Smartphones and Generational Differences… Are Smartphones a Barrier to Successful Patient Interactions in the Physical Therapy Clinic?
Authors: Lorio Anne Kilpatrick , Huggins Carla Friend , Leo Stephen Alexander , Wheeler Jonathan Michael , Housley Stephen Nicholas 
Published: April 2018

Introduction.
This study aimed to identify perceptions of older adults toward technology usage, as well as to examine the amount and purpose of smartphone usage by clinicians during practice.

Literature Review.
Current research in the area of smartphone usage in health care focuses on novel applications or programs, which may improve how students learn or clinicians practice. Studies have investigated smartphone use by physicians, nurses, and medical students; however, there is little research on how physical therapists (PTs) and physical therapy assistants (PTAs) use these devices.

Subjects.
This study involved the survey of 29 adults older than 50 years, observation of 11 PTs in various outpatient clinics, and a survey of 190 PTs and PTAs.

Methods.
Phase 1 consisted of the distribution of a paper survey to older adults (age ≥ 50), with the purpose of measuring their perceptions toward smartphones, both in general and in a health care setting. Phase 2 involved direct observations of PTs during practice to identify current patterns of technology usage in the clinical setting. Phase 3 was completed through the distribution of a nationwide electronic survey to PTs and PTAs with the purpose of determining perceptions, demographics, and usage behaviors of clinicians regarding smartphone usage during practice.

Results.
The results of this study showed that older adults are not comfortable with their health care providers using smartphones during their appointments. Observations revealed that clinicians are using their technology for personal reasons (61% of uses) more often than professional reasons (8%). A national survey found most clinicians report using their smartphone for personal reasons in a typical day and primarily during lunch breaks. When asked whether workplaces had formal policies/rules/guidelines regarding cell phone use at work, 47% said “yes,” 38% said “no,” and 15% said “I don't know.” Of those who said “yes” or “I don't know,” 80% said that the rules were not strictly enforced.

Discussion.
The clash between perspectives of older adults toward technology use and the usage patterns of clinicians is an issue that is likely to persist in the coming years as technology continues to grow in popularity and scope within our personal and professional lives. It is vital that clinicians, educators, and students are aware of these concerns so that we may communicate more effectively and optimize personal, academic, and professional interactions.

Conclusion.
Physical therapists and PTAs should be cautious when using their smartphone with older adults during their treatment sessions because older adults may not feel comfortable with this practice. Further research is needed to determine how smartphone use in physical therapy may be impacting patient care. In addition, future studies examining the benefits and effectiveness of specific clinic guidelines and policies on technology use in the workplace may help to ensure that PTs and PTAs are maximizing technological utility and limiting negative effects.