Mobile Medical Education (MoMEd): What is the impact of putting digital mobile

resources in the hands of medical students?

Tim Vincent, Learning Technologist

Jil Fairclough, Medical School Librarian

Brighton & Sussex Medical School

In 2005, BSMS became the first UK medical school to introduce the widespread use of mobile devices to its

students

Offered to all Year 3, 4, and 5 students (approx. 350 students)

Loaned PDA and software for free

Providing mobile hardware and software

BSMSM

odule

Handbook@

Resources on the Dr Companion card

British National Formulary

Chemical Laboratory References

Classification of Surgical Operations & Procedures

Clinical Evidence

Cochrane Abstracts

DSM IV

ICD 10

NICE Compilation Guidance

Netter Atlas of Human Anatomy

Evidence Based Medicine

Patient Organizations

Oxford Concise Medical Dictionary

Oxford Handbook of Emergency Medicine

Oxford Handbook of Clinical & Lab Investigation

Oxford Handbook of Clinical Medicine

Oxford Handbook of Clinical Surgery

Oxford Handbook of Practical Drug Therapy

Oxford Handbook of General Practice

Oxford Handbook of Medical Sciences

Supporting set-up, roll-out, maintenance, and training

Dir. of Undergraduate StudiesIT Manager

LibrarianLearning Technologist

Everyone!

Clinical Research Fellow

Divisional assistantIT Technicians x2

Useful mobile technology in the clinical setting

The CCU consultant asks you

“What evidence is there for the use of ACE inhibitors in

secondary prevention post MI?”

“And what dose is the SHO writing up?”

A 45-year-old Bangladeshi

gentleman is reviewed on

the Coronary Care ward

round. He was admitted 3

days previously and

underwent primary

angioplasty for a myocardial

infarction. He has mild

pulmonary oedema. The

SHO is prescribing some

ramipril.

Why mobile technology in medical training?

The future of education lies in the adoption of technology, such as mobile and wireless, that connects people, unifies

the education process and enhances learning.

BSMS, as a new medical school, wants students to

become familiar with mobile technology and take

advantage of the technology to explore innovative

approaches to teaching and learning.

Dr John D. Halamka, Associate Dean, Harvard Medical School, 2002

Prof Jon Cohen, Dean of BSMS, 2003

GMC’s: Tomorrow’s Doctors (2009) expects doctors to be able to “use information effectively in a

medical context”

“Access information sources and use the information in relation to patient care, health promotion, advice and

information to patients, and research and education”

“Make effective use of computers and other information systems, including storing and retrieving

information.”

What is the impact of putting digital mobile resources in the hands of medical students?

How much do medical student really use mobile devices to access learning

resources?

What is the impact on students’ learning?

What are the advantages and disadvantages of mobile devices in the

clinical setting

Data collection

Focus groups Questionnaires Usage stats on server

Results: Amount of use

Questionnaire Tracking

1 – 10

11 – 5051 – 100

101 – 200Hardly ever

Once a month

Once a week

Daily

Results: Most popular resource

Questionnaire

Choose 3 most popular resources

Votes

BNF 91

OH Clinical Medicine 89

Medical dictionary 22

Netter’s anatomy 19

Tracking

Most popular resource No. of uses

OH Clinical Medicine 3,385

BNF 3,137

Medical dictionary 1,867

OH General Practice 791

OH Clinical Surgery 884

Access to knowledge

Consolidation of knowledge

Need for change

Analysis: Three major themes identified

Mobile Medical Education (MoMEd) - how mobile information resources contribute to learning for undergraduate clinical students: a mixed methods study. Bethany S Davies, Jethin Rafique, Tim R Vincent, Jil Fairclough, Mark H Packer, Richard Vincent and Inam Haq.BMC Medical Education 2012, 12:1 doi:10.1186/1472-6920-12-1http://www.biomedcentral.com/1472-6920/12/1/abstract

Theme 1: Access to knowledge

Mobility

Immediacy

Speed of access

Two devices

Theme 1: Access to knowledge

Mobility

Immediacy

Speed of access

Two devices

“The only thing is, you don’t have that many pockets. I would have my wallet in one pocket, my phone in another. I found it quite hard to carry [the PDA] around with me all the time.”

“The whole two devices thing is my major gripe.”

Theme 2: Consolidation of knowledge

Quick reference information

Repetition

Better use of ‘wasted’ time

Theme 2: Consolidation of knowledge

Quick reference information

Repetition

Better use of ‘wasted’ time

“It has enhanced [my knowledge] by reinforcing key points at point-of-need. If you want to know then-and-there, you can find it then-and-there. It’s just the memory jog you need to reinforce the point a bit more. It doesn’t mean you’re relying on the PDA – it just helps to reinforce and consolidate the knowledge a bit better.”

Theme 2: Consolidation of knowledge

Quick reference information

Repetition

Better use of ‘wasted’ time

“The more repetition I get, the more I’m able to look at something quickly – when I need to - the more it’s likely to stick. Because you can look and say ‘oh ok, that’s what it is again’”

“Initially, you may look at it three times and then after that you will become more confident in saying ‘yes I know this now’”

Theme 2: Consolidation of knowledge

Quick reference information

Repetition

Better use of ‘wasted’ time

“One of the drivers for me of using it might be more general is just my dislike of wasted time particularly during the day.”

“I agree. Actually, that’s one of the reasons I have started to use it a lot more. There and then when there isn’t anything to do you can make use of time.”

Theme 3: Change

Attitude, behaviour, approach

Resistance to change

Establishing change

Next section

Theme 3: Change

Attitude, behaviour, approach

Resistance to change

Establishing change

“…if you remember to take it with you”

“I think it’s about adopting a different mentality.”

“I’m worried that the nurses or patients will think I am texting or emailing”

Theme 3: Change

Attitude, behaviour, approach

Resistance to change

Establishing change

“What changed your mind?” “Finding I did use the PDA and it did come in handy several times.

It just makes life a bit easier.”

“...I have definitely got used to having that type of reference at my fingertips. I would definitely

look into ways of continuing that.”

The future of MoMEd

The emergence of smartphones

2005 2006 2007 2008 2009 2010 2011 2012 2013

BSMS becomes the first UK medical school to introduce the widespread use of PDAs to its students

Apple announces sales of 4.7m iPhones

First Android phone (G1) launches

Apple becomes largest smartphone vendor

Smartphone sales make up 31% of 1.8bn devices sold globally

Steve Jobs unveils the iPhone

Apple launches iPad

Nothing

PDA + DrCompan-ion

Own smartphone + Dr-Companion

Smartphone + DrCompanion

What do the students want?

iPhone pilot

4 month trial (Nov-Feb)

48 students with own iOS device

Novel logging to track usage

Contract to recording usage and research participation

Changing the model to information over technology

Offered to all students in years 3-5 with their own device

Is this the right approach?