical trainees. The app encompasses core urology topics subdivided into common urological presentations, urological examination, urological diseases, and urological devices. To make the app interactive, it includes 5 clinical cases that complement the reading material and six quizzes for self-assessment. A comprehensive checklist of 31 "must see" and "good to see" urology experiences is included. Within one month of launch, the app was downloaded 435 times in five countries across three continents. It has a 5-star rating on the Apple store.

Conclusions

High educational standards with relevant content make e-learning a valuable learning tool for surgical education. The Urology Med app facilitates easy access to urology and is ideal for quick reading while working or revising.

Evaluation of usefulness of smart device-based testing: a survey study of Korean medical students

PURPOSE

This study aims to understand the characteristics of smart device-based testing (SBT) by comparing the typical characteristics of students' satisfaction with SBT, its usefulness, advantages, and disadvantages when compared with existing testing methods.

METHODS

A total of 250 students from the first to third year were selected as the final targets of the study and the questionnaire was developed by faculty members who participated in the survey from the start of the SBT. The total number of questions is 12, and the questionnaire used a 4-point scale. The data obtained were analyzed using the IBM SPSS ver. 23.0 (IBM Corp., Armonk, USA).

RESULTS

Answers to the "satisfaction with SBT" were generally negative, while answers to the "usefulness of SBT" were generally positive. There was no difference in satisfaction across gender and smart device ownership, whereas there were significant differences across years. With reference to the usefulness of SBT, students responded positively, while about the overall configuration and completeness of SBT, students responded negatively. Students also seemed to show a greater preference toward the pencil-paper test.

CONCLUSION

On the other hand, students generally thought that SBT helped to assess medical knowledge better and was a more objective method of knowledge assessment than a pencil-paper test. We believe that students preferred the traditional paper-pencil test due to their unfamiliarity with SBT. We believe that an appropriate and careful remedy for drawbacks of the SBT will have a significant impact in the accumulation of actual clinical knowledge and in the improvement of practical skills for medical students.

Efficacy of smartphone-based Mobile learning versus lecture-based learning for instruction of Cephalometric landmark identification

BACKGROUND

Considering the increasing popularity of electronic learning, particularly smartphone-based mobile learning, and its reportedly optimal efficacy for instruction of complicated topics, this study aimed to compare the efficacy of smartphone-based mobile learning versus lecture-based learning for instruction of cephalometric landmark identification.

METHODS

This quasi-experimental interventional study evaluated 53 dental students (4th year) in two groups of intervention (n = 27; smartphone instruction using an application) and control (n = 26, traditional lecture-based instruction). Two weeks after the instructions, dental students were asked to identify four landmarks namely the posterior nasal spine (PNS), orbitale (Or), articulare (Ar) and gonion (Go) on lateral cephalograms. The mean coordinates of each landmark identified by orthodontists served as the reference point, and the mean distance from each identified point to the reference point was reported as the mean consistency while the standard deviation of this mean was reported as the precision of measurement. Data were analyzed using SPSS version 18 via independent sample t-test.

RESULTS

No significant difference was noted between the two groups in identification of PNS, Ar or Go (P > 0.05). However, the mean error rate in identification of Or was significantly lower in smartphone group compared with the traditional learning group (P = 0.020).

CONCLUSIONS

Smartphone-based mobile learning had a comparable, and even slightly superior, efficacy to lecture-based learning for instruction of cephalometric landmark identification, and may be considered, at least as an adjunct, to enhance the instruction of complicated topics.

TRIAL REGISTRATION NUMBER

This is not a human subject research. https://ethics.

RESEARCH

ac.ir/ProposalCertificateEn.php?id=33714&Print=true&NoPrintHeader=true&NoPrintFooter=true&NoPrintPageBorder=true&LetterPrint=true .

RETRACTED: The role of antibiotics in the preparation of antitumor drugs under fuzzy system

This article has been retracted. A retraction notice can be found at https://doi.org/10.3233/JIFS-219320.

Pilot Study Suggests Smartphone Application Knowledge Improves Resident Transesophageal Echocardiography Knowledge: A Randomized Controlled Trial

OBJECTIVE

The objective of this study was to determine whether an asynchronous smartphone-based application with image-based questions would improve anesthesiology resident transesophageal echocardiography (TEE) knowledge compared with standard intraoperative teaching alone.

DESIGN

Prospective, single-blinded, pilot, randomized controlled trial.

SETTING

Large university teaching hospital.

PARTICIPANTS

Participants were anesthesiology residents on their cardiac anesthesiology rotation.

INTERVENTIONS

EchoEducator, a TEE image-based smartphone application of learning content through questions, was developed. Content was derived from the Examination of Special Competence in Basic Perioperative Transesophageal Echocardiography and the Objective Structured Clinical Examination portion of the APPLIED Examination and focused on identification of basic TEE views, cardiac structures, and pathology. Residents were randomly assigned to receive access to either the application or to standard intraoperative teaching. Thirty residents met inclusion criteria, and 18 residents completed the study. A pre-intervention assessment was given at the beginning of the rotation, and a post-intervention assessment was given after 2 weeks.

MEASUREMENTS

The primary outcome was the difference between the post-test score and the pre-test score. Standard bivariate statistics and the chi-square test were used for categorical variables, and the Student t test was used for continuous variables. Tests were 2-sided, and statistical significance was set at p < 0.05. The intervention group demonstrated a greater increase in score; (+19.19% [95% confidence interval 4.14%-34.24%]; p = 0.02) compared with the control group.

CONCLUSIONS

This study supports the hypothesis that use of a smartphone-based asynchronous educational application improves TEE knowledge compared with traditional modalities alone. This supports an opportunity to improve medical education by expanding the role of web-based asynchronous learning.

The Use of a Mobile Learning Tool by Medical Students in Undergraduate Anatomy and its Effects on Assessment Outcomes

Hand-held devices have revolutionized communication and education in the last decade. Consequently, mobile learning (m-learning) has become popular among medical students. Nevertheless, there are relatively few studies assessing students' learning outcomes using m-learning devices. This observational study presents an anatomy m-learning tool (eMed-App), an application developed to accompany an anatomy seminar and support medical students' self-directed learning of the skeletal system. Questionnaire data describe where, how frequently, and why students used the app. Multiple choice examination results were analyzed to evaluate whether usage of the app had an effect on test scores. The eMed-App application was used by 77.5% of the students, mainly accessed by Android smartphones, and at students' homes (62.2%) in order to prepare themselves for seminar sessions (60.8%), or to review learning content (67%). Most commonly, students logged on for less than 15 minutes each time (67.8%). Frequent app users showed better test results on items covering eMed-App learning content. In addition, users also achieved better results on items that were not related to the content of the app and, thus, gained better overall test results and lower failure rates. The top quartile of test performers used the eMed-App more frequently compared to students in lower quartiles. This study demonstrated that many students, especially the high-performing ones, made use of the eMed-App. However, the app itself did not result in better outcomes, suggesting that top students might have been more motivated to use the app than students who were generally weak in anatomy.

The 'connectaholic' behind the curtain: medical student use of computer devices in the clinical setting and the influence of patients

BACKGROUND

The use of mobile devices such as tablets and laptops by students to support their learning is now ubiquitous. The clinical setting is an environment, which lends itself to the use of mobile devices as students are exposed to novel clinical scenarios that may require rapid location of information to address knowledge gaps. It is unknown what preferences students have for these devices and how they are used in the clinical environment.

METHODS

In this study we explored medical students' choices and their use of different devices in their first year of clinical attachments. We sought to evaluate learners' experiences with these devices using a mixed methods approach. All students newly entered into the clinical years were given the option of a MacBook Air or iPad. We surveyed these students using an online survey tool followed by individual semi-structured interviews to explore survey findings in more depth.

RESULTS

Students owned a multitude of devices however their preferences were for the 11 in. MacBook Air Laptop over the iPad mini. Students made constant use of online information to support their clinical learning, however three major themes emerged from the interview data: connection and devices (diverse personal ownership of technology by students and how this is applied to source educational materials), influence and interaction with patients (use of any device in a clinical setting) and influence and interaction with staff. In general students preferred to use their device in the absence of patients however context had a significant influence.

CONCLUSIONS

These mobile devices were useful in the clinical setting by allowing access to online educational material. However, the presence of patients, and the behaviour of senior teaching staff significantly influenced their utilisation by students. Understanding the preferences of students for devices and how they use their preferred devices can help inform educational policy and maximise the learning from online educational content.

A meta-analysis for comparing effective teaching in clinical education

Aim: Many factors affect learning outcomes, however studies comparing the effectiveness of different clinical teaching methods are limited. We utilize the list of influences on educational achievement compiled by John Hattie to inform a meta-analysis of learning effect sizes (ESs) associated with teaching-learning factors (TLFs) in clinical education. Methods: A literature search was conducted in PubMed to identify articles examining clinically relevant TLFs. Selection criteria were applied to identify learner-focused studies, with subsequent categorization by study design (pretest-posttest or controlled group). The Cohen's ES (d) for each TLF was extracted and a pooled ES determined. Results: From 3454 studies, 132 suitable articles enabled analysis of 16 TLFs' ESs. In general, ESs derived from pretest-posttest data were larger than those from controlled group designs, probably due to learner maturation effect. The TLFs of mastery learning, small group learning and goal settings possessed the largest ESs (d ≥ 0.8), while worked examples, play programs, questioning, concept mapping, meta-cognitive strategies, visual-perception programs and teaching strategies demonstrated ESs between 0.4 and 0.8. Conclusions: This is the first study to provide a rigorous and comprehensive overview of the effectiveness of TLFs in clinical education. We discuss the practical traits shared by effective TLFs which may assist teaching design.

Online webinar training to analyse complex atrial fibrillation maps: A randomized trial

BACKGROUND

Specific tools have been recently developed to map atrial fibrillation (AF) and help guide ablation. However, when used in clinical practice, panoramic AF maps generated from multipolar intracardiac electrograms have yielded conflicting results between centers, likely due to their complexity and steep learning curve, thus limiting the proper assessment of its clinical impact.

OBJECTIVES

The main purpose of this trial was to assess the impact of online training on the identification of AF driver sites where ablation terminated persistent AF, through a standardized training program. Extending this concept to mobile health was defined as a secondary objective.

METHODS

An online database of panoramic AF movies was generated from a multicenter registry of patients in whom targeted ablation terminated non-paroxysmal AF, using a freely available method (Kuklik et al-method A) and a commercial one (RhythmView-method B). Cardiology Fellows naive to AF mapping were enrolled and randomized to training vs no training (control). All participants evaluated an initial set of movies to identify sites of AF termination. Participants randomized to training evaluated a second set of movies in which they received feedback on their answers. Both groups re-evaluated the initial set to assess the impact of training. This concept was then migrated to a smartphone application (App).

RESULTS

12 individuals (median age of 30 years (IQR 28-32), 6 females) read 480 AF maps. Baseline identification of AF termination sites by ablation was poor (40%±12% vs 42%±11%, P = 0.78), but similar for both mapping methods (P = 0.68). Training improved accuracy for both methods A (P = 0.001) and B (p = 0.012); whereas controls showed no change in accuracy (P = NS). The Smartphone App accessed AF maps from multiple systems on the cloud to recreate this training environment.

CONCLUSION

Digital online training improved interpretation of panoramic AF maps in previously inexperienced clinicians. Combining online clinical data, smartphone apps and other digital resources provides a powerful, scalable approach for training in novel techniques in electrophysiology.

The tablet computer’s impact on learning and National Dental Examination scores in orthodontics - a mixed-method research

Background

To assess the educational impact of a one-to-one tablet PC (TPC) program by analysing university students’ learning skills and related scores of the National Dental Examination (NDE) in Germany.

Methods

The study design was a mixed-method approach consisting of a survey and a comparison of NDE scores. Students received a loaned non-preloaded and non-managed TPC during three consecutive orthodontic semesters. Usability and learning benefits in clinical and nonclinical settings were assessed by a survey. After the participating students had passed the NDE in a standard period of study, their grades were compared with those of students from the semester prior to TPC introduction.

Results

One hundred and eight students (36 females and 72 males) received an TPC and participated in the survey. Of these, 53 passed the NDE in a standard period of study. 64 students from the semester before TPC introduction, who passed in the regular period of study, were chosen as non-TPC control group.

Survey: Students’ expectations concerning TPC benefits increased significantly after TPC usage (P = 0.000). TPCs were rated more useful for learning at places outside the clinic setting than for inside (P = 0.000). PDFs and communication applications were used more in nonclinical settings (P = 0.008 and 0.000, respectively). NDE scores: Concerning the examination parts relating to theoretical knowledge and clinical knowledge, students with full TPC use achieved higher scores than did those without TPC use (P = 0.006 and 0.002, respectively). Scores for manual skills showed no differences, neither for students with and without TPC, nor within the semester after TPC introduction (P = 1.000).

Conclusions

This is the first study to analyse a one-to-one TPC program in the orthodontic curriculum and measure the effect of TPC usage on NDE scores. Students’ expectations concerning the TPC benefit in the orthodontic curriculum improved significantly after using the devices. We have shown that NDE scores in theoretical knowledge increased significantly after TPC deployment whereas scores in motor skills remained unchanged. The results suggest that the TPC has a positive learning effect on theoretical knowledge in orthodontics.

Trial registration

Permission to conduct this study was given by the Ethics Committee of the Department of Medicine of the University of Münster, Germany (2012-12-13).

Mobile Digital Education for Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration

Background

There is a pressing need to implement efficient and cost-effective training to address the worldwide shortage of health professionals. Mobile digital education (mLearning) has been mooted as a potential solution to increase the delivery of health professions education as it offers the opportunity for wide access at low cost and flexibility with the portability of mobile devices. To better inform policy making, we need to determine the effectiveness of mLearning.

Objective

The primary objective of this review was to evaluate the effectiveness of mLearning interventions for delivering health professions education in terms of learners’ knowledge, skills, attitudes, and satisfaction.

Methods

We performed a systematic review of the effectiveness of mLearning in health professions education using standard Cochrane methodology. We searched 7 major bibliographic databases from January 1990 to August 2017 and included randomized controlled trials (RCTs) or cluster RCTs.

Results

A total of 29 studies, including 3175 learners, met the inclusion criteria. A total of 25 studies were RCTs and 4 were cluster RCTs. Interventions comprised tablet or smartphone apps, personal digital assistants, basic mobile phones, iPods, and Moving Picture Experts Group-1 audio layer 3 player devices to deliver learning content. A total of 20 studies assessed knowledge (n=2469) and compared mLearning or blended learning to traditional learning or another form of digital education. The pooled estimate of studies favored mLearning over traditional learning for knowledge (standardized mean difference [SMD]=0.43, 95% CI 0.05-0.80, N=11 studies, low-quality evidence). There was no difference between blended learning and traditional learning for knowledge (SMD=0.20, 95% CI –0.47 to 0.86, N=6 studies, low-quality evidence). A total of 14 studies assessed skills (n=1097) and compared mLearning or blended learning to traditional learning or another form of digital education. The pooled estimate of studies favored mLearning (SMD=1.12, 95% CI 0.56-1.69, N=5 studies, moderate quality evidence) and blended learning (SMD=1.06, 95% CI 0.09-2.03, N=7 studies, low-quality evidence) over traditional learning for skills. A total of 5 and 4 studies assessed attitudes (n=440) and satisfaction (n=327), respectively, with inconclusive findings reported for each outcome. The risk of bias was judged as high in 16 studies.

Conclusions

The evidence base suggests that mLearning is as effective as traditional learning or possibly more so. Although acknowledging the heterogeneity among the studies, this synthesis provides encouraging early evidence to strengthen efforts aimed at expanding health professions education using mobile devices in order to help tackle the global shortage of health professionals.

A library mobile device deployment to enhance the medical student experience in a rural longitudinal integrated clerkship

Objective

Investigators implemented the Rural Information Connection (RIC) project, a library-initiated deployment of iPad Mini 3s for third-year medical students who were enrolled in a seven-month rural longitudinal integrated clerkship (LIC) rotation. The research aims were to determine if devices preloaded with high-quality mobile health apps enhanced the experience and increased access to and awareness of mobile health information resources for the enrolled project participants.

Methods

Nine participants enrolled in this mixed methods research project. Pre- and post-survey and structured learning journals (SLJs) were used for data collection on device and app use. Descriptive statistics and thematic coding analysis included data from seven pre-surveys, nine post-surveys, and sixty-four SLJ prompts. The validated Technology Acceptance Model instrument was also incorporated to gauge the devices’ integration into the participants’ workflow.

Results

The investigation indicated that the iPad Mini 3 and resources were utilized and integrated at varying levels in the participants’ workflow. Reported use of health information apps suggests a preference for broad-based information sources rather than specific or specialized information resources. Participants performed several tasks on the device, including seeking background information, educating patients, and managing rotation schedules. Participant reflections indicated positive experiences utilizing the device and health information resources, which enhanced their rural LIC rotations.

Conclusions

The research analysis demonstrates the information-seeking behavior of medical students immersed in a rural environment and indicates an acceptance of mobile technology into the workflow of participants in this project. Mobile device deployments offer great opportunities for librarians to design innovative programming in medical education.

Mobile app technology is associated with improved otolaryngology resident in-service performance

OBJECTIVE

Otolaryngology residents face time-management challenges between clinical duties and self-directed learning. Mobile devices provide a new medium for education that could aid with educational efficiency. The objective of this study was to investigate whether spaced repetition mobile app use of an otolaryngology question bank was associated with improving factual knowledge as measured by in-service exam performance.

METHODS

For approximately 6 months prior to the 2016 in-service examination, 12 otolaryngology residents at a single institution were provided access to a spaced-repetition app with a preloaded licensed otolaryngology review question bank. The number of questions answered, as well as the time spent on the app, were electronically tracked. The associations of app usage on in-service results were analyzed using an autoregressive model adjusted for prior historical Otolaryngology Trainee Examination performance and postgraduate year.

RESULTS

Eleven residents used the mobile app and were included in the analysis for an average of 304 minutes (range: 3 to 1,020) and reviewed on average 679 questions (range: 6 to 1,934). Controlling for residency year and prior performance, app usage was associated with an improvement by 2.92 percentage points (pp) (95% confidence interval [CI]: 0.14, 5.70) on overall in-service score. Allergy and pediatric subsection scores improved by 11.3 pp (95% CI: 3.8, 18.8) and 15.2 pp. (95% CI: 8.9, 21.5), respectively. Increased app use was associated with a score improvement by 0.008 pp per minute of use (95% CI: 0.004, 0.012).

CONCLUSION

Use of mobile spaced-repetition technology can aid resident factual knowledge retention measured by improved in-service exam performance.

LEVEL OF EVIDENCE

4 Laryngoscope, 129:E15-E20, 2019.

Going Mobile: Resident Physicians' Assessment of the Impact of Tablet Computers on Clinical Tasks, Job Satisfaction, and Quality of Care

BACKGROUND

There are few published studies of the use of portable or handheld computers in health care, but these devices have the potential to transform multiple aspects of clinical teaching and practice.

OBJECTIVE

This article assesses resident physicians' perceptions and experiences with tablet computers before and after the introduction of these devices.

METHODS

We surveyed 49 resident physicians from 8 neurology, surgery, and internal medicine clinical services before and after the introduction of tablet computers at a 415-bed Boston teaching hospital. The surveys queried respondents about their assessment of tablet computers, including the perceived impact of tablets on clinical tasks, job satisfaction, time spent at work, and quality of patient care.

RESULTS

Respondents reported that it was easier (73%) and faster (70%) to use a tablet computer than to search for an available desktop. Tablets were useful for reviewing data, writing notes, and entering orders. Respondents indicated that tablet computers increased their job satisfaction (84%), reduced the amount of time spent in the hospital (51%), and improved the quality of care (65%).

CONCLUSION

The introduction of tablet computers enhanced resident physicians' perceptions of efficiency, effectiveness, and job satisfaction. Investments in this technology are warranted.

Mobile learning in medicine: an evaluation of attitudes and behaviours of medical students

BACKGROUND

Mobile learning (mLearning) devices (such as tablets and smartphones) are increasingly part of the clinical environment but there is a limited and somewhat conflicting literature regarding the impact of such devices in the clinical learning environment. This study aims to: assess the impact of mLearning devices in the clinical learning environment on medical students' studying habits, attitudes towards mobile device supported learning; and the perceived reaction of clinicians and patients to the use of these devices as part of learning in the clinical setting.

METHODS

Over three consecutive academic years, 18 cohorts of medical students (total n = 275) on a six-week rotation at a large teaching hospital in London were supplied with mLearning devices (iPad mini) to support their placement-based learning. Feedback on their experiences and perceptions was collected via pre- and post-use questionnaires.

RESULTS

The results suggest mLearning devices have a positive effect on the students' perceived efficiency of working, while experience of usage not only confirmed pre-existing positive opinions about devices but also disputed some expected limitations associated with mLearning devices in the clinical workplace. Students were more likely to use devices in 'down-time' than as part of their clinical learning. As anticipated, both by users and from the literature, universal internet access was a major limitation to device use. The results were inconclusive about the student preference for device provision versus supporting a pre-owned device.

CONCLUSION

M-learning devices can have a positive impact on the learning experiences medical students during their clinical attachments. The results supported the feasibility of providing mLearning devices to support learning in the clinical environment. However, universal internet is a fundamental limitation to optimal device utilisation.