Medical Education, PDAS and Smartphones: Welcome to the 21st Century

PDAs and Smartphones allow medical professionals to access medical information more easily than ever before. This literature review examines use of these devices and associated “apps” in medical education, finding widespread use by medical students, residents, and faculty. Surprisingly, little generational bias was noted. Business and Health Administration Association Annual Conference 2014 Page 249 INTRODUCTION Background The usage of smartphone devices by Americans continues to rise. A 2013 report from the Pew Research Center’s Internet & American Life Project found that, for the first time, more than 90% of Americans own a mobile phone and 56% owned a smartphone (Rainie, 2013), a cell phone that contains additional software functions such as e-mail and Internet browsing capabilities (Merriam Webster Dictionary, 2012). Based upon another recent survey (Anonymous, 2013), it is predicted that 80% of Americans will be using a smartphone regularly by 2014. The predecessor to the smartphone, the personal digital assistant (PDA), once dominated the market for hand-held mobile devices and had sales growing “exponentially” (Wiggins, 2004), but its sales actually started dropping about 2003 (Krazit, 2004), with the decline quickly becoming precipitous (Anderson, 2007). The transition from PDA to smartphone should not be terribly surprising: a 2011 smartphone had over 16,000 times the data storage of the Palm III, one of the earliest PDAs (Friedman, 2011). Despite their relative departure from the current scene, PDAs are included in this review for two reasons: (1) due to several studies demonstrating their contribution to the study of mobile medical devices on medical education and (2) as recently as 5 years ago, PDAs were considered to be a “valuable tool” in medical education (Lindquist et al., 2008) and “an essential part” of medical practice (Chatterley and Chojecki, 2010). Mobile technology has changed the landscape of the medical profession, as the majority of providers and providers-to-be desire decision support and current clinical information at the point of care (Baumgart, 2011; Mosa, Yoo and Sheets, 2012). PDAs allowed healthcare professionals and the general public to communicate more efficiently, collect data and research topics in healthcare (Lindquist et al., 2008). A 2008 study of Canadian medical students found that 65% owned a PDA, and 77.4% of those used it for accessing drug references and 49.1% for looking at medical textbooks. The vast majority (over 75%) had received no formal training in how to use a PDA; i.e., they were self-taught (Chatterley and Chojecki, 2010). Another study was conducted in 2012 among medical students at Brighton and Sussex Medical School to determine how the use of mobile devices affected learning (Davies et al., 2012). After students were given preloaded PDAs containing software known as DrCompanion to use over a ten month period, the authors conducted a survey as well as a focus group. Of 387 total participants, 134 surveys were able to be used finding that 102 students (76%) actually used the device during the allotted time. The authors determined four ways in which the PDAs enabled learning. First, they found that PDAs allowed for timely access to key facts. They also found that there was consolidation of knowledge through repetition since students were able to look up information with ease leading to a higher degree of confidence. Third, the students saw that PDAs allowed them to make use of wasted time as they could use the device during times when they had a few minutes to spare. Finally, authors determined that students felt the PDAs were more a supplement, rather than a complete replacement of textbooks (Davies et al., 2012). Recent surveys have determined that more than 80% of physicians (O’Reilly, 2012) and Certified Registered Nurse Anesthetists (Johns, 2012) used smart phones. About 70% of nurses report using smartphones while working (Spyglass Consulting Group, 2012), a 40% increase in two years (RNsearch, 2010). Smartphones have offered physicians a less cumbersome format for Health Information Technology (HIT) without the imposition of a large financial burden (Sarasohn-Kahn, 2010), by combining the features of a cellular telephone, pager, and a PDA (Burdette, Herchline and Oehler, 2008), although some have posited Business and Health Administration Association Annual Conference 2014 Page 250 that this new technology may be more of an interruption than a help (Ross and Forgie, 2012). Nonetheless, doctors have moved away from the traditional pagers to smartphone devices (Putzer and Park, 2012; Sheth and Kane, 2009), enhancing the efficiency within healthcare organizations by allowing for improved time management and communication between other medical colleagues (Ozdalga, Ozdalga and Ahuja, 2012; Voalté, 2010). In 2012, there were an estimated 121.40 million smartphones in the US, with this number predicted to grow to 207.4 by 2017 (Staitista, 2012). It has been estimated that $14 to $27 billion in financial incentives will be distributed over ten years under the Health Information Technology for Economic and Clinical Health (HITECH) act of the American Recovery and Reinvestment Act of 2009 as encouragement for those in the medical field to adopt and meaningfully use HIT (Blumenthal, 2010; Farley, 2013). Many have argued that the implementation of HIT into medical education has not kept pace with the growth of HIT and physician training and accreditation must be reevaluated as to become parallel with the increased use of HIT throughout the country (GrahamJones et. al., 2012). Research purpose The purpose of this paper was to analyze how medical students and medical educators can benefit from the use of smart phone technology. The study was performed to determine if there is benefit from the use of smartphones for medical education.