Mobile technology supporting trainee doctors’ workplace learning and patient care: an evaluation

Abstract

BackgroundThe amount of information needed by doctors has exploded. The nature of knowledge (explicit and tacit) and processes of knowledge acquisition and participation are complex. Aiming to assist workplace learning, Wales Deanery funded “iDoc”, a project offering trainee doctors a Smartphone library of medical textbooks.MethodsData on trainee doctors’ (Foundation Year 2) workplace information seeking practice was collected by questionnaire in 2011 (n = 260). iDoc baseline questionnaires (n = 193) collected data on Smartphone usage alongside other workplace information sources. Case reports (n = 117) detail specific instances of Smartphone use.ResultsMost frequently (daily) used information sources in the workplace: senior medical staff (80% F2 survey; 79% iDoc baseline); peers (70%; 58%); and other medical/nursing team staff (53% both datasets). Smartphones were used more frequently by males (p < 0.01). Foundation Year 1 (newly qualified) was judged the most useful time to have a Smartphone library because of increased responsibility and lack of knowledge/experience.Preferred information source varied by question type: hard copy texts for information-based questions; varied resources for skills queries; and seniors for more complex problems. Case reports showed mobile technology used for simple (information-based), complex (problem-based) clinical questions and clinical procedures (skills-based scenarios). From thematic analysis, the Smartphone library assisted: teaching and learning from observation; transition from medical student to new doctor; trainee doctors’ discussions with seniors; independent practice; patient care; and this ‘just-in-time’ access to reliable information supported confident and efficient decision-making.ConclusionA variety of information sources are used regularly in the workplace. Colleagues are used daily but seniors are not always available. During transitions, constant access to the electronic library was valued. It helped prepare trainee doctors for discussions with their seniors, assisting the interchange between explicit and tacit knowledge.By supporting accurate prescribing and treatment planning, the electronic library contributed to enhanced patient care. Trainees were more rapidly able to medicate patients to reduce pain and more quickly call for specific assessments. However, clinical decision-making often requires dialogue: what Smartphone technology can do is augment, not replace, discussion with their colleagues in the community of practice.

Use of Mobile Devices to Access Resources Among Health Professions Students: A Systematic Review

“…Online textbooks and journals on the mobile devices were used as a just-in-time information resource in daily clinical practice when other sources were not available or when students were in the transition from medical students to first-year trainees. The use of information sources in the workplace was attributable to several factors such as ease and speed of access, perceived reliability of the information source, senior staff's experience, and application of information in context [23].…”

“…These issues include problematic WiFi or Internet connectivity at clinical settings [19,23,25,29,32,35,38,40], slow processing of data [19,23,31,35,36], short battery life [30,31,36,40], and limited storage capacities of mobile devices [36]. The portability of mobile devices came with a trade-off.…”

“…These resources included drug guides, handbooks, manuals, dictionaries, encyclopedias, online textbooks, lab values, nursing procedures, and specialty resources (e.g., internal medicine, radiology, pathology, neurology, neurosurgery). A few others were visual resources of mobile applications such as VisualDX [18], DrawMD [18], and anatomy atlases [21][22][23][24].…”

“…The use of mobile applications to improve learning and enhance workplace performance and communications were also reported in 10 studies. Examples of these applications included a multiplatform journaling app Evernote [25], the iPad "air-play-mirroring" for presentations, FaceTime, Dropbox [29], Skyscape [33], KeyNote [17], DocTool Cross Library Search Tool [23], PDFExpert for reading and editing PDF files on the iPad, and QuickOffice [18]. Various clinical tools were used to access EMR (DICOM viewers), make call schedules, and access PACS and EMR remotely via the Citrix Receiver [24]; Cisco WebEx Meeting videoconference software was installed for iPad users to make didactic and case-conference lectures anywhere with an Internet connection; the ResponseWare app was embedded into the iPad to offer the capability of audience response during resident training events [24].…”

Crônicas do grupo: ferramenta para análise colaborativa e melhoria da reflexão na pesquisa-ação

“…Some action-research projects in the field of health are referred to in the Community of Practice and Identity (CoP) 9 for presenting a theoretical-methodological structure that favors the combination of these characteristics [22][23][24][25][26][27][28] . In this way, Toledo, Giatti and Jacobi…”